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Low Back Pain What is low back pain? Low back pain is pain
and stiffness in the lower back. It is one of the most common reasons people
miss work. How does it occur? Low back pain is
usually caused when a ligament or muscle holding a vertebra in its proper
position is strained. Vertebrae are bones that make up the spinal column through
which the spinal cord passes. When these muscles or ligaments become weak, the
spine loses its stability, resulting in pain. Because nerves reach all parts of
the body from the spinal cord, back problems can lead to pain or weakness in
almost any part of the body. Low back pain can
occur if your job involves lifting and carrying heavy objects, or if you spend a
lot of time sitting or standing in one position or bending over. It can be
caused by a fall or by unusually strenuous exercise. It can be brought on by the
tension and stress that cause headaches in some people. It can even be brought
on by violent sneezing or coughing. People who are
overweight may have low back pain because of the added stress on their back. Back pain may occur
when the muscles, joints, bones, and connective tissues of the back become
inflamed as a result of an infection or an immune system problem. Arthritic
disorders as well as some congenital and degenerative conditions may cause back
pain. Back pain accompanied
by loss of bladder or bowel control, difficulty in moving your legs, or numbness
or tingling in your arms or legs may indicate an injury to your spine and
nerves, which requires immediate medical treatment. What are the symptoms? Symptoms include:
pain in the back or legs
stiffness and limited motion. The pain may be
continuous or may occur only in certain positions. It may be aggravated by
coughing, sneezing, bending, twisting, or straining during a bowel movement. The
pain may occur in only one spot or may spread to other areas, most commonly down
the buttocks and into the back of the thigh. A low back strain
typically does not produce pain past the knee into the calf or foot. Tingling or
numbness in the calf or foot may indicate a herniated disk or pinched nerve. Be sure to see your
health care provider if:
You have weakness in your leg, especially if you cannot lift your foot,
because this may be a sign of nerve damage.
You have new bowel or bladder problems as well as back pain, which may be
a sign of severe injury to your spinal cord.
You have pain that gets worse despite treatment. How is it diagnosed? Your health care
provider will review your medical history and examine you. He or she may order
x-rays. In certain situations a myelogram, CT scan, or MRJ may be ordered. How is it treated? The early stages of
back pain with muscle spasms should be treated with ice packs for 20 to 30
minutes every 4 to 6 hours for the first 2 to 3 days. You may lie on a frozen
gel pack, crushed ice, or a bag of frozen peas. The following are ways
to treat low back pain:
After the initial injury, applying heat from a heating pad or hot water
bottle.
Resting in bed on a firm mattress. Often it helps to lie on your back
with your knees raised. However, some people prefer to lie on their side with
their knees bent.
Taking aspirin, ibuprofen, or other anti-inflammatory medications; muscle
relaxants; or other pain medications if recommended by your health care
provider.
Having your back massaged by a trained person.
Having traction, if recommended by your provider.
Wearing a belt or corset to support your back.
Talking with a counselor, if your back pain is related to tension caused
by emotional problems.
Beginning a program of physical therapy, or exercising on your own. Begin
a regular exercise program to gently stretch and strengthen your muscles as soon
as you can. Your health care provider or physical therapist can recommend
exercises that will not only help you feel better but will strengthen your
muscles and help avoid back trouble later. When the pain subsides,
ask your health care provider about starting an exercise program such as the
following:
Exercise moderately every day, using stretching and warm-up exercises
suggested by your provider or physical therapist.
Exercise vigorously for about 30 minutes two or three times a week by
walking, swimming, using a stationary bicycle, or doing low-impact aerobics. Participating regularly
in an exercise program will not only help your back, it will also help keep you
healthier overall. How long will the effects
last? The effects of back
pain last as long as the cause exists or until your body recovers from the
strain, usually a day or two but sometimes weeks. How can I take care of myself? In addition to the
treatment described above, keep in mind these suggestions:
Use an electric heating pad on a low setting (or a hot water bottle
wrapped in a towel to avoid burning yourself) for 20 to 30 minutes. Dont let
the heating pad get too hot, and dont fall asleep with it. You could get a
burn.
Try putting an ice pack wrapped in a towel on your back for 20 minutes,
one to four times a day. Set an alarm to avoid frostbite from using the ice pack
too long.
Put a pillow under your knees when you are lying down.
Sleep without a pillow under your head.
Lose weight if you are overweight.
Practice good posture. Stand with your head up, shoulders straight, chest
forward, weight balanced evenly on both feet, and pelvis tucked in. Pain is the best way to
judge the pace you should set in increasing your activity and exercise. Minor
discomfort, stiffness, soreness, and mild aches need not interfere with
activity. However, limit your activities temporarily if:
Your symptoms return.
The pain increases when you are more active.
The pain increases within 24 hours after a new or higher level of
activity. When can I return to my
sport or activity? The goal of
rehabilitation is to return you to your sport or activity as soon as is safely
possible. If you return too soon you may worsen your injury, which could lead to
permanent damage. Everyone recovers from injury at a different rate. Return to
your sport will be determined by how soon your back recovers, not by how many
days or weeks it has been since your injury occurred. In general, the longer you
have symptoms before you start treatment, the longer it will take to get better. It is important that
you have fully recovered from your low back pain before you return to your sport
or any strenuous activity. You must be able to have the same range of motion
that you had before your injury. You must be able to run, jump and twist without
pain. What can I do to help
prevent low back pain? You can reduce the
strain on your back by doing the following:
Dont push with your arms when you move a heavy object. Turn around and
push backwards so the strain is taken by your legs.
Whenever you sit, sit in a straight-backed chair and hold your spine
against the back of the chair.
Bend your knees and hips and keep your back straight when you lift a
heavy object.
Avoid lifting heavy objects higher than your waist.
Hold packages you carry close to your body, with your arms bent.
Use a footrest for one foot when you stand or sit in one spot for a long
time. This keeps your back straight.
Bend your knees when you bend over.
Sit close to the pedals when you drive and use your seat belt and a hard
backrest or pillow.
Lie on your side with your knees bent when you sleep or rest. It may help
to put a pillow between your knees.
Put a pillow under your knees when you sleep on your back.
Raise the foot of the bed 8 inches to discourage sleeping on your stomach
unless you have other problems that require that you keep your head elevated. To
rest your back, hold each of these positions for 5 minutes or longer:
Lie on your back, bend your knees, and put pillows under your knees.
Lie on your back, put a pillow under your neck, bend your knees to a
90-degree angle, and put your lower legs and feet on a chair.
Lie on your back, bend your knees, and bring one knee up to your chest
and hold it there. Repeat with the other knee, then bring both knees to your
chest. When holding your knee to your chest, grab your thigh rather than your
lower leg to avoid over flexing your knee. Developed by Phyllis G. Cooper, RN, MN, and McKesson Clinical Reference Systems Published by McKesson Clinical Reference Systems. This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional. Sports Medicine Advisor 2002.2 Index Sports Medicine Advisor 2002.2 Credits Copyright © 1997-2002 McKesson Health Solutions LLC. All rights reserved. |
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