Low Back Pain

Low back pain is the most common form of physical disability. An estimated 80 percent of all Americans will suffer from back pain at some point in their lives. Back pain is the second leading cause of work absenteeism. Studies show that early aggressive treatment of back injuries by a physiatrist results in quicker recovery and fewer lost work days. Treatment by physiatrist center’s around various combinations of exercise and medication.

Overview of Low Back Pain/ Developing a Program That's Right for You

Information is readily available on the way to stop back pain. The challenge is to tailor it to the particular patient. For example, it's often said that swimming is good for the back. But which stroke? And how often?

Strengthening the abdominal muscles is also commonly ordered for low back pain. But how is this done? And are you exercising the proper way for your back injury? The list goes on: cold or hot applications, rest or activity?

What Kinds of Problems Might Cause Low Back Pain?

Treatment for any back condition is recommended as soon as possible to minimize the danger of further aggravation. The following is a list of only some of the conditions that may cause low back pain and is not a substitute for a visit to your doctor:

  • Radiculopathy - A pinched nerve, also called sciatica, usually from a herniated, or slipped, disk. This can cause a shooting pain down the leg that's often described as an electrical feeling.

  • Myofascial Pain - Generally an aching pain in muscles that tends to come from poor posture, sitting at a computer, or other job-related tasks. With myofascial back pain, the patient can become sore in different parts of the body like the back and legs. Often patients report that they have difficulty sleeping or feeling restored from sleep.

  • Spinal Stenosis - A narrowing of the nerve openings either around the spinal cord or nerve roots that can cause symptoms similar to a pinched nerve. It can cause leg pain in anyone, but most often does so in older people. Patients with spinal stenosis can have trouble walking, and the difficulty is usually relieved by sitting down or bending forward. It can cause aching or heaviness in the back and legs.

  • Tendon, Ligament and Soft Tissue Pain - Localized pain when an area is stretched or its muscles are overused. This results in tenderness.

  • ·Non-Spinal Causes of Low Back - Pain Pain imitating a back injury, but from another cause. Appendicitis, kidney disease, uterine disorders and urinary tract infections are a few examples of problems that can refer pain to the back.

Treatment Options

The rehabilitation of low back problems occurs in three phases. During the first phase, called the acute phase, physiatrists treat pain and inflammation. After they make a specific diagnosis and develop a treatment plan, physiatrists may offer treatment options like ultrasound, electrical stimulation, mobilization, medication, ice and even specialized injections.

In the second, or recovery, phase of treatment, flexibility and strength are developed to get the body parts into their proper positions. The goal of this phase is to get you back to your usual work, sports and leisure activities. This goal is achieved through specially designed exercises that rebuild the body.

The main goal of the third phase of treatment, the maintenance phase, is to minimize recurrence of the problem and to prevent further injury. This often consists of a total body fitness program, designed to maintain body mechanics and increase endurance after the original symptoms have resolved.

These are very broad and general approaches to the treatment of low back pain. The physiatrist that you choose will develop an individual treatment plan for you.
Early Diagnosis and Treatment of
Back Pain Is Key to Preventing Recurrence

It is estimated that 80% of Americans will experience low back pain some time during their lives. Many of these people will choose to delay treatment hoping the pain will go away. Procrastination is not the best avenue to take when experiencing back pain say specialists in physical medicine and rehabilitation (PM&R).

It is extremely important to treat low back pain at the onset in order to avoid aggravation and compounding the problem. Untreated low back pain can cause changes in your posture, gait, and bearing that may in turn worsen the problem or cause new ones. PM&R physicians, also called physiatrists, are medical specialists dedicated to restoring or maximizing function and self-sufficiency in patients who have physical disability resulting from injury or chronic illness.

Not all back pain is caused by muscle or nerve conditions. There are many different possible causes of back pain such as appendicitis, kidney disease, or urinary tract infections. Back pain can be an early warning sign for one of these more serious conditions that can be effectively treated if caught early on. That's why it's important to see a PM&R physician soon after pain develops.

While every case of low back pain is unique, many are remedied with non-surgical treatments supported by a regime of exercises to strengthen the back and prevent recurrence of the condition.

Don't Gamble with Your Low Back Pain

If you like to play the odds, here is a sure bet. 80 percent of all adults will experience low back pain at some time in their life - so chances are pretty good that if you haven't already been sidelined by it, low back pain could be on the horizon for you. It is the second most common reason for people to visit their primary care physicians.

So, if (when!) it does happen to you, what should you do? Wait for it to go away? Maybe you've heard the statistic that 45-50 percent of patients with low back pain improve within a week? Well, that may be true. But, here's the morning line from researchers:

• Over 40 percent of all patients with low back pain will have persistent complaints of pain one and two years later.

• 62 percent of patients are likely to have one or more relapses during a one-year follow-up.

• Continued problems with low back pain are even more likely in patients who wait six to 10 weeks from the first onset of pain before seeking medical care.

Don't Take that Back Pain Lying Down

Uh oh, there it is. The first twinges of low back pain. What should you do? First, experiment a little to find which positions are more comfortable for you and decrease some of that pain. Contrary to what you may think, don't just rest. Recent studies have shown that prolonged rest may cause certain kinds of low back pain to worsen because your muscles will weaken with lack of movement or exercise. You can limit your activity, but do not stop it completely. Some PM&R physicians have reported seeing more patients for low back pain in the winter, which they sometimes attribute to our tendency to be "couch potatoes" when cold weather sets in. But remember, don't ignore your back pain. If it persists, consult with a PM&R physician.


Great Expectations: Tips for Pregnant Women to Prevent Low Back Pain

With that expanding tummy, a pregnant woman's posture will begin to shift forward, changing her balance and putting new strain on back muscles. She may not notice that she is gradually adjusting her movements with compensations that might actually cause pain. Some suggestions from Dr. Prather for expectant mothers:

  • When standing, work abdominal muscles to unload the back by pulling your belly button toward your spine. Avoid high-heeled shoes.

  • When sitting, ensure that your chair height allows knees to align parallel with hips.

  • When lifting, lower your body by bending at the knees and lift by pushing up with the thighs.

  • When sleeping, lie on your side with knees and hips flexed and a pillow between your legs and under your abdomen.

PM&R physicians advise that pregnant women may want to ask their doctors about a back brace or a special sling called a "sacroiliac belt." They can ease the tension on the spine by forcing the buttocks and hip muscles to contract in support of the pelvic joints and abdomen.