Article # 426. Low Back Pain: Tips on Pain Relief and Prevention

What can cause low back injuries? Many things can cause low back injuries--muscle strain or spasm, sprains of ligaments (which attach bone to bone), joint problems or a "slipped disk." The most common cause is using your back muscles in activities you're not used to, like lifting heavy furniture or doing yard work or while exercising you might have attempted the workouts wrongly. A slipped disk happens when the disk between the bones bulges and presses on nerves. This is often caused by twisting while lifting. But many people won't know what caused their slipped disk. As people age, bone strength and muscle elasticity and tone tend to decrease. The discs begin to lose fluid and flexibility, which decreases their ability to cushion the vertebrae. Pain can occur when, for example, someone lifts something too heavy or overstretches, causing a sprain, strain, or spasm in one of the muscles or ligaments in the back. If the spine becomes overly strained or compressed, a disc may rupture or bulge outward. This rupture may put pressure on one of the more than 50 nerves rooted to the spinal cord that control body movements and transmit signals from the body to the brain. When these nerve roots become compressed or irritated, back pain results. Low back pain may reflect nerve or muscle irritation or bone lesions. Most low back pain follows injury or trauma to the back, but pain may also be caused by degenerative conditions such as arthritis or disc disease, osteoporosis or other bone diseases, viral infections, irritation to joints and discs, or congenital abnormalities in the spine. Obesity, smoking, weight gain during pregnancy, stress, poor physical condition, posture inappropriate for the activity being performed, and poor sleeping position also may contribute to low back pain. Additionally, scar tissue created when the injured back heals itself does not have the strength or flexibility of normal tissue. Build-up of scar tissue from repeated injuries eventually weakens the back and can lead to more serious injury. Occasionally, low back pain may indicate a more serious medical problem. Pain accompanied by fever or loss of bowel or bladder control, pain when coughing, and progressive weakness in the legs may indicate a pinched nerve or other serious condition. People with diabetes may have severe back pain or pain radiating down the leg related to neuropathy. People with these symptoms should contact a doctor immediately to help prevent permanent damage. Who is most likely to develop low back pain? Nearly everyone has low back pain sometime. Men and women are equally affected. It occurs most often between ages 30 and 50, due in part to the aging process but also as a result of sedentary life styles with too little (sometimes punctuated by too much) exercise. The risk of experiencing low back pain from disc disease or spinal degeneration increases with age. Low back pain unrelated to injury or other known cause is unusual in pre-teen children. However, a backpack overloaded with schoolbooks and supplies can quickly strain the back and cause muscle fatigue. To avoid back strain, children carrying backpacks should bend both knees when lifting heavy packs, visit their locker or desk between classes to lighten loads or replace books, or purchase a backpack or airline tote on wheels. What can I do for relief when I've hurt my lower back? The best position for relief when your back hurts is to lie on your back on the floor with pillows under your knees, with your hips and knees bent and your feet on a chair, or just with your hips and knees bent. This takes the pressure and weight off your back. If you're resting a hurt back, you may need 1 to 2 days of this sort of rest. Resting longer than this can cause your muscles to weaken, which can slow your recovery. Even if it hurts, walk around for a few minutes every hour. Is there relief for ongoing back problems? Treatment of on-going back problems must be directed at the cause. This may mean losing weight (because being overweight can make back pain worse), getting your muscles in better shape, and improving your posture when you're sitting, standing and sleeping. Tips for preventing back strain Don't lift by bending over. Lift an object by bending your hips and knees and then squatting to pick up the object. Keep your back straight and hold the object close to your body. Avoid twisting your body while lifting. Push rather than pull when you must move heavy objects. If you must sit at your desk or at the wheel of a car or truck for long hours, break up the time with stops to stretch. Wear flat shoes or shoes with low heels (1 inch or lower). Exercise regularly. An inactive lifestyle contributes to lower back pain. What's the best way to sit? Sit in chairs with straight backs or low-back support. Keep your knees a little higher than your hips. Adjust the seat or use a low stool to prop your feet on. Turn by moving your whole body rather than by twisting at your waist. When driving, sit straight and move the seat forward. This helps you not lean forward to reach the controls. You may want to put a small pillow or rolled towel behind your lower back if you must drive or sit for a long time. What's the best position for standing? If you must stand for long periods, rest 1 foot on a low stool to relieve pressure on your lower back. Every 5 to 15 minutes, switch the foot you're resting on the stool. Maintain good posture: Keep your ears, shoulders and hips in a straight line, with your head up and your stomach pulled in. What's the best position for sleeping? The best way to sleep is on your side with your knees bent. You may put a pillow under your head to support your neck. You may also put a pillow between your knees. If you sleep on your back, put pillows under your knees and a small pillow under your lower back. Don't sleep on your stomach unless you put a pillow under your hips. Use a firm mattress. If your mattress is too soft, use a board of 1/2-inch plywood under the mattress to add support. What exercises can I do to strengthen my back? Some specific exercises can help your back. One is to gently stretch your back muscles. Lie on your back with your knees bent and slowly raise your left knee to your chest. Press your lower back against the floor. Hold for 5 seconds. Relax and repeat the exercise with your right knee. Do 10 of these exercises for each leg, switching legs. While some exercises are specific for your back, it's also important to stay active in general. Swimming and walking are good overall exercises to improve your fitness.