How to avoid back problems?

Low Back Pain Fact Sheet

Traction involves the use of weights and pulleys to apply constant or intermittent force to gradually “pull” the skeletal structure into better alignment. Some people experience pain relief while in traction, but that relief is usually temporary. Once traction is released the back pain tends to return. There is no evidence that traction provides any longterm benefits for people with low back pain.

Acupuncture is moderately effective for chronic low back pain. It involves the insertion of thin needles into precise points throughout the body. Some practitioners believe this process helps clear away blockages in the body’s life force known as Qi (pronounced chee). Others who may not believe in the concept of Qi theorize that when the needles are inserted and then stimulated (by twisting or passing a low-voltage electrical current through them) naturally occurring painkilling chemicals such as endorphins, serotonin, and acetylcholine are released. Evidence of acupuncture’s benefit for acute low back pain is conflicting and clinical studies continue to investigate its benefits.

Biofeedback is used to treat many acute pain problems, most notably back pain and headache. The therapy involves the attachment of electrodes to the skin and the use of an electromyography machine that allows people to become aware of and selfregulate their breathing, muscle tension, heart rate, and skin temperature. People regulate their response to pain by using relaxation techniques. Biofeedback is often used in combination with other treatment methods, generally without side effects. Evidence is lacking that biofeedback provides a clear benefit for low back pain.

Nerve block therapies aim to relieve chronic pain by blocking nerve conduction from specific areas of the body. Nerve block approaches range from injections of local anesthetics, botulinum toxin, or steroids into affected soft tissues or joints to more complex nerve root blocks and spinal cord stimulation. When extreme pain is involved, low doses of drugs may be administered by catheter directly into the spinal cord. The success of a nerve block approach depends on the ability of a practitioner to locate and inject precisely the correct nerve. Chronic use of steroid injections may lead to increased functional impairment.

Epidural steroid injections are a commonly used short-term option for treating low back pain and sciatica associated with inflammation. Pain relief associated with the injections, however, tends to be temporary and the injections are not advised for long-term use. An NIH-funded randomized controlled trial assessing the benefit of epidural steroid injections for the treatment of chronic low back pain associated with spinal stenosis showed that long-term outcomes were worse among those people who received the injections compared with those who did not.

Transcutaneous electrical nerve stimulation (TENS) involves wearing a battery-powered device consisting of electrodes placed on the skin over the painful area that generate electrical impulses designed to block incoming pain signals from the peripheral nerves. The theory is that stimulating the nervous system can modify the perception of pain. Early studies of TENS suggested that it elevated levels of endorphins, the body’s natural pain-numbing chemicals. More recent studies, however, have produced mixed results on its effectiveness for providing relief from low back pain.

Surgery

When other therapies fail, surgery may be considered an option to relieve pain caused by serious musculoskeletal injuries or nerve compression. It may be months following surgery before the patient is fully healed, and he or she may suffer permanent loss of flexibility.

Surgical procedures are not always successful, and there is little evidence to show which procedures work best for their particular indications. Patients considering surgical approaches should be fully informed of all related risks. Surgical options include:

  • Vertebroplasty and kyphoplasty are minimally invasive treatments to repair compression fractures of the vertebrae caused by osteoporosis. Vertebroplasty uses three-dimensional imaging to assist in guiding a fine needle through the skin into the vertebral body, the largest part of the vertebrae. A glue-like bone cement is then injected into the vertebral body space, which quickly hardens to stabilize and strengthen the bone and provide pain relief. In kyphoplasty, prior to injecting the bone cement, a special balloon is inserted and gently inflated to restore height to the vertebral structure and reduce spinal deformity.
  • Spinal laminectomy (also known as spinal decompression) is performed when spinal stenosis causes a narrowing of the spinal canal that causes pain, numbness, or weakness. During the procedure, the lamina or bony walls of the vertebrae, along with any bone spurs, are removed. The aim of the procedure is to open up the spinal column to remove pressure on the nerves.
  • Discectomy or microdiscectomy may be recommended to remove a disc, in cases where it has herniated and presses on a nerve root or the spinal cord, which may cause intense and enduring pain. Microdiscectomy is similar to a conventional discectomy; however, this procedure involves removing the herniated disc through a much smaller incision in the back and a more rapid recovery. Laminectomy and discectomy are frequently performed together and the combination is one of the more common ways to remove pressure on a nerve root from a herniated disc or bone spur.
  • Foraminotomy is an operation that “cleans out” or enlarges the bony hole (foramen) where a nerve root exits the spinal canal. Bulging discs or joints thickened with age can cause narrowing of the space through which the spinal nerve exits and can press on the nerve, resulting in pain, numbness, and weakness in an arm or leg. Small pieces of bone over the nerve are removed through a small slit, allowing the surgeon to cut away the blockage and relieve pressure on the nerve.
  • Intradiscal electrothermal therapy (IDET) is a treatment for discs that are cracked or bulging as a result of degenerative disc disease. The procedure involves inserting a catheter through a small incision at the site of the disc in the back. A special wire is passed through the catheter and an electrical current is applied to heat the disc, which helps strengthen the collagen fibers of the disc wall, reducing the bulging and the related irritation of the spinal nerve. IDET is of questionable benefit.
  • Nucleoplasty, also called plasma disc decompression (PDD), is a type of laser surgery that uses radiofrequency energy to treat people with low back pain associated with mildly herniated discs. Under x-ray guidance, a needle is inserted into the disc. A plasma laser device is then inserted into the needle and the tip is heated to 40-70 degrees Celsius, creating a field that vaporizes the tissue in the disc, reducing its size and relieving pressure on the nerves. Several channels may be made depending on how tissue needs to be removed to decompress the disc and nerve root.

    Radiofrequency denervation is a procedure using electrical impulses to interrupt nerve conduction (including the conduction of pain signals). Using x-ray guidance, a needle is inserted into a target area of nerves and a local anesthetic is introduced as a way of confirming the involvement of the nerves in the person’s back pain. Next, the region is heated, resulting in localized destruction of the target nerves. Pain relief associated with the technique is temporary and the evidence supporting this technique is limited.

  • Spinal fusion is used to strengthen the spine and prevent painful movements in people with degenerative disc disease or spondylolisthesis (following laminectomy). The spinal disc between two or more vertebrae is removed and the adjacent vertebrae are “fused” by bone grafts and/or metal devices secured by screws. The fusion can be performed through the abdomen, a procedure known as an anterior lumbar interbody fusion, or through the back, called posterior fusion. Spinal fusion may result in some loss of flexibility in the spine and requires a long recovery period to allow the bone grafts to grow and fuse the vertebrae together. Spinal fusion has been associated with an acceleration of disc degeneration at adjacent levels of the spine.
  • Artificial disc replacement is considered an alternative to spinal fusion for the treatment of people with severely damaged discs. The procedure involves removal of the disc and its replacement by a synthetic disc that helps restore height and movement between the vertebrae.

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Can back pain be prevented?

Recurring back pain resulting from improper body mechanics is often preventable by avoiding movements that jolt or strain the back, maintaining correct posture, and lifting objects properly. Many work-related injuries are caused or aggravated by stressors such as heavy lifting, contact stress (repeated or constant contact between soft body tissue and a hard or sharp object), vibration, repetitive motion, and awkward posture. Using ergonomically designed furniture and equipment to protect the body from injury at home and in the workplace may reduce the risk of back injury.

The use of lumbar supports in the form of wide elastic bands that can be tightened to provide support to the lower back and abdominal muscles to prevent low back pain remains controversial. Such supports are widely used despite a lack of evidence showing that they actually prevent pain. Multiple studies have determined that the use of lumbar supports provides no benefit in terms of the prevention and treatment of back pain. Although there have been anecdotal case reports of injury reduction among workers using lumbar support belts, many companies that have back belt programs also have training and ergonomic awareness programs. The reported injury reduction may be related to a combination of these or other factors. Furthermore, some caution is advised given that wearing supportive belts may actually lead to or aggravate back pain by causing back muscles to weaken from lack of use.

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Recommendations for keeping one’s back healthy

Following any period of prolonged inactivity, a regimen of low-impact exercises is advised. Speed walking, swimming, or stationary bike riding 30 minutes daily can increase muscle strength and flexibility. Yoga also can help stretch and strengthen muscles and improve posture. Consult a physician for a list of low-impact, age-appropriate exercises that are specifically targeted to strengthening lower back and abdominal muscles.

  • Always stretch before exercise or other strenuous physical activity.
  • Don’t slouch when standing or sitting. The lower back can support a person’s weight most easily when the curvature is reduced. When standing, keep your weight balanced on your feet.
  • At home or work, make sure work surfaces are at a comfortable height.
  • Sit in a chair with good lumbar support and proper position and height for the task. Keep shoulders back. Switch sitting positions often and periodically walk around the office or gently stretch muscles to relieve tension. A pillow or rolled-up towel placed behind the small of the back can provide some lumbar support. During prolonged periods of sitting, elevate feet on a low stool or a stack of books.
  • Wear comfortable, low-heeled shoes.
  • Sleeping on one’s side with the knees drawn up in a fetal position can help open up the joints in the spine and relieve pressure by reducing the curvature of the spine. Always sleep on a firm surface.
  • Don’t try to lift objects that are too heavy. Lift from the knees, pull the stomach muscles in, and keep the head down and in line with a straight back. When lifting, keep objects close to the body. Do not twist when lifting.
  • Maintain proper nutrition and diet to reduce and prevent excessive weight gain, especially weight around the waistline that taxes lower back muscles. A diet with sufficient daily intake of calcium, phosphorus, and vitamin D helps to promote new bone growth.
  • Quit smoking. Smoking reduces blood flow to the lower spine, which can contribute to spinal disc degeneration. Smoking also increases the risk of osteoporosis and impedes healing. Coughing due to heavy smoking also may cause back pain.

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What research is being done?

The National Institute of Neurological Disorders and Stroke (NINDS) is a component of the National Institutes of Health (NIH) and is the leading federal funder of research on disorders of the brain and nervous system. As a primary supporter of research on pain and pain mechanisms, NINDS is a member of the NIH Pain Consortium, which was established to promote collaboration among the many NIH Institutes and Centers with research programs and activities addressing pain. On an even broader scale, NIH participates in the Interagency Pain Research Coordinating Committee, a federal advisory committee that coordinates research across other U.S. Department of Health and Human Services agencies as well as the Departments of Defense and Veterans Affairs.

NINDS-funded studies are contributing to a better understanding of why some people with acute low back pain recover fully while others go on to develop chronic low back pain. Brain imaging studies suggest that people with chronic low back pain have changes in brain structure and function. In one study, people with subacute back pain were followed for one year. Researchers found that certain patterns of functional connectivity across brain networks correlated with the likelihood of pain becoming chronic. The findings suggest that such patterns may help predict who is most likely to transition from subacute to chronic back pain. Other research seeks to determine the role of brain circuits important for emotional and motivational learning and memory in this transition, in order to identify new preventive interventions.

Disc degeneration remains a key cause of chronic low back pain and the pain often persists despite surgery. NIH-funded basic science and preclinical studies are investigating molecular-level mechanisms that cause discs in the spine to degenerate, as well as protective mechanisms involved in disc remodeling that may diminish with advancing age. Such studies may help identify future therapeutic strategies to block degenerative mechanisms or promote remodeling processes. NIH also is funding early research on stem cell approaches to promote disc regeneration and rejuvenate cells of the nucleus pulposus, the jelly-like substance in the center of intervertebral discs that loses water content as people age.

Several NIH-funded clinical trials and other studies in patients aim to improve treatment options and prevention strategies for chronic low back pain, as well as add to the evidence base about existing treatments. A multi-year multicenter study called the Spine Patient Outcomes Research Trial (SPORT) compared the most commonly used surgical and nonsurgical treatments for patients with the three most common diagnoses for which spine surgery is performed: intervertebral disc herniation, spinal stenosis, and degenerative spondylisthesis. SPORT represented the largest clinical investigation to date looking at treatment results for these disabling and costly causes of chronic low back pain.

Results after four years of follow-up showed that in general, otherwise healthy people who have surgery for one of these three conditions are likely to fare better than those who receive non-operative care. However, the results also indicated that people who are reluctant to have surgery may also recover with non-operative treatments if their conditions are not progressing and their pain is tolerable, and importantly, delaying or avoiding surgery did not cause additional damage in most cases. Researchers are continuing to track SPORT patient cohorts over a nine-year follow-up period to assess longer term treatment results and cost effectiveness across treatment options. In the interest of improving surgical techniques, NIH also is funding research on factors that contribute to the success or failure of artificial disc replacement surgery, including studies to compare discs on the market for significant differences in their durability rates over time.

Epidural injections of steroid drugs are frequently used to treat sciatica, despite limited evidence for their effectiveness. Moreover, these treatments are based on the assumption that reducing local inflammation in the vertebral column will relieve pain, but an association between structural abnormalities, inflammation, and sciatica symptoms has not been clearly demonstrated. NINDS-funded researchers are using a new imaging technique that can detect inflammation to better understand what causes chronic sciatica pain and to provide evidence to inform treatment selection.

Other NIH-funded studies are investigating physical therapy and chiropractic approaches. For example, researchers are studying whether therapy programs that emphasize certain types of exercises, such as core stabilization exercises, provide benefit to people who experience recurrent low back pain.

The increasing use of spinal manipulation and mobilization, despite lacking evidence for more than small or moderate benefit, has prompted NIH-funded researchers to study the mechanisms of these two techniques and to conduct a randomized controlled trial to assess and compare their effectiveness for the treatment of chronic low back pain.

Finally, NIH-funded researchers are studying various complementary and alternative therapies for low back pain, including those aimed reducing stress and negative emotions believed to aggravate the experience of pain. For example, virtual reality programs are being studied for their ability to help people cope with persistent pain.

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Where can I get more information?

For more information on neurological disorders or research programs funded by the National Institute of Neurological Disorders and Stroke, contact the Institute’s Brain Resources and Information Network (BRAIN) at:

BRAIN
P.O. Box 5801
Bethesda, MD 20824
800-352-9424

Information also is available from the following organizations:

American Academy of Neurological and Orthopaedic Surgeons
10 Cascade Creek Lane
Las Vegas, NV 89113

Tel: 702-388-7390
Fax: 702-871-4728

“Back Pain Fact Sheet”, NINDS, Publication date December 2014.

NIH Publication No. 15-5161

Back to Back Pain Information Page

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Prepared by:
Office of Communications and Public Liaison
National Institute of Neurological Disorders and Stroke
National Institutes of Health
Bethesda, MD 20892

NINDS health-related material is provided for information purposes only and does not necessarily represent endorsement by or an official position of the National Institute of Neurological Disorders and Stroke or any other Federal agency. Advice on the treatment or care of an individual patient should be obtained through consultation with a physician who has examined that patient or is familiar with that patient’s medical history.

All NINDS-prepared information is in the public domain and may be freely copied. Credit to the NINDS or the NIH is appreciated.

  • Lower back pain is an injury that can be caused by conditions such as muscle strains from heavy lifting, a pinched nerve, or arthritis.
  • Runners may experience lower back pain from weak hip and glutes that can cause the lower back to become strained during a run.
  • Core strengthening, stretching, and aerobic exercise can help relieve lower back pain.

While you may not think your lower back has much of a role in running, it actually plays a pivotal part in the kinetic chain that powers your running mechanics.

Your core muscles—not just your abdominals, but the muscles that wrap around your midsection—support your spine and lower back. And your core, hips, glutes, and hamstrings together form one big stability machine, so weakness in any one of those muscles forces the others to take up the slack. If you have weak hip and gluteal muscles, for example, as they become fatigued during a run, your lower back is forced to work harder to keep you upright and stable, and you become vulnerable to injury.

Once lower back pain strikes, it can sideline you, but strengthening your core and stretching the muscles that support the lower spine can help. Research backs this—one 2016 review of studies published in JAMA Internal Medicine found that exercising can play a key role in preventing lower back pain. But to properly address the issue, it’s important to understand the root of the problem.

Causes of Lower Back Pain

While every case is different and individual, there are three common causes of that pain in your back:

  1. Muscular pain that comes on suddenly in your lower back is often indicative of a muscle spasm. Your muscles will feel as though they have locked up, and the pain can be severe and debilitating. You will not feel the shooting pain characteristic of sciatic or discogenic pain.
  2. Pain in your lower back that is associated with shooting pains down the back of one or both legs indicates sciatica or discogenic pain. A pinched nerve causes this discomfort. It often feels sharp compared to the muscle-gripping sensation that you would feel with a spasm.
  3. If you feel a chronic general achiness across the whole area of your lower back, you may have arthritis.

Back Pain Prevention

To prevent back pain, you need to work on strength and flexibility through the entire kinetic chain. Your spine and spinal muscles get lots of support from your core. In addition, tightness or weakness in your glutes, hips, quads, and hamstrings will impact the muscles in your lower back, putting more strain on those muscles and setting them up for a spasm.

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If you’re trying to fix that nagging back pain—or more importantly prevent it—try the following strength exercises and lower back stretches, demonstrated by Hollis Tuttle, certified personal trainer and run coach in New York City. As always, consult with your doctor before starting any new exercise routine to ensure it’s safe for your condition.

How to use this list: Complete 3 to 5 sets of the following exercises in order. Perform each exercise for the specified number of reps or seconds, resting for 30 seconds between exercises. You will need a large stability ball and an exercise mat.

1. Plank

Julia Hembree Smith

Start on all fours. Lower onto your forearms with shoulders directly over elbows. Step feet back into a plank position. Draw your shoulders down and back—not hunched. Engage abdominal muscles tight to keep hips in line with shoulders so your body forms a long, straight line. Squeeze legs and glutes for support. Hold this position for 45 to 60 seconds. Gradually add time as your core gets stronger. Repeat for 3 to 5 reps.

Make it harder: Roll onto your right forearm and stack feet to perform a side plank. Repeat on other side.

2. Stability Ball Back Extension

Start facedown on a stability ball with feet resting on floor and core engaged so body forms a straight line. Keeping your back naturally arched, place hands behind ears and lower your upper body as far as you comfortably can. Squeeze glutes and engage back to and raise your torso until it’s in line with your lower body. Pause, then slowly lower your torso back to the starting position. Repeat for 12 to 15 reps.

3. Stability Ball Pike

Start in a high plank position with shoulders directly over wrists and tops of feet resting on a stability ball. Your body should form a straight line from head to ankles. Without bending your knees, roll the ball toward your chest by raising your hips as high as you can toward the ceiling. Pause, then lower hips as you roll the ball back to the starting position. Perform 15 reps.
Make it easier: Start with a Knee Tuck: In a high plank position, place shins on ball. Draw knees toward chest without raising your hips as you roll the ball to feet. Repeat, then work your way up to the pike position as you get stronger and more stable.

4. Stability Ball Reverse Leg Raise

Lie facedown on a stability ball with your hips on the ball, hands on the floor with shoulders over wrists, and legs extended out straight, toes resting on floor. Keeping legs as straight as possible, engage glutes and lower back to lift legs until they are in line with your torso. Lower back down to the starting position. Repeat for 15 reps.

5. Glute Bridge

Lie faceup on the floor with knees bent, feet flat on the floor, arms resting at sides. Squeezing your glutes, lift your hips until your body forms a straight line from shoulders to knees. Pause for 3 seconds, and then lower back down to the starting position. Repeat for 15 reps.

6. Locust Pose

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Lie facedown on the mat with legs extended straight and arms down at your sides, palms down. Contract your glutes and lower back muscles as you lift head, chest, arms, and legs off the mat and rotate arms so thumbs point toward the ceiling. Hold for 30 seconds, and then relax back to the floor for 5 seconds. Repeat for 10 reps.

Julia Hembree Smith / Zack Kutos

All images by:Julia Hembree Smith

Dr. Jordan Metzl’s Running Strong amazon.com $21.99 $11.50 (48% off) This article has been excerpted and adapted from Dr. Jordan Metzl’s Running Strong: The Sports Doctor’s Complete Guide to Staying Healthy and Injury-Free for Life. (Published by Rodale Books). Dr. Jordan Metzl Jordan Metzl is a sports medicine physician in New York City.

6 Tips to Prevent Back Pain

Back pain can be the result of trauma, such as a fall or a car accident. But most often back pain is the result of an everyday activity done incorrectly — activities as common as twisting to reach or lift an object, sitting at a computer in the same position for hours, bending over to vacuum, and carrying shopping bags. The good news is that back pain prevention isn’t all that difficult, often requiring just a few adjustments that will soon become second nature.

Here are six simple but effective back pain prevention tips.

  1. Exercise. One of the most important things you can do for back pain prevention is to get up and get moving. Why does exercise prevent back pain? Muscles are meant to move, says Robin Lustig, DC, a chiropractor at New Jersey Total Health Center in Lodi and Pompton Plains, N.J. If you aren’t in good shape, you’re more likely to hurt your back and feel pain when you do even simple movements, such as lifting your child from his crib. “Also, exercise helps keep your joints fluid,” Dr. Lustig says. Another reason exercise prevents back pain is that exercise helps you keep your weight down — being overweight, especially around your stomach, can put added strain on your back.
  2. Eat right. “If you maintain good eating habits, you not only will maintain a healthy weight, but you also will not put unnecessary stress on your body,” Lustig says. A steady diet of excessively spicy or fast food can strain your nervous system, which is going to create back problems, she adds. Conversely, a healthy diet of fresh fruits and vegetables, lean meats, dairy products, and whole grains will keep your digestive tract on track. “If your intestines are working and functioning properly, that will maintain your spine because your inside and your outside relate to one another,” Lustig says. “I have found that many people who come in complaining of low back pain also have irritated bowels.”
  3. Sleep sideways. You don’t want to sleep flat on your back. The best position for sleeping is on your side. If you must sleep on your stomach, put a pillow under your lower abdomen to help take stress off your back. Having a supportive mattress and pillow for your head are vital as well. “Getting enough, restful sleep is always an important part of maintaining good health,” Lustig says. Also, if you exercise during the day, you sleep better at night.
  4. Maintain proper posture. “People sitting at their computer for seven or eight hours a day is keeping me in business,” says Lustig. “People slouch over their computers and their telephones when they’re texting, and they don’t realize the damage they’re doing to their backs and the pain they could be causing.” Be sure to work at an ergonomically correct workstation, both at the office and at home, and break up long periods in front of the computer with stretching exercises. If you practice good posture, you will maintain the natural curves of your back and help keep it strong.
  5. Reduce stress. You probably don’t realize how much stress can impact your back health. Stress causes you to tense your muscles, and constant tension of this kind can cause back pain. Any activity that helps you reduce stress will help prevent back pain, Lustig says. Stress reduction activities can include yoga, meditation, biofeedback, deep breathing, tai chi, and guided imagery.
  6. Quit smoking. It’s well known that smoking raises your risk for heart disease and cancer, including lung and colon cancers, but most people don’t realize that smoking also can be a cause of persistent back pain. Research also shows smoking can make existing back pain worse. It’s not entirely clear how smoking affects back health, but one possibility is that it narrows blood vessels. Narrowed blood vessels result in less oxygen and nutrients reaching the spine and, in turn, it becomes more susceptible to injury and slower to heal.

You can reduce your risk for back pain with simple lifestyle changes. However, if you should experience back pain, don’t ignore it. It could be a sign of a more serious condition. Talk to your doctor about your symptoms and what you should do to find and treat the cause.

Self care for neck and back pain

Not all chronic pain is treatable. Pain management is an integrated approach to making pain tolerable by learning physical, emotional, intellectual and social skills. This may include exercise, physical therapy, medication, relaxation, acupuncture, behavior changes, biofeedback, hypnosis, and counseling. When you use pain management techniques, you stay in control of your own health. These techniques also help the brain produce it’s own pain medications called endorphins, which literally means “morphine within” (see Pain Management).

Sources & Links

If you have more questions, please contact Mayfield Brain & Spine at 800-325-7787 or 513-221-1100.

Glossary

acute: a condition of quick onset lasting a short time, opposite of chronic.

chronic: a condition of slow progression and continuing over a long period of time, opposite of acute.

disc (intervertebral disc): a fibrocartilagenous cushion that separate spinal vertebrae. Has two parts, a soft gel-like center called the nucleus and a tough fibrous outer wall called the annulus.

lordosis: abnormal forward curve of the lumbar spine, also called sway back.

kyphosis: abnormal curve of the thoracic spine, also called hunchback.

vertebra: (plural vertebrae): one of 33 bones that form the spinal column, they are divided into 7 cervical, 12 thoracic, 5 lumbar, 5 sacral, and 4 coccygeal. Only the top 24 bones are moveable.

updated: 9.2018
reviewed by: Banita Bailey, RN and Lisa Cleveland, PT, Mayfield Clinic, Cincinnati, Ohio

Mayfield Certified Health Info materials are written and developed by the Mayfield Clinic. This information is not intended to replace the medical advice of your health care provider.

Home remedies for low back pain

80% of people will experience back pain at some time, but there are ways to find relief.

Published: February, 2017

As people enter middle age, they are more likely to experience bouts of low back pain. In fact, according to the Harvard Special Health Report Men’s Health: Fifty and Forward, back pain affects about four in five Americans at some point in their lives and equally strikes men and women.

Age is often the culprit. Over time, the bones and joints in your lower back begin to change. Your discs (the structures that serve as cushions between the bones in the spine) tend to wear out and sometimes become fragmented. These structural alterations sometimes cause pain.

Another cause of low back pain, although it occurs less often, is a herniated disc. Sometimes, a disc pushes outside the space between the bones and compresses a nerve at the point where it branches off the spinal cord. When the sciatic nerve that leads into the buttocks and leg is affected, the pain is called sciatica.

Yet, most cases of low back pain stem from strain or sprain due to simple overuse, unaccustomed activity, excessive lifting, or an accident. In most cases the best move is to wait and see if the pain resolves on its own. If the pain does not improve after three to four days, then it’s time to see a doctor.

However, depending on the source of your back pain and its severity, you might try a few home remedies for low back pain to help ease the pain until your back returns to normal. Here are several options to consider:

Cold and heat therapies. It’s best to use cold compresses or an ice pack, not heat, immediately following a back injury, since this can alleviate pain by numbing the area and prevent or reduce swelling. About 48 hours after the onset of back pain, though, applying heating pads or a hot-water bottle to your back may be helpful. The warmth soothes and relaxes aching muscles and increases blood flow, which helps the healing process. Keep in mind that heat therapy is only helpful for the first week.

Limited bed rest. Once the mainstay of treatment for back pain, bed rest has fallen out of favor. Doctors now know it’s better to keep moving, so that your muscles don’t become stiff. Bed rest can still be useful relief from low back pain, particularly if your pain is so severe that it hurts to sit or stand. But try to limit it to a few hours at a time and for no more than one or two days.

Physical activity. Exercise helps build strong, flexible muscles that will be less prone to injury. It can also help the healing process for an aching back, prevent problems in the future, and improve function. Work with your doctor to develop an exercise program, or seek a referral to another health professional who can. A good program typically includes the three major forms of exercise: aerobic activity, strength training, and flexibility exercises.

Complementary therapies. Several types of complementary therapy may be helpful for relief from low back pain. These include:

  • acupuncture, in which therapists insert hair-thin sterilized needles into precise points in the body to release blocked energy
  • spinal manipulation, in which chiropractors apply pressure directly to the body to correct spinal alignment
  • therapeutic massage to relax aching muscles
  • movement therapies, such as yoga and tai chi, which can help stretch and strengthen back muscles.

Although the evidence is mixed about whether these therapies are effective, when they do work, it is often when they are combined with the other home remedies for low back pain.

– By Matthew Solan
Executive Editor, Harvard Men’s Health Watch

Disclaimer:
As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.

7 Tips to Protect Your Lower Back

The marvelous strength and flexibility that’s engineered into your lower back also makes it susceptible to developing lots of problems. And because of the many nerves that run throughout your spine and into the rest of your body, a problem in the lower back can lead to leg pain, hip problems, and more.

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Learn more about the anatomy of your lower spine. Watch: Lumbar Spine Anatomy Video

Protecting your lower back involves taking measures to avoid direct injury, prevent indirect trauma, and control the progression of a problem that may have already occurred.

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Here are 7 proven tips that can go a long way in protecting and stabilizing your lower back.

1. Strengthen your core muscles daily

Strong and supportive muscles throughout the trunk of your body are essential to support your spine. Core-building exercises include:

  • Low-impact cardiovascular exercise, such as normal or brisk walking, which helps increase blood flow to the spine and stretch your muscles. An adequate flow of blood supplies healing nutrients and hydration to the structures in your lower back.1,2

    See Low-Impact Aerobic Exercise

  • Water therapy, which provides a greater range of motion due to the buoyancy of water, particularly for exercises that require lifting the legs. Water also provides resistance by means of gentle friction, allowing the strengthening and conditioning of an injured muscle.3 This therapy is optimal for people who have chronic back pain and find it too painful to exercise without the supportive effect of water.

    See Water Therapy Exercise Program

  • Exercise ball workouts, such as sitting on the ball intermittently for about 20 to 30 minutes and/or using the ball for stretches and exercises that engage your core muscles.4

    See Exercise Ball Therapy for Lower Back Pain Relief

If exercise seems difficult or impossible to you, make small goals to slowly get yourself moving, such as going up and down your stairs 3 times in a row or walking in a park with a friend.

Consider engaging a physical therapist or other qualified health practitioners to help you get started and provide correct guidance on how to safely exercise.

Read more about Physical Therapy for Low Back Pain Relief

2. Invest in an ergonomic office chair

Slouching forward while working at a desk places excessive pressure on the discs in your lower back and can cause problems, such as disc degeneration to occur or further deteriorate. Support the natural curve in your lower spine by:

  • Using an ergonomic chair that helps you align and support your back and thighs correctly
  • Placing a small rolled-up towel in the small of your back for additional support
  • Using a standup desk, if possible for at least part of the day

It is helpful to set a timer for every 50 minutes to an hour on your phone to remind yourself to check your posture, walk for a few minutes, and stretch your lower back and leg muscles.

See Choosing the Right Ergonomic Office Chair

In This Article:

  • 4 Reasons You May Have a Stiff Back
  • Is My Lower Back Pain Serious?
  • 7 Tips to Protect Your Lower Back
  • 3 Beginner Yoga Poses for Lower Back Pain Relief
  • Causes of Lower Back Pain Video

3. Safeguard your back while lifting

Lifting is a common cause of lower back pain. Common everyday activities, such as unloading grocery bags from the car or lifting your young child, can lead to lower back problems.

Lifting with your back bent, or lifting while twisting, may cause a sudden injury to your lower back or repetitive injury over a period of time, leading to chronic tissue damage.

Follow these lifting-guidelines to prevent lower back injury5:

  • Bend at your knees, not at your lower back; a completely flexed (forward bent) back can be highly susceptible to a ligament and/or disc injury
  • Pivot your feet and hips, rather than twisting your lower back
  • Hold the object close to your chest while straightening your spine

While lifting is a part of everyday activities, having a job that includes heavy lifting may increase your risk of developing lower back problems.5

See Avoid Back Injury with the Right Lifting Techniques

How to lift small objects

The golfer’s lifting technique is particularly helpful in lifting small and light objects. This technique includes the following steps5:

  • While one leg bears the body’s weight, lift the other leg off the floor and toward the back for counterbalance
  • Support one arm on a stationary object, such as a table or a countertop and bend down at the hip (like a fulcrum) so that the body becomes almost parallel to the floor
  • Reach the free arm to pick up the object

This technique is considered safe for the lower back tissues because lifting one leg toward the back allows the spine to stay straight and the counterbalance offsets the strain on the back. The golfer’s lift is particularly useful for the repetitive lifting of small objects.5

See Additional Lifting Techniques to Avoid Back Injury

4. Dissipate stressors during everyday activities

Even small amounts of stressing on the intricate structures in your lower back can add up and lead to degeneration and pain over time. Here are recommendations on how to reduce everyday stresses to concentrate on your lower back5:

  • Opening a door. While opening a door, stand straight in front of the door’s handle and pull it perpendicular to your body. Avoid standing on the side of the handle and twisting your trunk while opening the door, which may injure your spinal ligaments.
  • Using a vacuum cleaner. While vacuuming, hold the vacuum cleaner in front of your body with both hands and use small arm movements while cleaning. Holding the vacuum to the side of your body with just one hand results in large arm movements and requires more twisting torque forces on your lower spine.
  • Shoveling snow or while gardening. While shoveling, rest one arm on your thigh while slightly bending the knees. This technique helps prevent large arm movements and prolonged stooping, which significantly loads your lower back.

    See Snow Shoveling Techniques to Prevent Low Back Injuries

Using spine-sparing principles such as these on a daily basis helps prevent chronic injury to the tissues.

5. Rest your back after prolonged bending

When you bend forward for a long time, such as while weeding your garden, certain changes take place in your discs and ligaments. These changes last for a few minutes, during which time, the stability of your spine is reduced. The joints also become temporarily stiff during this period.5

Your lower back is at risk for sustaining a sudden injury after these tissue changes if you exert stress on your back immediately afterward, such as lifting a bag of soil right after you’ve been bending and weeding for a long time.5

It is advisable to stand upright for a few minutes and allow the spinal tissues to recover and re-shape after prolonged stooping or bending before attempting strenuous exertions.5

6. Protect your discs immediately after waking

The pressure within your discs rises up to 240% when you sleep at night (for a minimum of 7 hours).6 At this time, your discs are fully hydrated and are typically at a higher risk of herniation when subject to bending or lifting forces.5,6

See Techniques for Effective Exercise Walking

Maintaining a straight back for an hour or two after waking allows your discs to regain their normal pressure and withstand loads more effectively.5,6

7. Stretch your hamstrings

A little-known cause of low back pain is tight hamstrings. Simple hamstring stretching exercises can help decrease the pressure on your pelvis and provide relief across your low back. Certain hamstring stretches also help relieve leg pain associated with lower back problems, such as sciatica.7

See Easy Hamstring Stretches

Not all hamstring stretches are good for all types of back conditions. Check with your physical therapist or doctor first to find out which exercise modification may be suitable for you.

Watch Hamstring Exercises for Low Back Pain Relief Video

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Bonus tip: Lower back pain is directly impacted by your overall health

When you improve your overall physical fitness and general health, it will benefit your lower back. The following simple measures can help prevent the development, chronicity, or flaring of your lower back pain, such as:

  • Staying active
  • Drinking lots of water
  • Minimizing the consumption of alcohol
  • Getting enough deep, restorative sleep
  • Following an anti-inflammatory diet
  • Avoiding smoking and any form of nicotine intake
  • Managing mental and psychological stress by participating in related therapies

The damage to any single tissue can lead to biomechanical changes that progressively affects the other structures.5 The resulting effects may cause pain in your lower back, hip, and/or leg(s).

Incorporate these tips and techniques in your daily activities to help prevent or minimize the development of new problems or future flareups of your lower back pain.

Early Treatments for Lower Back Pain

Video: 5 Overlooked Tips to Protect Your Lower Back

If you’re prone to backaches, you know how frustrating it can be. Back pain can prevent you from engaging in activities you enjoy and may cause you to miss work. It can keep you awake at night and affect your mood. Back pain is one of the most common reasons people go to the doctor.

For those susceptible to back pain. here are some top tips for good habits and practices promoting spine health that can also help people avoid back pain in the first place:

  • Always pay attention to your posture and movements. Don’t slouch when you’re sitting or standing. Be mindful of the way you move, even during everyday activities such as loading the dishwasher or taking out the garbage.
  • Maintain a healthy weight or try to lose weight if necessary, as this can put stress on your back.
  • Exercise to strengthen your back. Work on your abdominal muscles, which can help support the back. Swimming is beneficial, but make sure you maintain good form.
  • When lifting heavy packages, always bend your knees and keep your back straight. Keep the object close to your body and avoid twisting at the waist. If you also have knee problems, you may want to avoid lifting heavy packages altogether.
  • Don’t engage in activities that you know will irritate your back.
  • Pace yourself when doing chores. Don’t go on a cleaning spree or tackle extensive home improvement projects if you’re susceptible to back pain. Ask for help if you need it.
  • If you sit at a desk for hours at time, get up and take a walk or stretch occasionally. Get a chair with good lumber support and make sure it’s the right height. A pillow or rolled-up towel placed behind the small of the back can also provide support.
  • If you have a long drive, take breaks so you’re not sitting in the same position for hours.
  • Research shows that emotional stress or mental pain can exacerbate physical pain.
  • Be wary of exercises you find online. If they’re not geared toward your particular problem, they can make the pain worse.

Dr. Bernard Rawlins is a board-certified orthopedic spine surgeon with a comprehensive practice that spans the entire scope of spinal disorders from cervical (neck) spine to scoliosis in both the adult and pediatric population. With a background in engineering in addition to his medical degree, Dr. Rawlins is highly knowledgeable of the latest advances in surgical implants and techniques. His expertise has led to the development of numerous patents used in complex spine surgery.

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