Low back pain is one of the most common reasons for
visiting a primary care physician. People may experience
back pain after lifting heavy objects, twisting and turning
their backs during exercise or household chores, or after a
period of inactivity. Acute low back pain is often caused
by muscle inflammation and spasm and may start suddenly or
increase gradually over time. It may occur in the center of
the low back or next to the spine on either side. The pain
from muscle strain and spasm is often achy and crampy with
periods of sharpness that occur because of "stressing" the
involved muscle. Laying down usually relieves the pain. The
pain is often accompanied by stiffness when moving the
lower back and very tender muscles. It will usually get
better with regular use of rest, heat, massage and/or
anti-inflammatories and/or muscle relaxants for two to four
weeks. Moist heat applied for 20 minutes three to four
times daily and taking 200 to 800 mg per day of ibuprofen
helps relieve the contracted and inflamed muscles. People
can hasten recovery by continuing to be as active as
tolerated and not to lift heavy objects or move in ways
that aggravate the pain.
Low back pain which lasts more than 6 weeks and/or begins
to change in character needs to be evaluated by a
physician. If the pain becomes sharp and begins to radiate
into the buttocks or down the legs, a nerve may be pinched.
The most common nerve affected by muscular spasm, spinal
stenosis or a herniated disk is the sciatic nerve. The
sciatic nerve is a combination of nerve roots which come
from the lower spinal cord (L4-S3) and form the largest
nerve in the body. When a combination of the nerve roots or
the whole nerve is pinched, one experiences pain, tingling
or numbness in the buttock or the backside of the leg past
the knee to the foot. One may notice the affected leg is
weak and have foot drop or the inability to extend the
great toe. Although pain caused by a pinched sciatic nerve
(sciatica) can be very painful and debilitating, there is
no risk of permanent nerve damage or paralysis. Sciatica is
treated with physical therapy, massage, anti-inflammatories
and manipulative treatments.
A herniated disk or narrowed spinal column (spinal
stenosis) can also cause low back pain. The pain is achy or
sharp and can worsen suddenly if nerves are compressed,
leading to the symptoms discussed above. A primary
difference between these conditions is that the pain from a
bulging disk is made worse from bending forward and
decreased by leaning backward. The opposite is true for
spinal stenosis pain. The pain from both of these
conditions gets better with laying down. Thee pain caused
from sciatica is usually is not relieved by laying down (it
may even get worse). The development of sudden leg
weakness, lack of sensation in the pelvic area and
involuntary leakage of urine or stool are signs of cauda
equina syndrome. The cauda equina is a "tail" of nerves at
the end of the spinal cord. If these nerves are pinched, it
produces the cauda equina syndrome. In addition to the
conservative treatments for a pinched nerve, surgery may be
an option to reduce the impingement by removing the disk or
fusing the vertebrae to widen the spinal column.
Other non-muscular and non-neurologic causes of back pain
are infection and cancer. Warning signs that these
conditions may be a cause of acute or chronic low back are
fever, chills, lack of improvement with regular use of
anti-inflammatories and exercise, and pain that worsens
with laying on the back. It is important to inform a
physician about these symptoms so that blood tests and
imaging studies can be ordered to diagnose and treat these
conditions before complications arise.
The injury associated with low back pain can be prevented
by regular exercise (such as walking and low back
exercises), maintenance of a healthy body weight and using
correct body mechanics when lifting heavy objects.
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Roger Hutchison, with his wife Dawn Hutchison, D.O. offer
more articles, tips, online videos and downloadable reports
at http://www.greatimmunity.com . This project focuses
their background in sports nutrition and athletic
performance on ways to boost the immune system for
workouts, training and long term health.
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