Spinal Column The lumbar region of the back is located between our lowest rib and the pelvis, or just behind our abdomen. It is also called the lower back.
The bones, muscles, tendons, and ligaments of the lower back, or lumbar region, serve a number of important functions:
- structural support for the lumbar spine
- supporting and holding the weight of our body when we stand
- acting as a hinge between the upper and lower body, allowing us to bend or rotate at the waist
- protecting the spinal cord, and the nerves as they enter and leave the spinal column
Because the lower back is involved in almost every movement and activity we engage in, when it is "hurting", we are literally brought to a stand still. The most frequent causes of lower back pain are muscle strains and sprains.
Muscles of the back
A muscle strain occurs when muscle fibers are abnormally stretched or torn. A sprain occurs when the ligaments, the tough bands of tissue that hold the vertebrae together, are torn from their attachments. It is difficult to differentiate a strain from a sprain, as both injuries usually show similar symptoms. Also, the treatment and prognosis for both strains and sprains is usually the same, therefore, a definitive diagnosis is not usually needed.
The symptoms of most lumbar strains and sprains are localized to the lower back region and buttocks, and do not radiate to the legs or upper back.
- Early symptoms may include tightness in the lower back muscles with certain movements or prolonged standing. This feeling usually subsides quickly when the offending movements cease, or after sitting and resting for a short period. This is a "warning sign". If left unheeded, the real pain will usually begin.
- As the symptoms take hold, one may experience:
- Muscle spasms
- Stiffness that does not subside quickly
- Dull aching pains
- Sharp pains that may "take one's breath away" with certain movements
- The onset of the actual pain is usually sudden, and aggravated by:
- Specific movements relieved by rest
- Certain positions, even when lying down, which are relieved by position changes.
- The most severe pain usually lasts 48 to 72 hours and may be followed by days or weeks of diminishing pain. During this time, the back muscles are weak and can easily be re-injured.
Most pain in the lower back is triggered by some combination of:
- Weak lumbar back muscles
- Overuse (excessively repetitive movements and activities)
- Muscle strain
- Injury to the muscles and ligaments that support the spine
The onset of pain can usually be traced to two or more of these causes. Precipitating activities need not be excessive and include activities such as gardening or sitting in front of a computer too long.
When the back is strained or sprained, muscles and ligaments are abnormally stretched or torn. This produces inflammation, swelling, pain and spasms in the soft tissues. Continued activity, even at a lessened pace, aggravates the injured structures, which in turn stretches or tears the healing tissues even more. This will cause the pain and muscles spasms to become more intense. This cycle continues until one just finally gives up and rests.
Many physicians feel:
- Even after the back muscles and ligaments heal, they will never be the same...but will always be a bit weaker than normal. This makes it easier to re- injure the back in the future.
- When repeated episodes of back strains and sprains occur, you are likely to use your back differently....trying to subconsciously prevent further injuries. This may make other parts of the back work harder or in unaccustomed ways, which could cause other back problems to occur.
These last two facts make prevention of further episodes of back injuries imperative. While this may seem easier said than done, we offer some treatments which have proven over time to be effective in helping to eliminate recurring episodes of lower back pain.
These are some risk factors that make one more susceptible to lower back strains and sprains:
- Hereditary or congenital spinal defects, such as scoliosis. Scoliosis is an abnormal side to side curving of the spine. When the spine is not straight, the muscles of the back are not balanced. This may lead to chronic muscle strains and sprains.
- Short Leg Syndrome: When one leg is shorter than the other, the body compensates by leaning towards the short side, trying to "make the leg longer." When this occurs, the muscles in the back are no longer balanced, and muscle strains and sprains may occur. (Click here to find out more about how a short leg can affect the back).
- Pregnancy/weight gain
- Traumatic injury to the back
- Previous history of back pain
- Being middle-aged increases the chances of muscle strains. This is due to decreased reduced strength, flexibility and conditioning that occur with aging.
- Jobs and activities which expose individuals to long periods of sitting, lifting or pulling heavy objects, frequent bending and twisting movements, and frequent jarring motions (like riding on bumpy roads with no shock absorbers). There are many more repetitive activities that may cause back pain...however, the above are the more common ones.
- Chronic coughing places a great deal of stress on the spine and attached muscles. This may eventually cause a strain or sprain of the muscles of the back.
Treatment or Prevention: The old adage, "An ounce of prevention is worth a pound of cure," is most apropos when trying to prevent the debilitating effects of lower back strains and sprains. If these strains and sprains are not prevented or treated in their earliest stages, they may produce such debilitating pain that only a complete life style change will relieve symptoms.
Short-Term Pain Relievers: These steps will help to provide you with short-term pain relief:
- Protection. By gently limiting the movement of the strained or sprained muscles, healing will occur more quickly. This is best accomplished with the use of one of the following Back Braces. We have found these braces to be soft, comfortable, and uniquely effective. Our braces will help to reduce pain, swelling, and healing time! Not only are they effective in the treatment of lower back pains, but they are also recommend for preventing reoccurrence of this problem. These braces allows you to "jump-start" the healing process! For more information about our truly unique and comfortable braces click here.
- Rest. Avoid weight-bearing activities whenever possible, and try to assume a position or posture that is not painful.
- Avoid any activity that requires frequent bending.
- For the first 72 hours after injuring the back muscles, apply ice to the lower back for 20 minutes every few hours. This will help to reduce inflammation and pain. If the ice becomes uncomfortable, discontinue its use immediately. Heat during this time may increase swelling and inflammation, and should usually be avoided.
- Beginning on the 4th day, mild and comfortable moist heat may be applied to the strained back muscles. This will bring more blood to the area, and speed up healing. Use moist heat for 20 minutes every few hours. If the heat is uncomfortable, stop it immediately. Sometimes combining moist heat treatments, followed by ice packs, will not only hasten healing, but will help to reduce pain (try after the first 72 hours).
- When the pain subsides, you should try a gradual return to activities, with the use of a brace which will protect, support, and stabilize the lumbar back region, such as our back braces. If you are careful, but the pain returns, we suggest that you seek medical care.
Long-Term Pain Relievers: The following remedies will help to provide you with long-term pain relief:
1. The use of one of our recommended Back Braces, especially in the early stages of "return to full activities," will help to prevent a reoccurrence of back pain and spasms. Our braces allow normal back movements, but help to prevent those excessive and abnormal movements that will strain and sprain the back muscles.
2. Modify your activities to reduce stress on the lower back. Here are two simple, yet effective changes you can make to help reduce your chances of suffering lower back pain again:
- Sitting and standing in a slouched position may feel comfortable, but it is stressing some of the back muscles. Eventually, these muscles will go into spasm and become inflamed and painful. To prevent this from occurring, try to stand and sit straight with a natural curve in the lower back. We offer some very effective back cushions and seat supports that help relieve lower back stress and pain. To view these click here.
- Change the way that you lift heavy or awkwardly shaped objects. Use your knees, not your back. For further information about one Lifting Technique click here.
3. Mobility and strengthening exercises for the lower back are important to help prevent further episodes of back pain. If the muscles are strong, they will have less tendency to succumb to an injury...strong muscles can fight off stress better than weaker muscles. Exercise should begin only after healing has occurred to the point that the exercises do not increase pain. Use good judgment when exercising: start slow, do not overdo, and stop if pain begins. Click here for some back exercises that may help you.
4. We have found that custom-made orthotics are effective in providing our body with shock absorption, and in helping to stabilize our feet and lower back.
- Increased shock absorption will reduce the jarring effect on the lower back muscles, and this will help to reduce muscle spasms and pain. Our custom-made orthotics are designed to absorb the shock created each time we step down, instead of allowing this shock to travel to our lower backs. These custom-made orthotics act much like the shock absorbers on an automobile.
- Our feet are the foundation of our body. Just as with a building, when the foundation is not straight or it is weak, the building will not stand straight. When this occurs, extreme forces are placed on the building. If our feet are not straight, stable, or they are weak, the lower back will be subjected to abnormal forces. The back muscles will try to compensate and keep the body straight. This compensation will eventually cause the muscles to go into spasm and be painful. Our custom-made orthotics designed for the back will stabilize the feet, and provide the body with a proper foundation. When this occurs, back muscle spasms and pain are reduced. To find out more about our custom made orthotics for back pain, click here.
Improper lifting of objects is one of the most common causes of lower back strain and pain. If you can adhere to the following lifting technique, you may prevent many hours of debilitating back pain.
Proper Lifting Technique
- Wear proper shoes.
- Wear a back brace.
- Stand close to the object you wish to lift.
- Bend at the knees, not at the waist. Keep your back and neck straight so that your head and eyes are directed forward and not down.
- Contract the stomach muscles, and hold the object close to your body.
- Lift slowly by standing straight up (un-bending your knees). Allow your legs to carry the weight.
- Use good common sense: if the object is too heavy for you, do not lift it by yourself!
Before starting any exercise program you should first consult with your doctor. Do only those exercises that do not cause pain. If you are in pain, then do not even begin an exercise program.
The McKenzie Press-Up Exercise:
- The McKenzie Press-Up Exercise helps to relieve stress and lower back pain.
- Begin by laying flat on the ground (face down). When doing this exercise it is important to keep the hips and legs relaxed and in contact with the floor.
- Keep your hands in line with your shoulders.
- Inhale, then exhale and press up using the hands keeping the lower half of your body relaxed. Hold until you need to inhale, then move down, lay flat on the ground to rest, and repeat ten times.
Stop if Pain Occurs.
Knee to Chest
Knee to Chest Exercise:
- Lie on your back on a table or firm surface.
- Clasp your hands behind the thigh and pull your knee towards your chest.
- Keep the opposite leg flat on the surface of the table Maintain the position for 30 seconds. Switch legs and repeat.
Stop if Pain Occurs.
Pelvic Lift Pelvic Lift Exercise:
- Lie on your back on a flat surface, with your feet flat on the surface and your knees bent.
- Keep your legs together
- Cross your arms over your chest.
- Tilt your pelvis and push your low back to the floor.
- Then slowly lift your buttocks off the floor as far as possible without straining.
- Maintain this position for 5 seconds. Lower your buttocks to the floor Do not hold breath.
Stop if Pain Occurs.
Backward Bending Exercise:
- Stand up straight with your feet shoulder width apart.
- Keep your knees as straight as possible.
- Place your hands on your back at your waist.
- Bend backwards at your waist keeping the knees as straight as possible.
- Hold for 5 seconds (or less, depending on comfort).Return slowly to the upright position.
Stop if Pain Occurs.
Side Bend Side Bending Exercise:
- Stand up straight with your arms at your sides and your feet shoulder width apart.
- Bend your trunk to one side, by lowering your shoulder.
- Run your hand down the outside of your thigh.
- Hold for 5 seconds (or less, depending on comfort).
- Slowly straighten up. Repeat to the opposite side.
Stop if Pain Occurs.