The human spine (or backbone) is made up of small bones called vertebrae. The vertebrae are stacked on top of each other to form a column. Between each vertebra is a cushion known as a disc. The vertebrae are held together by ligaments, and muscles are attached to the vertebrae by bands of tissue call tendons.
Openings in each vertebra line up to form a long hollow canal from the base of the brain. Nerves from the spinal cord branch out and leave the spine through the spaces between the vertebrae.
The lower part of the back holds most of the body’s weight. Even a minor problem with the bones, muscles, ligaments, or tendons in this area can cause pain when a person stands, bends, or moves around. Less often, a problem with a disc can pinch or irritate a nerve from the spinal cord, causing pain that runs down the leg, below the knee called sciatica.
Even with today’s technology, the exact reason or cause of the low back problems can be found in very few people. Most times, the symptoms are blamed on poor muscle tone in the back, muscle tension or spasm, back sprains, ligament or muscle tears, joint problems. Sometimes nerves from the spinal cord (see Figure 1) can be irritated by “slipped” discs causing buttock or leg pain. This may also cause numbness, tingling, or weakness in the legs.
People who are in poor physical condition or do work that includes heavy labor or long periods of sitting or standing are greater risk for low back problems. These people also get better more slowly. Emotional stress or long periods of inactivity may make back symptoms seem worse.
Low back problems are often painful. But the good news is that very few people turn out to have a major problem with the bones or joints of the back or a dangerous medical condition.
Many people who develop mild low back discomfort may not need to see a chiropractor right away. Often, within a few days, the symptoms go away without any treatment.
A visit to your chiropractor is a good idea if:
· Your symptoms are severe.
· The pain is keeping you from doing things that you do every day.
· The problem does not go away within 5 days.
*IMPORTANT NOTE* - If you also have problems controlling your bowel or bladder, if you feel numb in the groin or rectal area, or if there is extreme leg weakness, call you health care provider right away.
Your chiropractor will check to see if you have a medical illness causing your back problem (chances are you will not). Your chiropractor can also help you get some relief from your symptoms.
Your chiropractor will:
· Ask about your symptoms and what they keep you from doing.
· Ask about your medical history.
· Give you a physical exam.
Your chiropractor will want to know about your back problem. Here are some examples of the kinds of questions he or she may ask you:
· When did your back symptoms start?
· Where is the pain specifically located?
· Have you noticed any problem with your legs?
· Is there anything you do that makes the symptoms better or worse?
· Which of your daily activities are you not able to do because of your back symptoms?
Be sure to tell your health care provider about your general health and about illnesses you have had in the past. Here are some questions your health care provider may ask you about your medical history.
· Have you had a problem with your back in the past? If so, when?
· What medical illnesses have you had (for example, cancer, arthritis, or diseases of the immune system)?
· Which medicines do you take regularly?
· Have you ever used intravenous (IV) drugs?
· Have you recently lost weight without trying?
Your chiropractor will examine your back. Even after a careful physical examination, it may not be possible for your chiropractor to tell you the exact cause of your low back problem. But you most likely will find out that your symptoms are not being caused by a dangerous medical condition. Very few people (about 1 in 200) have low back symptoms caused by such conditions. You probably won’t need special tests (blood tests, CT Scan, MRI) if you have had low back symptoms for only a few weeks.
Your chiropractor will help you get relief from your pain and discomfort. A number of treatments help with low back symptoms. The good news is that most people start feeling better soon.
Your chiropractor may recommend one or more of the following to help relieve your pain:
· Heat or cold applied to the back. – Apply a cold pack (or a bag of ice) to the painful area for 15 to 20 minutes at a time. Repeat every 2 to 3 hours.
· Spinal manipulation – This treatment (using the hands to apply force to the back to “adjust” the spine) can be helpful for some people. IT shoulder only be done by a professional with experience in manipulation. Your symptoms shoulder respond to spinal manipulation within 4 weeks.
· Other treatments – a number of other treatments are sometimes used for low back symptoms. While these treatments may give relief for a short time, none have been found to speed recovery or keep acute back problems from returning. They may also be expensive. Such treatments include:
o TENS (transcutaneous electrical nerve stimulation)
o Back Supports
o Bed Rest – If your symptoms are severe, you may need a short period of bed rest. However, bed rest should be limited to 2 to 3 days. Lying down for longer periods may weaken muscles and bones and actually slow your recovery. If you feel that you must lie down, be sure to get up every few hours and walk around – even with minor pain. Feeling a little discomfort as you return to a normal activity is common and does not mean that you are hurting yourself.
Your chiropractor will want to know about physical demands of your job or daily activities. Your chiropractor may need to change some of your activities. You will want to talk to your chiropractor about your own personal situation. In general, when pain is severe, you should avoid:
· Heavy Lifting
· Lifting when twisting, bending forward and reaching.
· Sitting for long periods of time.
While waiting for your back to improve, you may be able to make yourself more comfortable if you:
· Wear comfortable, low-heeled shoes.
· Use a chair with good lower back support that may recline slightly.
· If you must stand for long periods of time, try resting one foot on a low stool.
· If you must drive long distances, try using a pillow or rolled-up towel behind the small of your back. Also, be sure to stop often and walk around for a few minutes.
· If you have trouble sleeping, try sleeping on your back with a pillow under your knees bent and pillow between your knees.
A gradual return to normal activities, including exercise, is recommended. Exercise is important to your overall health. Even you have mild to moderate low back symptoms, the following things can be done without putting much stress on your back:
· Walking short distances
· Using a stationary bicycle
It is important to start any exercise program slowly and gradually build up the speed and length of time that you do the exercise. At first, you may find that your symptoms get a little worse when you exercise or become more active. Usually, this is nothing to worry about. However, if your pain becomes severe, contact your chiropractor.
The best way to prevent low back problems is to stay fit. If you must lift something, even after your back seems better, be sure to:
· Keep all lifted objects close to your body.
· Avoid lifting while twisting, bending forward, and reaching.
You should continue to exercise even after your back symptoms have gone away. There are many exercises that can be done to condition muscles of your body and back. You should talk to your chiropractor about the exercises that would be best for you.