Understanding Acute Low Back Problems
·
Causes
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
Traction
o
TENS (transcutaneous electrical nerve stimulation)
o
Massage
o
Back Supports
o
Ultrasound
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.
Exercise
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
· Swimming
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.
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