Back Pain.
Last updated Tuesday, January 25, 2005
Figure 7 - Angry cat stretch Figure 8 - Double knee pull Figure 11 - The correct way to lift Figure 12 - The incorrect way to lift Management and treatmentTreatment More than 85 percent of people with lower back pain improve with
minimal treatment in a matter of days. However, if back problems
persist, doctors generally prescribe one or more of the following
treatments: proper exercise, rest, heat and cold, posture training, weight loss, stress management and relaxation exercises, medication, spinal manipulation and/or surgery.
For some back conditions, the doctor may refer you to another
specialist such as an orthopedist, rheumatologist, physiatrist,
physical or occupational therapist, psychologist, psychiatrist or
surgeon. Diet Don't be surprised if your doctor recommends weight loss as one way to
reduce your back pain and improve your general health. The best way to
lose weight is with a balanced diet along with regular exercise. Be sure to avoid fad diets or fast weight-loss programs.Exercise and therapy
For many people, the key to a healthy back is proper exercise.
Some exercises are designed to strengthen your back and stomach
muscles, while other exercises are designed to improve your posture. A
30-minute aerobic conditioning program three times a week is ideal for
overall fitness. Walking and/or water exercise are highly recommended for most people with back problems.
The right kind of exercise program may help keep your back problem
under control. It can make it easier for you to continue doing your
daily activities. You may need to take a break from vigorous exercise
if it makes your back pain worse. The exercises shown in figures 5-10
and in the movies may help strengthen the back or improve posture. Ask
your doctor and physical therapist which exercises you can do to
relieve back pain, stay fit, and prevent injuring yourself again.
The Arthritis Foundation and the University of Washington
disclaim any liability for loss, personal or otherwise, resulting from
the exercises presented here. If you have any leg pain or other
evidence of nerve injury, consult you physician before beginning
exercises. DO NOT carry out any exercise that makes your back pain
worse!
Rest
The most common treatment doctors recommend for severe back
pain is bed rest. Different people require different amounts of rest.
Usually, two to three days of staying in bed, except to go to the
bathroom, will be enough to ease your back pain. You may want to ask
the doctor if special pillows or devices are necessary. Sometimes these
aids give additional support to your neck, back or feet.
Hot and cold treatments
Many people have found that hot and cold treatments help relieve back
pain. You might try both to find out which works better for you.
Heat relaxes muscles and soothes painful areas. There are
many ways to apply heat. Some people like hot showers or baths, while
others prefer using heat lamps, heating pads or warm compresses. If you
have arthritis, heating your muscles first might make it easier for you
to do back exercises. Be sure not to fall asleep while using heat.
Cold has a numbing effect. This often helps relieve pain. You might try one of these methods for applying cold:
- an ice bag
- a large ice cube used to massage the area
- a frozen package of vegetables (peas work best)
- a commercially made cold pack.
Be sure not to leave ice on after the skin becomes numb. This
could lead to localized frostbite. Do not use cold if you are
especially sensitive to it or have decreased circulation or sensation.
Read the pain management article for more information about heat and cold.
Posture training
If poor posture is a factor, then posture training may help relieve
your back pain. During posture training, an occupational or physical
therapist will teach you healthier ways to sit, stand, sleep and lift
objects.
Techniques for good posture:
When sitting,
- Sit in a firm chair with armrests to relieve pressure in your back and shoulders.
- Keep
your upper back straight and shoulders relaxed. Keep stomach muscles
pulled in, and maintain the proper curve in your lower back. You can do
this by tightening your stomach and buttocks. Some people are more
comfortable sitting with the back of the chair at a 15- to 20-degree
angle. A small cushion behind the lower back to maintain the natural
curve of the back also can be quite helpful.
- Keep your knees slightly higher than your hips.
- Use a footstool or book under your feet if necessary.
- Keep your feet flat on the floor or other surface.
- Don't sit for a long period of time. Stand up every now and then to stretch tight muscles and give them a chance to relax.
When standing,
- Stand with weight equal on both feet.
- Avoid locking your knees.
- Ease tension in your back by placing one foot on a footstool.
- If you stand for long periods of time, wear flat or low-heeled shoes.
- Keep your back straight by tightening your stomach muscles and buttocks.
When sleeping,
- Lie on your side with your knees bent.
- If more comfortable, place a pillow between your knees while sleeping on your side.
- If
you sleep on your back, ask your doctor or physical therapist if
placing pillows under your knees would help your lower back pain or
make it worse.
- Use a firm mattress.
Body mechanics
To keep good posture while in motion is to use good body mechanics.
In lifting, this means that the object lifted is held close to the body
and that lifting is done with your legs. The normal back curves are
maintained, the legs lift the load. Avoiding twisting your back,
particularly when carrying a load, is also important for good body
mechanics. Move your feet, do not twist your torso. Avoid the incorrect
way; instead, lift correctly (see figures 11 and 12).
- When bending down to lift an object, bend with your knees instead of your back.
- Hold the object close to you.
- Straighten your legs to lift the object.
- Get help with an object that is too heavy.
The type of shoes you wear can also affect your posture. High heels
may put more stress on your lower back by changing your posture. You
might find it more comfortable to wear low or flat heels.
Cushioned-soled shoes also provide "shock absorbency" for your spine.
Movies
Medications
If your back pain is not relieved using other forms of treatment, your
doctor may prescribe medication. The medication chosen depends on the
back pain. For example, medications called analgesics can help relieve
pain. Other medications called muscle relaxants can help relax tight
muscles. If your back pain is caused by arthritis, your doctor can give
you medication that will reduce inflammation as well as relieve your
back pain. The most common medications prescribed are called nonsteroidal anti-inflammatory drugs (NSAIDs).
These medications can reduce inflammation without working like
cortisone, the body's anti-inflammation steroid hormone. Aspirin and
ibuprofen are NSAIDs. Other NSAID medications are prescribed when
needed.
Learn all you can about your medications by asking your doctor or pharmacist questions such as those listed below.
Questions to ask the doctor about medications:
- What will the medication do?
- How long will it take before I notice results?
- What is the name of the medication? Is there a generic brand?
- Are there side effects I should know about?
- How should I take the medication (i.e. before or after meals, with or without food, etc.)?
- How often should I take the medication?
- What should I do if I forget to take a dose at the specified time?
Let your doctor know if you are taking other medications. Sometimes certain medications cannot be taken together.
Surgery People with sciatica or spinal stenosis often benefit from surgery.
A few people with tumors within the spinal canal require it. Other than
that, few people with back pain need surgery. Most people can be
treated successfully with rest, exercise and medication. Surgery does
not always work for many common kinds of back pain, and it is difficult
to know who will be helped and who will not. An orthopedist can help
you decide if a back operation is necessary. It is recommended that you
also seek a second opinion.Unproven remedies It often is difficult to be patient when you are suffering from chronic back pain. You might be tempted to try unproven treatments.
A treatment that promises "a quick cure" or "miraculous relief" can
sound wonderful. But remember, these unproven treatments usually are
expensive and will do nothing for you. The sensational successes you
hear about usually are illusions. They even may be harmful and often
keep you from getting the medical care you really need. If you hear
about a new treatment, discuss it with your doctor and get his or her
advice.
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