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Back PainThe Mayo Clinic describes the various causes of back pain, and suggests when and X-ray, MRI,CAT, bone scan or electrymyography might be needed. Most back pain gets better with a few weeks of home treatment and careful attention. A regular schedule of pain relievers and hot or cold therapy may be all that you need to improve your pain. A short period of bed rest is okay, but more than a couple of days actually does more harm than good. If home treatments aren't working, your doctor may suggest stronger medications or other therapy. In a whole lot of patients, it's a case of strengthening weak muscles. The doctor can't find anything to treat, because medically, nothing's wrong. It's that simple. Here's a long post discussing the process of back pain diagnosis and subsequent rehab, and this is the back strengthening rehab followup post. Download this Dan John GetUP pdf, then scroll down to page three, Matt Spiller's Press Up for Back Pain article. Print, read and re-read. Do you remember an actual injury? Ice is your friend. If the pain isn't too bad, here are some thoughts on training around a back injury.
You ready for a couple of books on strengthen your back and/or back rehab? Look here: Stuart McGill and here Robin McKenzie. Let me ask you this: Is the pain in your upper back and neck, and do you sit at a computer? The fix may be far easier than you think, and faster, too. Or are you just plain sitting too much? Also, before you get too distracted, check out this video on posture and how the body should be aligned. Sloppy posture both at rest and at work is a significant cause of back pain. Here are some tips on correcting posture, and our discussion. Let's get to the rehab! Back and abdominal muscles stabilize the back, so we'll start there. But let's also make sure you're not doing your abdominal work wrong. There are several types of soft tissue massage that are helpful in easing back problems, such as ART (active release therapy) or myo-fascial release — this article describes the pros and cons.
An excerpt from the T-Nation intervew:
"When we test athletes who complain of being tight, and who have been stretching to deal with this sensation, many show their problem to be neurogenic tension – not always tight muscles.
So, while stretching the back, hamstrings, and the like, may feel good as the stretch receptors are stimulated – the neural tissues are stretched causing more stiffness the next day. Worse yet are those who may have stiffness due to disc bulges, and stretching only makes the bulges larger.
Immobility of the hip joint has been shown to be a correlate of back troubles. True hip joint mobility can be trained in some people, but again, the source must be ferreted out. It could be a tight or compromised hip joint capsule, tight muscles, or neural tension.
By the way, in lifters, neural tension usually originates in a lumbar root from a disc bulge. Stretching is contraindicated in this case. The key is to move or change posture to assist the bulge in reducing, then proceed with nerve root flossing techniques, then correct the faulty lifting pattern that caused the bulge in the first place."
Snipped from the Maryland Yoga site, In our culture we have a stiff thoracic spine with relatively hypermobile cervical and lumbar spines. ... In addition, the consistent slump sitting, forward bending movements, and forward head postures contribute to the stiffer, tenser mid backs. ... The mechanical stress of prolonged sitting tightens our hips, dulls our spine, and tenses our neck and shoulder muscles. Cultures that don’t use chairs, but rather sit on the floor as we did as infants and toddlers, maintain normal ranges of motion in their hips and spines. We sit too much in our culture with all the time we spend in cars, at computer workstations, and in easy chairs. Dull sitting causes prolonged spinal flexion and posterior pelvic tilt. Most chairs do not support the pelvis towards neutral or the lumbar spine out of flexion. There's more to research on that site.
Stretching and strengthening the back will help prevent and treat back pain. Check these links: * Spine-health.com on exercises * TheStretchingHandbook.com on back injuries * Spine-health.com on stretching At Globalspine.com you'll find brief descriptions and photos of spine and neck stretches that may be helpful. One popular avenue of alternative treatment is the Mc Kenzie Method, which is basically a program of back extension exercises to offset a rounded back and long-term sloppy posture. You may be able to find a practitioner trained in this to diagnose and suggest exercises, but once you've learned the exercises, full recovery by regular exercising is entirely possible. Here's more on the McKenzie Method, and here's an article covering how to get started on your own. * There is a book by the originator, Robin McKenzie, about which one reviewer writes, "Generally, the Mc Kenzie method works well with stiff spines that have lost the natural lordosis (lower back curvature) required to minimize pressure on the intervertebral discs. For hypermobile lumbar spines, these exercises may make symptoms worse and stabilzation exercises are more appropriate. A good physiotherapist will assess which category you fit into," suggesting, as do some of the other reviews, having a diagnosis is important and self-treatment not always the right option. The Mc Kenzie exercises work very well for many people -- very well, and very quickly. Scott Sonnon examines his experience with the McKenzie Method in this forum article.
Pavel Tsatsouline has a couple of outstanding stretching book/dvd packages. Super Joints will help with beginning a stretching program, while Relax into the Stretch is designed to take things up a notch. Both will absolutely help with posture-related back pain. This is a nice overview of the process of back pain diagnosis and treatment. When does chiropractic work? According to the Mayo Clinic: "Chiropractic treatment is based on the concept that restricted movement in the spine may lead to pain and reduced function. Spinal adjustment (manipulation) is one form of therapy chiropractors use to treat restricted spinal mobility. The goal is to restore spinal movement and, as a result, improve function and decrease back pain." This description of chiropractic comes from the American Chiropractic Association and this page of their site describes back pain and statistics. By the way, every site linked to on this page mentions smoking as a significant cause of back pain. Apparently, smoking impairs blood flow, resulting in oxygen and nutrient deprivation to spinal tissues.
Is osteoporosis causing your back pain? Or arthritis? What can be done about spinal arthritis? * Non-surgical * Surgery, including spine fusion, spinal stenosis or laminectomy Are you overweight, particularly in the mid-section? This is a common cause of back pain, and unless you address it, things will only get worse.
Will acupuncture help with back pain? -- the thinking of the Mayo Clinic. The Family Doctor site offers us this overview of a herniated disk: what it is and what can be done. Pretty much everyone agrees: Herniated discs will often get better without surgery if given attention. And take note, "Too much bed rest may give you stiff joints and weak muscles, which will make it harder to do activities that could help reduce the pain," so say the experts at Spine.org. According to Richard Tyler, D.C., author of Alternative Chiropractic, the DRX9000 machine is effective in curing herniated disc problems, but he adds that a) the machine is expensive (upwards of $100k) and needs to be paid for so overselling can get intense, and b) it takes an MRI to diagnose a herniated disk. The x-rays offered as a free introduction won't do the trick. Dr. Tyler uses a special table that does the same job in his chiropractic office. About low back pain specifically, Byron responded to a recent query with this overview: ''I would definitely buy the Swiss ball first. Stretching on it face down will help relieve pain and decompress the spine, it feels very good if you're a little stiff getting out of bed in the morning. You can do some basic exercises very safely with the swiss ball. The important thing is, the ball molds to your shape underneath you and supports the spine well while you work. Face down on the ball, you can do back extensions and reverse back extensions (reverse leg raises). These will safely strengthen the low back muscles and get some blood in the area. Crunches (face up on the ball) are very basic, reverse crunches are very hard. However the kind of abdominal strength that you build with crunches is probably of secondary importance for a pain free low back. Exercises for the deep abdominals (transverse abdominus, multifidus) such as planks are more important. You can get a lot of info on these on Paul Chek's web site. Static stretching for the hip flexors and hamstrings is very helpful for most people. Tight hip flexors and hamstrings make good posture difficult if not impossible. A simple kneeling lunge stretch for the hip flexors is good. For the hamstrings, a stretch where you lie on your back and raise one leg (straight) at a time works well. You are probably familiar with these stretches. Once you develop some basic static flexibility, working on dynamic flexibility will be helpful. The Core Performance Movement Preparation exercises are very good for this. Developing good posture takes more than just developing the requisite muscular strength and flexibility, it also requires changing habits, which can be more difficult. But ultimately it is good posture that preserves your back. Posture is as important in daily activities as good form is during exercise.'' On a related note, here's an article on pinched nerves in the neck, and how to rehab that. Last edited by Laree. Contributors: Laree, Wicked, and Sharon |