There is moderate quality evidence that suggests the combination of education and exercise may reduce an individual’s risk of developing an episode of low back pain. Lesser quality evidence points to exercise alone as a possible to the risk of the onset of this condition.
THE TAKEAWAY: Attempts to “release” or inhibit the Psoas through manual techniques is misguided. Stretching your hip flexors (illiacus, rectus femoris) is okay, but doing so isn’t stretching your psoas. Also, remember that tight hip flexors have not been shown to be associated with excessive lumbar lordosis, anterior pelvic tilt, or as a cause of LBP.
Low back pain is second only to the common cold as a cause of lost days at work. It is also one of the most common reasons to visit a doctor’s office or a hospital’s emergency department. It is the second most common neurologic complaint in the United States, second only to headache.
In most cases of low back pain, medical consensus advises not seeking an exact diagnosis but instead beginning to treat the pain. This assumes that there is no reason to expect that the person has an underlying problem. In most cases, the pain goes away naturally after a few weeks. Typically, people who do seek diagnosis through imaging are not likely to have a better outcome than those who wait for the condition to resolve.
Does that mean you shouldn’t seek treatment when your back locks up? Of course not. Just know that it’s unrealistic to credit any one particular treatment or special exercise method as the magic cure for acute back pain. When a back pain professional says, “I know what your problem is and I know how to cure it,” listen, but be skeptical. This person may be able to help you. But when you consider the time and financial investment involved, remember the scientific facts. No one can predict how one individual will respond to one type of back pain treatment.
Always stretch before any strenuous physical activity. In fact, I strongly advise you to engage in a regular stretching program. My favorite is active isolated stretching (AIS), developed by Aaron Mattes. It’s completely different from the traditional type of stretching, and is a great way to get flexibility back into your system.
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Use of a lumbar support pillow that allows space for the posterior pelvic bulk significantly decreased lumbar flattening during sitting in healthy individuals and patients with LBP. However, thoracolumbar curvature was increased. The difference in angular change was small and further study is required to determine clinical relevance over the long term. Furthermore, an objective measure of comfort was improved with the pillow but subjective reports on comfort were not significantly affected. Future studies should investigate the long term clinical benefit of using a lumbar pillow in males and females with a higher intensity of LBP.
My opinion is that people should not go longer than 30 minutes in a chair without standing, deep breathing, walking and stretching. If you think I am crazy for asking that much of you, then I suggest you not go longer than 20 minutes.
^ Cramer H, Haller H, Lauche R, Dobos G (2012). Mindfulness-based stress reduction for low back pain. A systematic review. BMC Complement Altern Med. 12: 162. doi:10.1186/1472-6882-12-162. PMC 3520871 . PMID 23009599.
Electromyogram or EMG is defined as a test that records the electrical activity of muscles. Normal muscles produce a typical pattern of electrical current that is usually proportional to the level of muscle activity. Diseases of muscle and/or nerves can produce abnormal electormyogram patterns.
Low back pain (LBP) is a common disorder involving the muscles, nerves, and bones of the back. Pain can vary from a dull constant ache to a sudden sharp feeling. Low back pain may be classified by duration as acute (pain lasting less than 6 weeks), sub-chronic (6 to 12 weeks), or chronic (more than 12 weeks). The condition may be further classified by the underlying cause as either mechanical, non-mechanical, or referred pain. The symptoms of low back pain usually improve within a few weeks from the time they start, with 40-90% of people completely better by six weeks.
Pregnancy commonly leads to low back pain by mechanically stressing the lumbar spine (changing the normal lumbar curvature) and by the positioning of the baby inside of the abdomen. Additionally, the effects of the female hormone estrogen and the ligament-loosening hormone relaxin may contribute to loosening of the ligaments and structures of the back. Pelvic-tilt exercises and stretches are often recommended for relieving this pain. Women are also recommended to maintain physical conditioning during pregnancy according to their doctors’ advice. Natural labor can also cause low back pain.
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THE TAKEAWAY: Age or being overweight isn’t a guaranteed back pain sentence. And, back pain shouldn’t be blown off as simply a side effect of these issues. Losing excess weight is always a good idea for overall health, but having LBP while overweight doesn’t mean you won’t have future bouts of back pain after losing the weight.
Spondylolisthesis: Spondylolisthesis is the partial forward movement (dislocation) of one vertebra over the one below it. Usually, the fifth lumbar (low back) vertebra is dislocated over the first sacral (tail bone) vertebra.
In his “Myths and Misconceptions about Psoas Major: Where is the Evidence?” Comerford states, ”There is almost no evidence for psoas being short; it does not produce significant movement in the spine; it has a significant stability role for the lumbar spine, the sacroiliac joint, and the hip; and, like the TvA, the psoas has been shown to have delayed activation in the presence of LBP.” So again, delay in psoas activation is a symptom of back pain, not a cause.
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Be mindful that these life-threatening side effects of painkillers are not restricted to prescription NSAIDs like Celebrex, but may also come from over-the-counter drugs like aspirin, Advil, and Motrin.
Intradiscal electrothermal therapy (IDET) is a treatment for discs that are cracked or bulging as a result of degenerative disc disease. The procedure involves inserting a catheter through a small incision at the site of the disc in the back. A special wire is passed through the catheter and an electrical current is applied to heat the disc, which helps strengthen the collagen fibers of the disc wall, reducing the bulging and the related irritation of the spinal nerve. IDET is of questionable benefit.
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In addition to good back support while sitting, it’s best to try to avoid sitting in the same position for more than thirty minutes at a time. If possible, stand up, stretch, and walk around a bit before returning to the sitting position.
In human anatomy the five vertebrae in the lumbar region of the back are the largest and strongest in the movable part of the spinal column, and can be distinguished by the absence of a foramen in the transverse process, and by the absence of facets on the sides of the body. In most mammals, the lumbar region of the spine curves outward.
M-Pranesh A, Rakheja S, Demont R. Influence of support conditions on vertical whole-body vibration of the seated human body. Ind Health. 2010;48:682–697. doi: 10.2486/indhealth.MSWBVI-25. [PubMed] [Cross Ref]
^ a b Vinod Malhotra; Yao, Fun-Sun F.; Fontes, Manuel da Costa (2011). Yao and Artusio’s Anesthesiology: Problem-Oriented Patient Management. Hagerstwon, MD: Lippincott Williams & Wilkins. pp. Chapter 49. ISBN 1-4511-0265-8. Archived from the original on 8 September 2017.