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^ a b c Stockwell, Serena (2017-05-01). New Clinical Guideline for Low Back Pain Says Try Nondrug Therapies First. AJN, American Journal of Nursing. 117 (5). doi:10.1097/01.naj.0000516263.01592.38. ISSN 0002-936X.
Table 2 provides details of the descriptive statistics for the CoP LSR. The results of the three-factor ANOVA for the entire sample of participants suggested that there was a significant effect of Condition (p = 0.017) and Epoch (0.028) but not Group (p = 0.095). The lack of any significant interaction effects, however, suggested that the effect of Condition was consistent over Epoch, in that the LSR was consistently lower in the lumbar support condition for both healthy and LBP groups than in the standard chair condition, suggesting greater comfort.
According to Eyal Lederman, Ph.D., an osteopath and author of several manual therapy textbooks and research papers, “There is no correlation between pelvic obliquity/asymmetry and the lateral sacral base angle and LBP. But there may be an association between severe scoliosis and back pain.”
LEG LENGTH ASYMMETRY: According to Dr. Lederman, “Although some earlier studies suggest a correlation, more relevant are prospective studies in which no correlation was found between leg length inequality and LBP. Even who have acquired their leg length differences later in life as consequence of disease or surgery had a poor correlation between leg-length inequality, lumbar scoliosis and low-back disorders several years after the onset of the condition.”
We generally ignore back pain, and only seek medical attention when the pain becomes unbearable. In many cases, timely treatment would help to resolve the issue immediately. However, the prolonged period of neglect aggravates the condition to a point where extensive and aggressive treatment is necessary. Mild back pain that acts up occasionally is usually trivial and may simply be caused by muscle pulls, stiffness or muscle fatigue. But back pain that occurs with increasing frequency or greater severity is usually indicative of a more serious problem.
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Herniated discs develop as the spinal discs degenerate or grow thinner. The jellylike central portion of the disc bulges out of the central cavity and pushes against a nerve root. Intervertebral discs begin to degenerate by the third decade of life. Herniated discs are found in one-third of adults older than 20 years of age. Only 3% of these, however, produce symptoms of nerve impingement.
The prevention of back pain is, itself, somewhat controversial. It has long been thought that exercise and an all-around healthy lifestyle would prevent back pain. This is not necessarily true. In fact, several studies have found that the wrong type of exercise such as high-impact activities may increase the chance of suffering back pain. Nonetheless, exercise is important for overall health and should not be avoided. Low-impact activities such as swimming, walking, and bicycling can increase overall fitness without straining the low back.
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Similar to previous studies investigating healthy individuals [15,16], the results of this study indicated that a lumbar support pad was better at increasing (or preserving) the natural lumbar lordosis in sitting in both healthy individuals and patients with LBP. However, the reverse was seen in the thoracolumbar spine, whereby the neutral curvature was increased with the support pad compared to the standard chair. This is not surprising given the closed-chain nature of the seated task. Changes in one region of the spine may be compensated for by changes in other regions along the linked kinetic chain . Furthermore, use of the lumbar pillow often did not allow participants to make contact with the upper part of the back rest, which may account for the thoracolumbar change. Measures of comfort were not negatively affected, suggesting that any compensations that were employed may have been acceptable.
Surgery may be useful in those with a herniated disc that is causing significant pain radiating into the leg, significant leg weakness, bladder problems, or loss of bowel control. It may also be useful in those with spinal stenosis. In the absence of these issues, there is no clear evidence of a benefit from surgery.
A considerable percentage of patients with back pain experience both occasional bouts of more intense pain as well as more-or-less continuous mild back pain, making it harder for the doctor to determine whether they have acute or chronic back pain.
^ Manchikanti L, Glaser SE, Wolfer L, Derby R, Cohen SP (2009). Systematic review of lumbar discography as a diagnostic test for chronic low back pain. Pain Physician. 12 (3): 541–59. PMID 19461822. Archived from the original on 5 October 2013.
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