CORE STABILITY: According to Comerford, “The Transverse Abdominis (TvA) has never been shown to be off or weak, even in patients with LBP. It’s only been shown to activate 50-90 milliseconds late only in people with LBP. We know through the research that the TvA timing delay is NOT the cause of the pain, but a symptom of it.”
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The lumbar portion of the spine bears the most body weight and also provides the most flexibility, a combination that makes it susceptible to injury and wear and tear over time. This is why low back pain is so prevalent.
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CORE STRENGTH: According to Dr. McGill, “The differences between those with chronic, recurring back issues and matched asymptomatic controls,” or, people in the studies who have no pain, “have been shown to be variables other than strength or mobility.” In other words, in this research, core strength was not the cause of the sufferers’ pain.
After a thorough review, your doctor probably has come to one or two conclusions as to what is causing your back pain and other symptoms. To obtain more information about your back problem, and to help confirm the diagnosis, the doctor may order an x-ray, CT scan, or MRI. Sometimes lab tests are ordered too. Keep in mind that an accurate diagnosis is essential to a well-developed treatment plan.
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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.
Also, improving the quality and efficiency of how you move versus just improving strength can help you to avoid overusing your back. In other words, exercise technique and form matters, especially if you have LBP.
Analgesic medications are those specifically designed to relieve pain. They include OTC acetaminophen and aspirin, as well as prescription opioids such as codeine, oxycodone, hydrocodone, and morphine. Opioids should be used only for a short period of time and under a physician’s supervision. People can develop a tolerance to opioids and require increasingly higher dosages to achieve the same effect. Opioids can also be addictive. Their side effects can include drowsiness, constipation, decreased reaction time, and impaired judgment. Some specialists are concerned that chronic use of opioids is detrimental to people with back pain because they can aggravate depression, leading to a worsening of the pain.
Aota Y, Iizuka H, Ishige Y, Mochida T, Yoshihisa T, Uesugi M, Saito T. The effectiveness of a lumbar support continuous passive motion device in the prevention of low back pain. Spine. 2007;32:E674–E677. doi: 10.1097/BRS.0b013e318158cf3e. [PubMed] [Cross Ref]
This is the quick but not permanent fix for this problem. Since the underlying cause is weakness in the gluteus medius muscle you will want to back this up with some exercises for your low back that you can do a few times a I show you three options for this. The first is the hip bump against the wall. The second is called the sack swinger, and can be done with a dog leash if you don’t have a formal dip belt. The last is actually doing the same movement that you did for the treatment, but this time as a strengthening exercise for your low back.
The bottom line is that painkillers always come with risks. Unfortunately, if you consult your conventional physician about your chronic back pain, he will often prescribe a long-term treatment plan that may include anti-inflammatory drugs, muscle relaxants and possibly other types of pain medication or even anti-seizure drugs – a poisonous chemical cocktail that will put your health at severe risk!
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Let’s delve into what lumbar cushions are for starters. These are portable cushions designed to provide necessary support to the lower back and attach to your office chair or car seat with little to no hassle. They are generally inexpensive and have a curved profile to complement the natural curve of the spine. There is a wide variety of lumbar support cushions with subtle differences which we will be highlighting in our reviews. They are available in a couple of different designs in a variety of materials touting a number of attractive features which we will help you make sense of. At the end of the guide, you should be able to choose the best lumbar support cushion for your specific needs.
Osteoarthritis is painful and challenging and is caused by wear and tear and getting older. The cartilage that covers the surface joints at the back of the spine becomes worn. This can create bone spurs due to an overabundance of friction there. Any swelling of the joints can happen causing extreme tenderness. Pressure on the nerves can be experienced and range of motion can be inadequate.
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.
Surgical procedures are not always successful, and there is little evidence to show which procedures work best for their particular indications. Patients considering surgical approaches should be fully informed of all related risks. Surgical options include:
Injury to the bones and joints: Fractures (breakage of bone) of the lumbar spine and sacrum bone most commonly affect elderly people with osteoporosis, especially those who have taken long-term cortisone medication. For these individuals, occasionally even minimal stresses on the spine (such as bending to tie shoes) can lead to bone fracture. In this setting, the vertebra can collapse (vertebral compression fracture). The fracture causes an immediate onset of severe localized pain that can radiate around the waist in a band-like fashion and is made intensely worse with body motions. This pain generally does not radiate down the lower extremities. Vertebral fractures in younger patients occur only after severe trauma, such as from motor-vehicle accidents or a convulsive seizure.
Nick Tumminello is the 2016 NSCA Personal Trainer of the Year and the owner of Performance University, which provides practical fitness education for fitness professionals worldwide. He is the author of Strength Training for Fat Loss and Building Muscle and Performance (both books published by Human Kinetics) and has produced 15+ DVDs. He writes a very popular blog at www.NickTumminello.com.
^ a b c d e Vos, T (15 December 2012). Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 380 (9859): 2163–96. doi:10.1016/S0140-6736(12)61729-2. PMID 23245607.
Behavioral therapy may be useful for chronic pain. There are several types available, including operant conditioning, which uses reinforcement to reduce undesirable behaviors and increase desirable behaviors; cognitive behavioral therapy, which helps people identify and correct negative thinking and behavior; and respondent conditioning, which can modify an individual’s physiological response to pain. Medical providers may develop an integrated program of behavioral therapies. The evidence is inconclusive as to whether mindfulness-based stress reduction reduces chronic back pain intensity or associated disability, although it suggests that it may be useful in improving the acceptance of existing pain.
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In a pinch, an easy way to add lumbar support is to roll a towel up and place it behind your back. You can use it in bed, in a sitting position, and even in your car. Depending on the amount of lumbar support you want, you can adjust the thickness of the roll by using small or large towel.
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.
To understand various causes of low back pain, it is important to appreciate the normal design (anatomy) of the tissues of this area of the body. Important structures of the low back that can be related to symptoms in this region include the bony lumbar spine (vertebrae, singular = vertebra), discs between the vertebrae, ligaments around the spine and discs, spinal cord and nerves, muscles of the low back, internal organs of the pelvis and abdomen, and the skin covering the lumbar area.
No specific back exercises were found that improved pain or increased functional ability in people with acute back pain. Exercise, however, may be useful for people with chronic back pain to help them return to normal activities and work. These exercises usually involve stretching maneuvers.
Herbal medicines, as a whole, are poorly supported by evidence. The herbal treatments Devil’s claw and white willow may reduce the number of individuals reporting high levels of pain; however, for those taking pain relievers, this difference is not significant. Capsicum, in the form of either a gel or a plaster cast, has been found to reduce pain and increase function.