Everything about Back Pain

Back Pain is a complex problem and there is no simple answer to the question, “What causes back pain?”
One of the reasons that it is difficult to determine what causes back pain is that there are many structures that can be injured in the lower back (lumbar) region.
You can injure the muscles, the ligaments, the intervertebral discs, the nerve roots, and the cartilage that lines the joints, the bones in the lower back, over even the spinal cord. And of course you can injure multiple structures in the lumbar region.
In addition, you can get referred pain from the hip or the pelvis, and you can even get referred pain from internal organs such as the kidneys.
Back Pain can arise from autoimmune diseases, chronic wear and tear, or trauma or injury.
Okay, I think you get the point that the lower back is complex.
Now, I want to try to simplify back pain and focus on Mechanical Back Pain (associated with osteoarthritis) which one type of problem that affects the lower back.
Mechanical Back Pain or Arthritis primarily affects the cartilage that lines the joints between the vertebrae of the lower back. It is referred to as mechanical back pain because compression (a mechanical phenomenon) is generally the cause of pain.
When the joints get compressed, the cartilage wears away. When the cartilage wears away, your joints get stiff and achy.
Here are some other factors that can contribute to extra pressure on the joints of the lower back.
A sedentary lifestyle and sitting in front of a computer puts extra pressure on the joints of your lower back.
In the American society, one of the major causes of compression in the lower back is sitting (especially in front of a computer). When you sit, your upper body weight is supported only by your lower back compared to when you’re standing your ankle, knee, and thigh muscles take some of the pressure off your lower back.
Bad Posture puts extra stress on the lower back. When your body is not in good alignment, you will have more pressure in the area that is out of alignment and you will also have less stability in that area. Poor Stability and Increased pressure from bad posture may be one contributor to chronic lower back pain.
Weak Abdominal Muscles can increase the pressure on the lower back. The abdominal muscles help to maintain the position of the pelvis and lower back and stop the back from arching excessively. Weak abdominal muscles can be one contributor to chronic lower back pain.
Weak Lower Back Muscles can increase the pressure on the lower back. The lower back muscles just like the abdominal muscles play a major role in stabilizing the lower back. Weak lower back muscles can be a contributor to chronic lower back pain.
Poor Flexibility can increase the pressure on the lower back. When your body is inflexible, it does not move efficiently. If your body is stiff in one area, extra pressure will be placed on another area to make up for the stiffness. Stiff hip, thigh, and back muscles can contribute to lower back pain.
Poor Exercise Technique and Poor Lifting Technique can increase the pressure on the lower back. Incorrect form during exercise and bad body mechanics during lifting will place extra stress on the lower back.
Above is just a quick and simple perspective on mechanical back pain. Prolonged sitting, poor posture, weak abdominal muscles, weak lower back muscles, poor flexibility, and incorrect exercise or lifting technique can all increase the pressure on the cartilage that lines the joints of the lower back.
As a physical therapist, I try to encourage people who suffer from a slightly achy lower back to get up from in front on the computer periodically to move around.
In addition, I encourage people to be mindful of their posture and exercise regularly to strengthen the abdominal and lower back muscles.
And lastly, I encourage people to stretch regularly and use good lifting technique to decrease the pressure on the lower back.

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Lower back pain is a common affliction, with millions each year visiting physicians for relief. Not only will they seek relief, they will want a diagnosis.
It is not always easy to diagnose lower back pain. Many body structures can cause it. There are muscles, ligaments, and tendons; spinal column bones; joints, discs and nerves. In addition to these structures, there may be underlying medical conditions your physician needs to evaluate.
Whether you initially diagnose lower back pain yourself, or leave that to your physician, the diagnosis will need to consider both the location and symptoms of your pain.
Step 1 - Location
The first step is to decide the location. “Where does it hurt?”
1. Axial lower back pain: This lower back pain hurts only in the low back. Pain does not travel into any other area.
2. Radicular lower back pain: This lower back pain hurts in the low back, and also radiates down the backs of the thighs into one or both legs.
3. Lower back pain with referred pain: Diagnose lower back pain with referred pain if it hurts in the low back area, and tends to radiate into the groin, buttocks, and upper thighs. The pain will rarely radiate below the knee, but may seem to move around.
Step 2 - Symptoms
Once you diagnose lower back pain as to location, you will consider symptoms. “How does it feel?”
1. Worsens with certain activities: If you play football, for example, the pain is worse.
2. Worsens in certain positions: Perhaps it gets worse if you stand for too long. Or it is more painful after you sit in a car.
3. Feels better after rest: Resting from the activity or position usually reduces the lower back pain.
4. Deep and steady: Not a sharp muscle catch, this pain is constant and deep within the affected areas.
5. Severe: The pain is excruciating, possibly more so in the calf than the lower back.
6. Numbness and tingling: There may be “pins and needles” within the area.
7. Fleeting pain: Pain may seem to come and go, leaving you unsure at times just how it feels.
8. Achy and dull: Like the flu, this pain is sore and dull, though sometimes intensifying.
9. Migratory: It hurts in one spot, then another.
Diagnosis
AXIAL: If location is best described by number 1 above, and symptoms are a combination of 1, 2, and 3, you can probably diagnose lower back pain as being axial - the most common type. This is also called “mechanical” lower back pain. A variety of back structures can cause axial lower back pain, and it is difficult to identify which is the cause. Axial pain gets better on its own, and about 90% of patients recover within six weeks.
RADICULAR: If location is best described by number 2 above, and symptoms are a combination of 4, 5, and 6, you can probably diagnose lower back pain as being radicular - commonly called sciatica. This lower back pain is caused by compression of a lower spinal nerve, usually the sciatica nerve that runs from the spinal column, down the back of the thighs to the feet. Doctors usually recommend conservative treatment such as physical therapy exercises, medications, and possibly spinal injections, for six to eight weeks.
REFERRED: If location is best described by number 3 above, and symptoms are a combination of 7, 8, and 9, you can probably diagnose your pain as being lower back pain with referred pain - the least common type. This lower back pain is treated the same as axial back pain and frequently goes away as the problem resolves on its own.
How do you diagnose lower back pain?
Diagnose lower back pain with care. You need an accurate diagnosis, which your physician can best make, to be sure no underlying causes need attention. It is not enough to know you have sciatica. You need to know the underlying cause of the sciatica to determine treatment options.
If you do diagnose lower back pain, check the diagnosis with your physician.

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Lower back pain is one of the most common causes of job-related disability and why some people miss work. It is also the second most common neurological ailment in the United States, second only to headache. In fact, approximately 80% of adults in Western countries have, at some point, experienced lower back pain.
For some fortunate people, pain in the lower back may be resolved by itself or with the aid of medication within two to four weeks. However, there are some cases of lower back pain that may last for more than a few weeks, during which case the condition is termed as “chronic” and “progressive,” meaning it can only grow worse over time.
Moreover, 60-80% of those patients who suffer their first episode of lower back pain may experience recurring pain within one year.
According to current research, there are certain muscles in the back that work to stabilize the spine. When the spine or the back suffers an injury, these muscles are reflexively inhibited or shutdown. Worse still, these muscles do not spontaneously recover, and this is true even if patients do not feel pain and are able to return to normal activity levels.
As a result of the inhibition of these muscles, called lumbar multifidi and the transversus abdominus, lower back pain occurs. However, there are steps you can take to prevent the same thing from happening to you.
Lower Back Pain and Physical Therapy
One way to prevent the inhibition of the lumbar multifidi and transversus abdominus is through a series of physical therapy exercises.
Designed to strengthen the muscles of the lower back and keep the spine healthy, these physical therapy exercises may range from back stabilization exercises to muscle strength development and several wide variety of techniques.
In addition, a physical therapist may also recommend such methods as heat therapy, ultrasound, massage, mobilization, and education about posture and body mechanics in order to prevent lower back pain from recurring.
Some of these methods will be discussed later on. You will also find some practical self-help tips provided by experts to help you avoid lower back pain or prevent the condition from worsening.
However, before we head on to learning how lower back pain is treated through physical therapy, it is important that we first understand what causes lower back pain.
Lower Back Pain: CAUSES
There are actually many types of back pain, but the most common is pain in the lower back. Why? You might ask. The reason is simple: you carry most of your weight in the lower back. Thus, it is highly likely that a person would suffer pain in that area.
There is no definitive cause of lower back pain. Sometimes, the causes of the condition are so complex that it is difficult to pinpoint just a single one.
However, physical therapists and other healthcare professionals have observed that lower back pain is often a result of strained back muscles and ligaments due to any of the following activities:
Improper posture
Heavy lifting
Sudden awkward movement
Muscle spasm
Stress
We could all be guilty of the above activities. We may not suffer any back pains now, but it is likely that as we get older and the degree of inhibition of the back muscles as a result of these activities increases, back pain becomes a very distinct possibility.
In addition to these common activities, lower back pain may also result from specific conditions, such as:
Herniated disk (when the disk material presses on a nerve)
Sciatica (when a herniated disk presses on the sciatic nerve. The condition causes sharp, shooting pain through the buttocks and the back of the leg.)
Spinal stenosis (when the space around the spinal cord and nerve roots becomes narrow. This is caused by arthritis and bone overgrowth, the pain resulting from when a nerve gets pinched in the narrow space.)
Spondylosis (a type of arthritis affecting the spine due to degenerative changes brought on by aging)
Spondylolisthesis (when one vertebra in the spinal column slips forward over another)
Lower Back Pain: TREATMENT
The treatment of lower back pain depends on several factors, including the specific type of lower back pain (whether it is chronic or acute) and the purported cause.
For instance, acute lower back pain is commonly treated with pain relieving drugs, such as analgesics, or some forms of exercises that can help relax the muscles.
On the other hand, chronic back pain or one that lasts for more than two weeks and is progressive may be caused by some underlying condition, during which case the treatment plan may consist of resolving the underlying condition to treat the back pain.
Lower Back Pain and Physical Therapy Exercise
Physical therapy exercise is one of the most common methods of treating lower back pain. In fact, many home remedies for lower back pain consist of exercise, because the general theory is that if you remain active, you remain healthy. This is true in most cases.
However, for purposes of this article, the exercises featured here will be those that are practiced by physical therapists to treat patients with lower back pain.
Generally, in physical therapy exercises, the exercise program for back pain should encompass a set of stretching exercises, strengthening exercises, and low impact aerobics. Read below for more on these exercises:
-Stretching
The back of a person is composed of the spinal column and contiguous muscles, ligaments and tendons. All these are designed to move in consonance with each other so that any limitation in the range of motion in any of these components of the back result in back pain.
Stretching for lower back pain specifically targets soft tissues, such as muscles, ligaments and tendons, found in the back and around the spine. By stretching, the spine and soft tissues are mobilized, increasing motion and thus, relieving pain.
There are many kinds of stretching exercises employed by physical therapists. One is the Hamstring Stretching Exercise which works to relax tight hamstrings, a common symptom of lower back pain. This exercise is said to help decrease the intensity of lower back pain among sufferers.
-Strengthening
Physical therapists generally use two forms of strengthening and back pain relief exercises, usually depending on the specific condition of the patient. These are the McKenzie exercises and dynamic lumbar stabilization exercises. However, the two forms of strengthening exercises may also be combined should the therapist find it appropriate to do so.
-McKenzie Exercises
Named after a physical therapist in New Zealand, McKenzie exercises are primarily extension exercises that could help reduce pain generated from the disc space and also may help reduce the symptoms of herniated disc by reducing pressure on a nerve root.
For acute pain, the McKenzie exercises should be done frequently, at least once every two hours. In addition, patients are advised to avoid flexing their spine when exercising.
-Dynamic Lumbar Stabilization Exercises
Using this back exercise technique, the first thing that a physical therapist does is to look for the patient’s “neutral” spine. This refers to the position that allows the patient to feel the most comfortable.
Afterwards, when the patient is in that position, the back muscles are then exercised in order to “teach” the spine how to stay in this position.
Performing these exercises on a regular basis can help strengthen the back muscles and keep the spine well-positioned.
Low Impact Aerobic Exercises
The purpose of low impact aerobic exercise is to recondition the back. Patients who undergo reconditioning of the back through low impact aerobic exercise will have fewer episodes of lower back pain.
In addition, whenever an episode of lower back pain does occur, the pain is less intense and lasts only for a short period.
Another benefit of low impact aerobic exercise is that patients tend to stay functional that is, they can continue with their regular work and carry on with recreational activities. In contrast, patients who do not undergo low impact aerobic exercises typically experience the gradual loss of their functional abilities.
For low impact aerobic exercises to achieve their desired results, they should be continuous. This will increase the heart rate and keep it elevated as well as increase the production of endorphins, which are pain fighting hormones released by the body.
Here are some examples of low impact aerobic exercises that you may want to try in order to lessen or reduce lower back pain:
-Walking
One of the simplest forms of aerobic exercises, walking is generally considered as very gentle on the back. To get the maximum benefit from walking as a form of low impact aerobic exercise, walk two to three miles three times per week.
-Stationary Bicycling
This form of aerobic exercise is less painful on the back since there is lower impact produced. This is beneficial for patients with lower back pain who may find walking too painful.
-Water Therapy
Sometimes referred to as aqua therapy, water therapy is simply doing exercise in the water. The buoyancy works to provide effective conditioning at the same time stress on the back is reduced.

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Lower back pain (also called lumbar pain or backache) is very common. Virtually everyone at some time in their life experiences a backache. Except for the common cold, backaches account for more doctor visits and more missed days of work than any other illness. Typically, lower back pain sufferers experience a sharp pain or dull ache, occasionally accompanied by a tingling or burning sensation. The pain can result from a specific event such as lifting something which is too heavy, but often can be the result of numerous factors which weaken the back, such as sitting in a single position too long, then making a sudden movement. Most commonly, backaches are the result of a muscle strain (where the muscle fibers are stretched or torn) or a lumbar sprain (where the ligaments which tie muscles to bone separate from their attachments). Many problems can result in a backache including herniated, ruptured or degenerated intervertebral disks, structural problems like improper spinal alignment and scoliosis, or pain radiating from the testes, ovaries, kidneys and other tissues. Frequently, the specific structure causing the pain is not identified.
Regardless of the cause, lower back pain typically involves spasms of the muscles along the spine, where the muscles tighten and do not release. These spasms and the associated stiffness can result in severe pain, often leaving patients unable to walk or move normally.
To reduce the pain, a wide range of choices are available. These include applying ice for the first 2-3 days, followed by heat. Over the counter medication such as acetaminophen (Tylenol) or ibuprofen (Motrin, Advil) may provide relief. Many physicians will prescribe Soma (or its generic form carisprodol) to relieve the muscle spasms.
Soma is a muscle relaxant used to relieve the pain and stiffness of muscle spasms and discomfort due to strain and sprain. It blocks signals between nerves in the brain and the spinal cord. It’s action is not completely understood- Soma does not directly relax tense skeletal muscles. Its action may be related to its sedative properties instead. Regardless of the mechanism of action, for many patients the reduction of muscle spasm associated with lower back pain brings considerable relief. For these patients, the back relaxes, pain is reduced, and their ability function normally is enhanced.
Soma comes in a 350 mg round, white tablet. Its onset of action is rapid, and it effects last 4-6 hours. The usual dose is one 350mg tablet 3 times per day and at bedtime. Many patients now order this medication from online pharmacies without visiting a physician in person, so it is important to understand which back symptoms should cause you to visit a physician first. If you experience any of the following symptoms, consult a physician.
- Loss of bladder or bowel control
- Severe back pain following trauma like an object hitting you or a fall
- Fever
- Redness or swelling of the back
- Pain which radiates below the knee
- Weakness or numbness in the leg or pelvis
- Blood in the urine or a burning sensation when urinating
- Very severe pain
It is also important to be aware of the side effects of Soma to assure you are taking it safely and to avoid adverse reactions. Soma is a sedative and can cause drowsiness, dizziness, vertigo, agitation, irritability, headache and insomnia. Occasional allergic reactions are known to occur, including a skin rash and itching. Like all medications, there are very rare idiosyncratic reactions as well. Avoid taking Soma when drinking alcohol, as the alcohol will greatly increase the sedative effect of the medication. Avoid driving or operating machinery when taking this medication.
Lower back pain tends to resolve on its own. Most patients feel significantly better one week after the first onset of pain. After 4-6 weeks, the pain is typically completely resolved.

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There are a number of reasons that caused lower back pain. Some of these reasons include injury to the muscles, discs that support the spinal column or damage to the ligaments, muscle strain and overuse of muscles. If you find lower back pain annoying and would like to cure this, read on to find out some treatments that can help improve your lower back pains.
For a couple of days, choose a resting position that you find comfortable. You can try lying on your side with the pillow positioned in between your knees. Or try lying on your back on the floor then place a pillow beneath your knees. As much as possible, shift positions, never remain in one position for long. Then every two hours, take a ten to twenty minutes walk, after that rest. In cases where you are experiencing pain, take some medicine like acetaminophen or those that reduce the swelling and irritation such as Ibuprofen or Naproxen. These medicines are effective especially when taken regularly as compared to taking these when the pain is severe.
Another way to treat lower back pain is by using a heating pad set on low or medium or buy a single-use heating wraps that can last for 8 hours. Although there is no proof that this method actually works, however, you can try them to find out if this can help.
If you think you are able, resume your normal activities. Moving your muscles help keep these strong. It is not recommended that you stay in bed for more than a day because this will only make your lower back pain worse. Walking is another exercise that can help you with your lower back pain. Your physician may also recommend some other exercises that can make your back muscles stronger. Some of the exercises that your doctor may advise you to take can actually strengthen the trunk muscles, core and the spine. Strengthening your muscles usually lead to posture improvement, body balance and decreases the occurrence of injury.
There are other therapies that you may find helpful on reducing your lower back pain. A therapeutic massage can help ease the muscle spasm at your back. While spine adjustment or manipulation through an osteopath, physical therapist or chiropractor achieves the same effect of easing back muscle spasm. Many people will notice that there is a considerable improvement after a single session of therapy and sometime further spine manipulation is not necessary.
Another technique in the treatment of lower back pain involves biofeedback or Cognitive-behavioral therapy. This therapy is used for controlling pain and anything that trigger pain. For more information about this therapy, you can consult with a psychologist, or clinical social workers who are knowledgeable in pain management.
On the other hand, some people suffering from lower back pain prefer alternative treatment such as acupuncture to help them with their condition. There are studies that prove acupuncture to be effective with reducing pain and disabilities connected to back problems.

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