LOW BACK PAIN

Low back pain. a very common complaint among adults, ranges from I can’t sit or stand to mild pain in the lower back also referred to as the lumbar spine.

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Leroy had gone to many surgeons, with low back pain that had been there for years. He went to 6 physicians to be exact, and no one could diagnose or alleviate his pain. Leroy endured extreme pain for years, no one had ever heard of his pain and symptoms. He had gotten to the point that he couldn’t stand for longer than 10 minutes or walk for any distance. Leroy had surgery with Dr. Richard Hostin, Southwest Scoliosis and Spine Institute. “He feels like a normal person again after 10 to 20 years of pain! Dr. Hostin took care of my back and I feel great! ~ Leroy Foster – Low Back Pain Patient.

The Doctors and Surgeons at the Southwest Scoliosis and Spine Institute are experts at stopping low back pain

Low Back Pain

The spine, one of the most important parts of your body, provides the ability to keep yourself upright and stand up. It gives your body structure and support. It allows you to move about freely and bend with flexibility. The spine protects your spinal cord and has 33 vertebrae that interlock with each other to form the spinal column.

Low Back Pain The spinal cord, a column of nerves that connects your brain with the rest of your body, allows the control of body movements. A spinal cord injury (SCI) can occur anywhere along the spinal cord and causes a loss of communication between the brain and the parts of the body below the injury. Without a spinal cord, you could not move any part of your body, and your organs could not function. The preceding text clearly says that keeping your spine healthy remains vital if you want to live an active life.

Anatomy of the Lower Back

The parts of your spine and how they work

Your spine contains 24 small bones (vertebrae) that stack on top of each other to create the spinal column. Between each vertebra, exists a soft, gel-like cushion called a disc that helps absorb pressure and keeps the bones from rubbing against each other. Each vertebra connects to the others by groups of ligaments. Ligaments connect bones to bones, tendons connect muscles to bones. Then tendons fasten muscles to the vertebrae. The spinal column also has real joints (just like the knee or elbow or any other joints) called facet joints. The facet joints link the vertebrae together and give them the flexibility to move against each other.

Questions and Answers

What are the causes of Low Back Pain?

Low back pain can have various causes, including muscle strains or sprains, herniated discs, degenerative disc disease, spinal stenosis, sciatica, osteoarthritis, and poor posture. Other factors such as obesity, a sedentary lifestyle, poor lifting techniques, and underlying medical conditions can also contribute to low back pain.

How Can Low Back Pain be managed or relieved?

The management of low back pain depends on its underlying cause and severity. Treatment options may include:

Rest and activity modification: Initially, resting the affected area and avoiding activities that worsen the pain can help alleviate symptoms.
Pain medications: Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) or prescribed pain medications can provide temporary relief.
Physical therapy: Specific exercises and stretches can help strengthen the muscles supporting the spine, improve flexibility, and promote proper posture and body mechanics.
Heat or cold therapy: Applying heat or cold packs to the affected area can help reduce pain and inflammation.
Manual therapy: Techniques such as chiropractic adjustments or massage therapy may be beneficial in some cases.
Injections: Doctors often recommend Corticosteroid injections or nerve blocks for targeted pain relief, especially if conservative measures do not work effectively.
Lifestyle modifications: Maintaining a healthy weight, engaging in regular exercise, adopting good posture habits, and avoiding prolonged sitting or heavy lifting can help prevent or manage low back pain.

When should I seed Medical Attention for my Low Back Pain

While most cases of low back pain resolve with conservative measures, it’s important to consult with our spine experts if the pain:

Worsens over time.
Also comes with neurological symptoms such as numbness, tingling, or weakness in the legs.
Follows a traumatic injury or accident.
Also comes with bowel or bladder dysfunction.
Interferes with daily activities or quality of life.

The Spine experts at Southwest Scoliosis and Spine Institute can conduct a thorough evaluation, diagnose the underlying cause, and recommend appropriate treatment options based on individual circumstances.

Upon examining the vertebra, doctors observe a hole in the center, so when they stack on top of each other they form a hollow tube that holds and protects the entire spinal cord and its nerve roots. The spinal cord contains a large collection of nerve tissue that carries messages from your brain to the rest of your body. In order for your body to function, you need your nerves. The spine branches off into thirty-one pairs of nerve roots. These roots exit the spine on both sides through spaces (neural foramina) between each vertebra.

Spinal Segments

A spine has three main segments: the cervical spine, the thoracic spine, and the lumbar spine. The cervical spine, the upper portion, contains seven vertebrae (bones). The thoracic, in the center portion of the spine, consists of 12 vertebrae. A lower portion of the spine called the lumbar spine, usually contains five vertebrae; however, some people may have six lumbar vertebrae. Having six vertebrae does not seem to cause a problem.

Back specialists sometimes look at a spinal segment to understand and explain how the whole spine works. A spinal segment consists of two vertebrae attached together by ligaments, with a soft disc separating them. The facet joints fit between the two vertebrae, allowing for movement, and the neural foramen between the vertebrae allows space for the nerve roots to travel freely from the spinal cord to the body.

The spinal segment allows us to focus on the repeating parts of the spinal column to better understand what can go wrong with the various parts of the spine. Sometimes problems in the spine involve only one spinal segment, while other times the problems involve multiple segments.

Each spinal segment works like a well-tuned part of a machine. All of the parts should work together to allow weight-bearing, movement, and support. When all the parts are functioning properly, all spinal segments join to make up a remarkably strong structure called the spinal column. When one segment deteriorates to the point of instability, it can lead to problems in that segment causing pain and other difficulties.

Specific Parts of the Spine

A Sacrum

A sacrum, a group of specialized vertebrae, connects the spine to the pelvis. During development (those nine months before birth), these vertebrae grow together (or fuse) creating one large “specialized” vertebral bone that forms the base of your spine and the center of your pelvis. The nerves that leave the spine in the sacral region control the bowel and bladder functions and give sensation (feeling) to the crotch area.

Vertebrae

The individual bones of the spine are the vertebrae. These are the building blocks of the spinal column. The vertebrae protect and support the spinal cord. They also bear the majority of the weight put upon your spine. The body of each vertebra contains a large round bone, which attaches to a bony ring. When the vertebrae are stacked one on top of the other, this ring creates a hollow tube for the spinal cord to pass through.

The bony ring attached to the vertebral body consists of several parts. First, the laminae extend from the body to cover the spinal canal, the hole in the center of the vertebrae. Second, the spinous process refers to the bony portion opposite the body of the vertebra. You feel this part if you run your hand down a person’s back. Then there are two transverse processes (little bony bumps), where the back muscles attach to the vertebrae. Finally, the pedicle refers to a bony projection that connects both sides of the lamina.

The vertebra, like all bones, has an outer shell called cortical bone. The inside contains a soft, spongy type of bone called cancellous bone.

Intervertebral Disc

The intervertebral discs are flat, round “cushions” that act as shock absorbers between each vertebra in your spine. Only one disc fits between each vertebra. Each disc has a strong outer ring of fibers called the annulus, and a soft, jelly-like center called the nucleus pulposus.

The annulus refers to the disc’s outer layer and the strongest area of the disc. It also helps keep the disc’s center intact. The annulus connects each vertebra together by a strong ligament.

The mushy nucleus of the disc serves as the main shock absorber. A nucleus consists of moist tissue because it contains high water content. The water content helps the disc act like a shock absorber – somewhat like a waterbed mattress.

Facet Joint

The facets are the “bony knobs” that meet between each vertebra to form the facet joints that join your vertebrae together. There are two facet joints between each pair of vertebrae, one on each side. They extend and overlap each other to form a joint between the neighboring vertebra facet joints. Without the facet joints, you would not have flexibility in your spine, and you could only move in very straight and stiff motions.

The facet joints are what are known as synovial joints. A synovial joint, such as the knee or elbow allows movement between two bones. In a synovial joint, the ends of the bones are covered with a material called articular cartilage. This material, a slick, spongy material, allows the bones to glide against one another without much friction.

A watertight sack made of soft tissue and ligaments surrounds the facet joints. This sack creates the “joint capsule”. The ligaments are soft tissue structures that hold the two sides of the facet joint together. The ligaments around the facet joint combine with the synovium to form the joint capsule filled with fluid (synovial fluid). This fluid lubricates the joint to decrease friction, just like oil lubricates the moving parts of a machine.

Neural Foramen

The neural foramen refers to the opening between every two vertebrae where the nerve roots exit the spine. The nerve roots travel through the foramen to reach the rest of your body. There are two neural foramina between each pair of vertebrae – one on each side. Without the foramen, nerve signals could not travel to and from the brain to the rest of your body. Without nerve signals, your body would not function properly.

Spinal Cord

The spinal cord, a column of millions of nerve fibers, runs through your spinal canal. It extends from the brain to the area between the end of your first lumbar vertebra and the top of your second lumbar vertebra. At the second lumbar vertebra, the spinal cord divides into several different groups of fibers that form the nerves that will go to the lower half of the body. For a small distance, the nerves actually travel through the spinal canal before exiting out the neural foramen. This collection of nerves refers to the cauda equina while inside the spinal canal.

A protective membrane called the dura mater covers the spinal cord. The dura mater forms a watertight sack around the spinal cord and the spinal nerves. Inside this sack, the spinal cord contains fluid.

Nerve Roots

The nerve fibers in your spinal cord branch off to form pairs of nerve roots that travel through the small openings (foramina) between your vertebrae. The nerves in each area of the spinal cord connect to specific parts of your body. Therefore, damage to the spinal cord can cause paralysis in certain areas and not others — it depends on which spinal nerves become affected. The nerves of the cervical spine go to the upper chest and arms. The nerves in your thoracic spine go to your chest and abdomen. And finally, the nerves of the lumbar spine then reach your legs, bowel, and bladder. Thus, these nerves coordinate and control all the body’s organs and parts, and let you control your muscles.

The nerves also carry electrical signals back to the brain that allow you to feel sensations. If your body is being hurt in some way, your nerves signal to the brain that you have been hurt. Damage to the nerves themselves can cause pain, tingling, or numbness in the area where the nerve travels.

Paraspinal Muscles

The paraspinal muscles refer to the muscles next to the spine. They support the spine and are the motor for the movement of the spine. Your joints allow flexibility and your muscles allow mobility. There are many small muscles in the back – each controlling some part of the total movement between all the vertebrae and the rest of the skeleton. These muscles can get injured directly, such as when you have a pulled muscle or muscle strain of the back muscles. The muscles can also cause problems indirectly, such as when the muscles are in spasm after injury to other parts of the spine.

Lumbar Spine where Low Back Pain occurs

Doctors refer to the lowest part of the spine as the lumbar spine. This area has five vertebrae. However, sometimes people are born with a sixth vertebra in the lumbar region. The base of your spine (sacrum) consists of a fusion of many bones, and when one of them forms as a vertebra rather than part of the sacrum, it is called a transitional (or sixth) vertebra. This occurrence is not dangerous and does not appear to have any serious side effects.

A lumbar spine’s shape has what is called a lordotic curve. The lordotic shape is like a backward “C”. If you think of the spine as having an “S” shape, the lumbar region refers to the bottom of the “S”. The vertebrae in the lumbar spine area are the largest of the entire spine, so the lumbar spinal canal is larger than the cervical or thoracic parts of the spine. Because of its size, the lumbar spine has more space for the nerves to move about.

Low back pain is a very common complaint for a simple reason. Often, it is an acute back pain that doesn’t last long. Since the lumbar spine is connected to your pelvis, this is where most of your weight-bearing and body movement takes place. Typically, this is where people tend to place too much pressure, such as: lifting up a heavy box, twisting to move a heavy load, or carrying a heavy object. Such repetitive injuries can lead to damage to the parts of the lumbar spine.

Causes of Low Back Pain

Back pain can occur from a number of spinal conditions, and below are descriptions of various causes of discomfort:

Mechanical pain

Mechanical pain is often referred to as back strain because is linked with the movement, or “the mechanics” of the spine. This type of pain occurs when an injury to the spine’s discs, facet joints, ligaments, or muscles results in inflammation. It is called mechanical pain because it relates to the mechanics of your spine. The more you use the back, the more it hurts. This pain can be generated from many conditions in the spine. These conditions include fractures of the vertebra, muscle strains in the paraspinal muscles, ligament injuries in the spine, and wear and tear of the spine’s joints and discs.

Compressive pain

Compressive pain is often a result of pressure or irritation on the spinal cord, or nerves that leave the spine. For example, if an intervertebral disc herniates (usually called a ruptured disc) and pushes into the spinal canal, it can cause problems with the nerve. Usually, this pressure or irritation causes pain, numbness, and muscle weakness where the nerve travels.

Each part of the spine can cause pain. It helps to understand which part of the spine causes back pain and whether the pain emanates from a compressive or mechanical type of problem.

Arthritis Pain

The term arthritis means inflammation of the joints. Arthritis of the spine usually refers to a condition where there is inflammation of the facet joints between the vertebrae. The pain, from this medical condition, that results from arthritis is usually the mechanical type of back pain. If bone spurs develop due to arthritis and begin rubbing on the spinal nerves, it will produce a compressive type of pain. There are two types of arthritis: systemic inflammatory arthritis, and wear-and-tear arthritis. A systemic type of arthritis is actually a disease process that affects all the joints of the body – such as rheumatoid arthritis or ankylosing spondylitis. Many arthritis-type diseases affect the connective tissues of the body. All of these diseases cause inflammation of the joint tissues and the destruction of the joints.

Facet Joint Syndrome

Sometimes the facet joints are the main cause of back pain. In many cases, the facet joints are at least part of what is causing your back pain. When your doctor thinks the facet joints are a major source of your pain, he may use the term “facet joint syndrome”. The causes of facet joint degeneration, or osteoarthritis relate to a combination of aging, pressure overload of the facet joints, and injury.

Pressure overload on the facet joints is probably caused by the degeneration of the intervertebral disc. As the discs degenerate, they wear down and begin to collapse. This narrows the space between each vertebra. This narrowing of the space between each vertebra affects the way the facet joints line up. When this occurs, it places too much pressure on the articular cartilage surface of the facet joint. The excessive pressure leads to damage to the articular surface and eventually, the cartilage begins to wear away.

When facet joint arthritis gets bad enough, the cartilage and fluid that lubricate the facet joints are eventually destroyed as well, leaving bone rubbing on bone. Bone spurs begin to form around the facet joints. When bone spurs develop, they can take up space in the foramen (the opening between vertebrae where nerve roots exit the spine) and press into nerve roots. As the bone spurs begin to grow larger, they can eventually extend into the spinal canal itself. This leads to the narrowing of the spinal canal (spinal stenosis).

Pinched Nerve (Radiculopathy)

Lumbar Radiculopathy is the medical term used to describe a “pinched nerve” in the spine and the lower back pain with it. A radiculopathy occurs when a nerve is irritated by something that is either rubbing on the nerve or pressing on the nerve. In some cases, such as a herniated (or ruptured) disc, a chemical reaction may cause an irritation of the nerve. Chemicals released from the inside of the disc seem to irritate nerve tissue, causing pain and inflammation of the nerve.

Abnormal pressure or irritation on a particular nerve causes several problems. First, there is numbness in the area where the nerve usually provides a sensation or feeling. For example, if the nerve usually ends in the side of the foot and supplies sensation to that area, it will have decreased feeling, and often pain.

The key to understanding radiculopathy is understanding that your brain cannot tell where the problem really is. While the irritation or pressure on the nerve may exist in your back, your brain thinks the pain is coming from your foot. In addition, the muscles that the nerve usually controls will not work right. You will usually have weakness in the muscles, and the reflexes controlled by the muscles will not work. This is why doctors always check reflexes. The body has a pretty standard wiring diagram. By determining which reflexes are not working, the doctor can usually tell which nerve is involved with the problem.

Things that can cause Lumbar radiculopathy include herniated discs, bone spurs, tumors that are growing into the nerves, and fractures that put pressure on the nerves.

Sciatica

The term sciatica refers to a certain type of radiculopathy that occurs in the leg. It is called sciatica because it describes the radiculopathy that occurs when one or more of the nerves that make up the large sciatic nerve are irritated or pinched. Therefore, sciatica is not any different than a pinched nerve anywhere else in the spine. It simply has its own name because it is fairly common. It also occurs in the lumbar spine, the most common site of spinal nerve irritation.

Sciatica is used to describe the pain that travels from the sciatic nerve in the lumbar region into your buttocks, back of the thighs, and sometimes calf and foot. The pain is typically caused by irritation of the nerve roots that join outside the spine to make up the sciatic nerve. Conditions that can cause sciatica are herniated discs, bone spurs, cancerous tumors that are growing into the nerves, and fractures that put pressure on the nerves.

Spinal Stenosis

We have seen how individual nerve roots are affected by pressure and irritation, but what about the spinal cord itself? Pressure on the spinal cord typically results from a condition called stenosis. Stenosis means the narrowing of an opening or tube – in this case, the spinal canal. Spinal stenosis is a term commonly used to describe a narrowing of a portion of the spinal canal. Stenosis can occur in all areas of the spine, but it is most common in the cervical and lumbar spine. There can often be a narrowing of most of the lumbar spinal canal and of several segments of the cervical spine. Each behaves somewhat differently.

If anything begins to narrow the spinal canal, the risk of irritation and injury of the spinal cord or nerves increases. Some conditions that can lead to the narrowing of the spinal canal include infection, tumors, trauma, herniated discs, arthritis, thickening of ligaments, growth of bone spurs, and disc degeneration.

The narrowing of the spinal canal can lead to irritation of the nerves of the spine. This can cause pain and problems with the nerves not working right. The lack of space can also reduce the supply of blood and oxygen to the spinal cord. When the spine needs more blood flow during increased activity, the blood vessels may not swell to get more blood to the spine. This can lead to numbness and pain in the affected nerves. The nerves also lose some of their mobility when the space available to them is reduced. This leads to irritation and inflammation of the nerves.

Discogenic pain

Discogenic Pain is the term back specialists use when referring to pain caused by a damaged intervertebral disc. A degenerating disc may cause pain in the mechanical type. As the disc begins to degenerate, there is some evidence that the disc itself becomes painful. Movements that place stress on the disc can result in back pain that appears to come from the disc. This is similar to any other body part that is injured, such as a broken bone, or even a cut in the skin. When these types of injuries are held still, there is no pain. However, if you move a broken bone or the skin around a cut, it causes pain.

Discogenic pain usually causes pain felt in the lower back. It may also feel like the pain is coming from your buttock areas and even down into the upper thighs. The experience of feeling pain in an area away from the real spot causing the pain is common in many areas of the body, not just the spine. Examples include: a person who has gallstones may feel pain in their shoulder or a person experiencing a heart attack may feel pain in the left arm. This is called radiation of the pain. It is very common for patients with spine conditions (bulging discs) to experience pain in different areas of the body, including the back itself.

Bulging Disc

Bulging discs are fairly common in both young adults and older people. They are not a cause for panic. In fact, abnormalities that show up on MRIs, such as bulging or protruding discs, are seen at high rates in patients both with and without back pain. Most likely, some discs begin to bulge as a part of the aging process and the degeneration process of the intervertebral disc. A bulging disc is not necessarily a sign that anything serious is happening to your spine.

A bulging disc becomes important when it bulges enough to cause the narrowing of the spinal canal. If there are bone spurs present on the facet joints behind the bulging disc, the combination may cause a narrowing of the spinal canal in that area. This is sometimes referred to as segmental spinal stenosis.

Herniated Disc

A herniated disc occurs when the intervertebral disc’s outer fibers (the annulus) are damaged and the soft inner material of the nucleus pulposus ruptures out of its normal space. If the annulus tears near the spinal canal, the nucleus pulposus material can push into the spinal canal. This can cause added pressure on the spinal cord and nerve roots. There is also some evidence that the nucleus pulposus material causes a chemical irritation of the nerve roots.

Both the pressure on the nerve root and the chemical irritation can affect how the nerve root works. The combination of the two can cause pain, weakness, and/or numbness in the area of the body to which the nerve travels. For this reason, a herniated disc usually causes pain of the compressive type. Sometimes a herniated disc is referred to as a “slipped disc”, though the disc does not actually slip. A lumbar herniated disc will cause pain in the lower back.

Degeneration of the Intervertebral Disc

The process of degeneration of the intervertebral disc causes many problems in the spine. Everything you do during the day – once you stand upright – begins to test the spine’s ability to support your body weight. Over time, these repeated daily stresses and minor injuries can add up and begin to affect the discs in your spine. Minor injuries to a disc may occur and not cause pain at the time. However, as they add up, the disc eventually begins to suffer from wear and tear, and Disc Degeneration begins.

There is an intervertebral disc between each of your vertebrae. The intervertebral discs are designed to absorb pressure and keep the spine flexible by acting as cushions during body movement. The discs work similarly to shock absorbers. They are like cushions in running shoes without them, a jogger would feel every pound on the pavement, and the feet would soon tire out. Without the cushion effect of the discs, the vertebrae in your spine would probably fracture or break. Bones cannot sustain high stress repeatedly without being cushioned.

Diagnosing Low Back Pain

Before a healthcare professional can diagnose your condition and design a treatment plan, a complete history and physical examination are necessary. There are so many possible internal causes of pain, and it is important to determine what is and is not causing the problem. After the physician has a better idea of what is attributing to your discomfort, diagnostic tests of some sort may be recommended.

History of Low Back Pain

First, you will provide your doctor with a complete physical history of your condition. This may begin by filling out a written form that asks you a number of questions relating to your pain. The more information you share with your doctor, the easier problem will diagnose the cause of the condition. Your physical history is important because it helps your doctor understand: when the pain began, anything that could have caused an injury, your lifestyle, physical factors that might be causing the pain, and your family history of similar problems. After reading through your written history, your physician will ask more questions that relate to the information you have given. Some typical questions include:

When did the pain begin?
Was there an injury that could be related to the pain?
Where do you feel the pain? What is the intensity?
Does the pain radiate to other parts of the body?
What factors make the pain feel better or worse?
Have you had problems with your bladder or bowels?
Is there a history of osteoporosis in your family?

Physical Examination

After taking your history, the physician will give you a physical examination. This allows the doctor to rule out possible causes of pain and try to determine the source of your problem. The areas of your body that will be examined depend upon where you are experiencing pain – neck, lower back, arms, legs, etc. The following are some of the things that are checked in a typical exam:

The motion of the Spine and Neck – Is there pain when you twist, bend, or move? If so, where? Have you lost some flexibility?
Weakness – Your doctor will test your muscles for strength. The doctor will ask you to try to push or lift your arm, hand, or leg when light resistance is applied against them.
Pain – The doctor may try to determine if you have tenderness in certain areas.
Sensory Changes – Can you feel certain sensations in specific areas of the feet or hands?
Reflex Changes – Your doctor may test your reflexes, such as under the kneecap and under the Achilles tendon on your ankle.
Motor Skills – Your doctor might request a toe or heel walk.
Special Signs – The physician will also check for any “red flags” that could indicate something other than spinal/vertebrae problems. Some signs of other problems include tenderness in certain areas, a fever, an abnormal pulse, chronic steroid use (which leads to loss of bone mass), or rapid weight loss.

Treatments for Low Back Pain Include:

On your first visit to a back specialist, the initial decision will determine the seriousness of the condition. Chronic back pain needs immediate attention – possibly even surgery. However, the vast majority of back problems do not require surgery and are considered acute low back pain. Once the doctor identifies the most likely cause of your pain, you and your doctor can decide on a treatment plan.

A variety of treatment options exist for different types of back pain, and in most cases, simple therapies such as mild pain medications and rest, are effective in relieving the immediate pain. The overall goal of treatment is: to make you comfortable as quickly as possible, to design a program to reduce further degeneration, and to get you back to normal activity as soon as possible. The more you know about how your back works and what you can do to prevent further injury, the more effective your program will be. Below are descriptions of the most common forms of treatment, along with a brief explanation of what each is designed to do.

Conservative Treatment

Back specialists often use the term “conservative treatment” to describe any treatment option that does not involve surgery. Therefore, you may hear, or read in your records, that your provider is recommending a course of conservative treatment for your back problem. Treatment for your back problem may be as simple as reassuring you that it is not a serious problem and doing nothing but watching and waiting. However, usually, anyone who has a back problem that becomes symptomatic should consider some preventive measures.

This usually means that you should learn more about how to protect your back and consider beginning exercises to strengthen your back. These exercises can be quick and easy to do, do not require any special equipment, and can help prevent problems later.

A variety of treatment options exist for back pain that is the result of degeneration (wear and tear) on the parts of the spine. In most cases, simple therapies such as mild pain medications and rest are effective. The goal of treatment is to make you feel comfortable, reduce further degeneration, and get you back to normal activity as quickly as possible. As a last resort, and only if all other conservative treatments fail, your doctor may consider surgery.

Specific Rest

Immediately after a back injury, rest is often all your back needs to feel better. Rest is used to take the pressure off your spine and the muscles around your spine. You should rest in a comfortable position on a firm mattress. Placing a pillow under your knees can also help relieve pain. Do not stay in bed for several days! Bed rest for more than two or three days can weaken the back muscles, making the problem worse instead of better. Even though you may still feel some pain, a gradual return to normal activities is good for your muscles.

In most cases of sudden back pain, the sooner you start moving again, the sooner your back pain will resolve. If you are sent to see a physical therapist, the first few days may be spent educating you on ways to take the stress off your back while remaining as active as possible. Short periods of rest combined with brief exercises designed to reduce your pain may be suggested.

Medications

Mild pain medications can reduce inflammation and pain when taken properly. Medications will not stop degeneration, but they will help with pain control.

Aspirin NSAIDs (Non-Steroidal Anti-Inflammatory Drugs)
Non-narcotic Prescription Pain Medication
Narcotic Pain Medications
Muscle Relaxants
Antidepressants
Epidural Steroid Injections (ESI) – Nerve Blocks

Physical Therapy for Low Back Pain

If physical therapy is recommended, your treatment plan could include one or more types of therapy:

Modalities – alternating heat and ice, massage, ultrasounds, and electric stimulation
Bracing – ranging from a simple corset to a rigid plastic body jacket
Flexibility and Strength Training – This is achieved through exercises, posture retraining, stretching, etc.
Pool Therapy – unloads spinal pressure because of the decrease in gravity provided by the water
Posture Training – learning how to stand, sit, and move properly, incorrect posture can contribute to back pain

Traction

Traction can provide segmented unloading of pressure caused by disc compression and relief of pain. There are many types of traction devices on the market. Talk with your doctor or physical therapist before you use one. The old method of placing patients with back pain in traction in the hospital is not often used today. Most back specialists do not like placing patients on bed rest for that long.

Exercise for Low Back Pain

Exercise is vital to recovery and maintaining a healthy spine. Consider it part of long-term health management and risk reduction. Regular exercise is the most basic way to combat back problems. However, if you already have an injury or damage to the spine, talk to your doctor or physical therapist before you start an exercise routine. You need to make sure the exercises you choose are effective and safe for your particular case.

Why exercise? Scientific studies have shown that people who exercise regularly have far fewer problems with their back. It helps strengthen the muscles in your back that correspond with your spine. Exercise can reduce your risk of falls and injuries. It can strengthen your abdomen (your belly), arms, and legs, which reduces back strain. Stretching reduces the risk of muscle spasms. In addition, weight-bearing exercises help prevent the loss of bone mass caused by osteoporosis, reducing your risk of compression fractures. Aerobic exercise, the type that gets your heart pumping and pulse rate up, can provide a good pain reliever as well. The natural chemicals of the body that combat pain – called endorphins – are released during exercise and actually reduce your pain.

Two general guidelines for low back pain exercise are:

If you are recovering from injury, non-weight-bearing activity is suggested, such as swimming and water exercise. A stationary bike or treadmill walking is also a good bet, as they put less pressure on your back than running on a hard surface. While you are recovering, avoid sports that lead to twisting, quick stops, and impact. This means holding off on racquetball, basketball, tennis, and all contact sports.
Warming Up: Never begin exercise without properly warming up and stretching out your muscles. Proper stretching reduces the risk of injury, helps to prevent back pain from increasing, and increases long-term flexibility.

Tips for a Healthy Back

Pay Attention to Your Body: If something you are doing causes your back to hurt, stop and rest or stop altogether. Whether it is a particular exercise, prolonged sitting, bending, or twisting, listen to your body’s signals. Pain is a warning. Discuss the activity with your doctor or physical therapist before proceeding.

Sit and Sleep Comfortably: Ensure that your back and neck are properly supported when you sit or sleep. When you sit, make sure your lower back is supported. Talk to your healthcare provider about choosing an appropriate mattress and pillow. You can upset the alignment of your spine if a mattress is too soft, or a pillow is too high.

Lose Weight: If your weight is causing excessive pressure on your spine, weight loss can reduce your discomfort.

Lift Properly: No heavy lifting – Do not lift heavy loads by placing pressure on your lower back. Use your legs to lift, and always bend your knees so your arms are at the same level as the heavy object you plan to lift. This simple technique will save your back unnecessary wear and tear.

Avoid Osteoporosis: Talk with your physician about combating the effects of osteoporosis – bone thinning. The current recommendations include increasing your calcium and vitamin D intake, and weight-bearing exercises.

Why Choose Southwest Scoliosis and Spine Institute?

There are reasons why a patient should choose Southwest Scoliosis and Spine Institute over another practice.

The institute has a long history of experience in treating scoliosis and other spine conditions. The institute was founded in 1999, and its physicians have over 20 years of experience in the field. This experience means that they are well-versed in the latest diagnostic and treatment techniques, and they can provide patients with the highest quality care.
The institute offers a wide range of treatment options. In addition to traditional surgery, the institute also offers minimally invasive surgery and non-surgical treatments. This allows patients to choose the treatment that is best for them, and it gives them more control over their care.
The institute has a team of experienced and dedicated physicians and staff. The institute’s physicians are board-certified and fellowship-trained, and they are committed to providing patients with the highest quality care. The institute’s staff is also experienced and dedicated, and they are always available to answer patients’ questions and provide support.
The institute has a patient-centered approach to care. The institute’s physicians and staff take the time to listen to patients’ concerns and understand their individual needs. They then work with patients to develop a treatment plan that is right for them.

One of the Best World Wide

Overall, Southwest Scoliosis and Spine Institute is a well-respected practice with a long history of experience in treating scoliosis and other spine conditions. The institute offers a wide range of treatment options, and its team of experienced and dedicated physicians and staff are committed to providing patients with the highest quality care.

Here are some additional reasons why a patient might choose Southwest Scoliosis and Spine Institute:

The institute is located in three convenient locations in Dallas, Plano, and Frisco, Texas.
The institute accepts most major insurance plans.
The institute offers concierge services to help patients with travel arrangements and other logistical needs.

If you are considering treatment for scoliosis, back pain, or another spine condition, Southwest Scoliosis and Spine Institute has the experts and you can make an appointment and be seen in less than 24 hours.

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WebMD: Low Back Pain

If you or a loved one suffers from spinal pain, you owe it to yourself to call Southwest Scoliosis and Spine Institute at 214-556-0555 to make an appointment.