5 Effective Low Back Pain Exercises

Many adults suffer from low back pain, which is usually caused by injury, overuse or muscle strain. Seeking proper treatment and engaging in a well-rounded exercise program (eg strength, cardio & flexibility) can help you stay mobile for years to come. To improve low back pain, stay active and refrain from activities and positions that may worsen back pain. Gradually begin gentle strengthening and stretching exercises for your back, legs and abdominal muscles when the acute pain has dissipated. Strength and flexibility exercises will not only help you recover faster and prevent reinjury to your back, but it may also reduce low back pain and decrease the chance of long-term disability. You can do many low back exercises at home without any special equipment. Talk to your physical therapist or doctor before you begin an exercise program, and do not perform any exercises that can increase low back pain.

Cat Camel

The cat camel exercise helps to ward off sciatica and prevent back pain. When you perform this exercise, you will extend your spinal through a full range of motion to help alleviate any existing back pain ,, as well. First, you need to get down onto your hands and knees with your lower back in an arched position. Lower your head down in between your shoulders and lift your upper back up towards the ceiling until rounded, and then slowly return to the start position. Do 12 to 15 repetitions.

Heel Slides

Heel slides are a simple rehab exercise for the low back. Begin by lying on your back, and then slowly bend and straighten your knee. Do 10 repetitions.

Piriformis Muscle Stretch

The piriformis muscle runs from the back of the thigh bone (femur) to the base of the spine (sacrum). When this muscle gets too tight, it can lead to sciatic nerve problems. To perform this stretch, lie flat on your back and bend both knees. Cross the right knee over the left knee and place both hands under the left knee (lower leg), and then gently pull up toward your chest until you feel a good stretch in the glute area (buttock muscles). Hold for 20 to 30 seconds and then cross the left knee over the right knee and repeat. This exercise can be done one to three times per day.

Abdominal Muscle Strengthening

Strong abdominal muscles help to support the low back. Begin this exercise by lying on your back with both knees bent and feet shoulder-width apart. Contract your abs toward the spine, while keeping your spine in a neutral position. Next, breathe out and reach toward the ceiling, lifting your head and shoulder blades off the floor. Hold for 2 to 3 seconds, breathe in and return to start position. Repeat until fatigued or can no longer maintain a neutral strain. Do this exercise one time per day, 3-4 days per week.

Hamstring Stretch

Your hamstrings are located behind your thigh (or quadricep) muscles, and they help your buttock muscles extend the hip and are responsible for bending the knee. When your hamstrings get tight, it becomes extremely difficult (if not impossible) to sit up straight, which can increase your risk of degenerative disc disease, low back pain and other back issues. To stretch the hamstrings, lie in the supine position (on back) and bend your right leg to a 90-degree angle and grasp the leg behind the knee. Slowly straighten your right leg, with the toes pointed toward you, and give your hamstring a gentle stretch. Hold for 30 seconds and then switch to the left leg. Repeat 4 to 5 times on each side, and try to do this exercise 2 times per day.

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How To Find The Right Chiropractor – 4 Tips To Help You Find The Perfect Provider

A chiropractor can provide great relief from an aching back, as well as a number of other ailments. However, the last thing you want to do is do a simple online search or pull a name out of the phone book. Before you book your first appointment for chiropractic care, take a few moments to understand how to choose the perfect chiropractor for your needs.

Ask If The Chiropractor Accepts Your Insurance Plan

Depending on your individual insurance plan, it may be possible for your visits to be covered by your insurance. Before you book your first appointment, ask if the office accepts payments from your insurance company. Then, look through your policy handbook or call your insurance provider to verify that your visit will be covered. Individual plans can vary a great deal and it's the patient's responsibility to understand what is and is not covered, which means it's important to read your policy carefully.

If your visits are not covered by insurance, many chiropractors offer discounts for cash paying customers. This can help ensure that patients can get the care they need – regardless of their insurance situation. If your company offers a health savings account, it may also be possible to use these funds to pay for your visits. These funds are often taken out of a paycheck on a pre-tax basis, which means that patients can save some money.

Ask Your Friends And Family Members For Recommendations

If you have not visited a chiropractor before, it can be hard to know which to choose. Instead of just pulling a name off the Internet or out of the phone book, ask your friends and family members for recommendations. You can also ask your primary care physician for help so that you know you're going to be well cared for.

Visit A ​​Chiropractor Who Listens To Your Concerns And Creates A Personalized Treatment Plan

If you're suffering from back pain, you probably do not care what causes it – you just want it stopped. However, a chiropractor will take the steps to get to know what caused your problems, so he or she can effectively help remedy them. Different causes can require very different treatment plans, which means that you could have some problems if your healthcare provider treats you the same as other patients. Your provider should fully understand the root of your pain and create an individual plan so that you can start feeling better quickly. Look for a provider who offers a number of different treatment options, including specialized soft tissue techniques, rehabilitation and physiotherapy.

Make Sure The Chiropractic Center's Hours Meet Your Needs

If you work full time, an office that's only open during the day just will not cut it. However, many chiropractors realize that it can be difficult to take time off work and offer late night or even weekend hours. These late night and weekend visits are often available on an appointment-only basis so it's important to schedule these in advance if you need them.

Using these tips can help you find someone who can provide chiropractic care, especially if you've never needed this before. Finding a center that accepts your insurance, is recommended by your family or friends, and creates personalized treatment plans with convenient hours will help ensure that you can manage your pain and get back to living the life you want.

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Motor Neuron Stem Cells May Restore Mobility

Stem cell therapy is emerging as a promising form of treatment for a number of conditions, from joint and spinal disc degeneration to spinal cord injuries. In the procedure, stem cells, which are “blank slate” cells that can develop into specialized cells dependent on where they are transplanted, are injected into the body to regenerate damaged tissues.

The road from animal to human trials into the effectiveness and safety of stem cell therapy is a long one. Recently, human studies into the efficacy of the therapy in degenerative disc conditions were given the green light. However, human trials into other applications are some years away.

Researchers who recently conducted a mouse study into the therapy's ability to replace damaged motor neurons that lead to muscle deactivation hope that the results of their study add to a body of research that makes human studies possible within the next five years. Patients with either spinal cord injury or motor neuron disease often lose the ability to move parts of their body due to damaged or destroyed motor neurons, which are responsible for transmitting motor signals from the brain to muscles in the body.

The procedure implemented by the researchers was rather complicated. They derived motor neurons from embryonic stem cells and equipped them with a survival gene, which allows the cells to connect with muscle, and a light sensor, which allows the muscle's activation to be controlled by light pulses. The use of light to activate muscles is similar to the use of electrical stimulation by other existing therapies. However, in patients with motor neurons that have been destroyed, electrical stimulation is not an option.

In their study, researchers implanted their engineered motor neurons into injured mice and found that the therapy restored mobility. While not exclusive on its own, the study is a promising piece in the larger body of research.

See more of the study at http://www.sciencedaily.com/releases/2014/04/140404140303.htm .


Stem cell therapy is controversial – particularly the kind used by the study above. Many, if not most, practitioners and researchers today use mesenchymal stem cells in their procedures; this type of cell can be derived from the patient him- or herself and re-implanted in a different area of ​​the body. Ethical issues arise when embryonic cells are used. While mesenchymal cells are highly useful in many applications, they are not ideal for the regeneration or replacement of motor neuron cells.

The study above used embryonic stem cells to replace the mice's motor neurons. This type of cell is controversial because it is derived from a human embryo that is destroyed thereafter. The main opponents of this type of procedure and research are pro-life individuals and groups that believe the destruction of an embryo marks the devaluation of human life, and that this is a dangerous road for science to embark upon.

However, proponents defend the procedure mainly by pointing out the kind of embryos that are used. All current research uses embryos that are left over from in vitro fertilization procedures. When a woman decides to receive in vitro fertilization, many eggs are combined with many sperm in a lab dish. Typically, a number of blastocysts (early embryos) form. Some of these blastocysts are implanted in the woman, and others are stored in a freezer. Once a woman has achieved her reproductive goal, she decides what to do with the embryos that remain frozen. They can be defrosted, which destroys them; they can be donated for adoption; they can, finally, be donated to scientific research. Federal funding is only allocated to research using embryonic cells obtained through a donor's consent. Learn more about the guidelines at http://stemcells.nih.gov/policy/pages/2009guidelines.aspx .

Time will tell if the controversial nature of embryonic cells interferees with the use of this therapy in the treatment of motor neuron conditions. For patients suffering debilitating conditions in the near future, much is at stake with research into this potential regenerative treatment.

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What You Need To Know About Back Pain

The anatomy of the back is complex, but the central feature is the column column, 33 vertebrae stacked atop one another, 26 of which are articulating and the reminder fused together to form the base of the spinal column known as the sacrum and coccyx. The bones of the spinal column are separated by intervertebral discs and lined with cartilage. Ligaments, tendons and muscles that overlay the spine hold the column column together. The vertebrae are composed of the vertebral body, the vertebral arch, and the vertebral processes that form facet joints that allow the bones to articulate.

The spinal column bears most of the weight of the upper body and it also functions to protect the spinal cord. The spinal column begins with a completely shaped vertebra known as the atlas, which is a ring like structure that connects to the skull with the second cervical vertebra known as the axis. There are 7 cervical vertebrae (neck region), 12 thoracic vertebra that demarcate the midback, and 5 lumbar vertebrae that compose the lower back or lumbar spine.

Intervertebral disks are soft tissue pads that cushion the bones of the spinal column from rubbing against one another, and the disks are composed of a rubbery annulus and a gel-like nucleus pulposus. Discs may degenerate with age, breaking at the annulus or extruding and pressing on the nerve roots of the spinal nerves, causing neurogenic pain. Neurogenic pain is felt in the area served by the particular nerve exiting the spinal canal from the spinal cord. Disc herniation may also be caused by injury or trauma, usually occurring in the cervical portion of the spine, or neck region, or in the lumbar (low back) region.

Overuse or injury of the muscles, ligaments and intervertebral discs that support the spinal column can all be causes of back pain in the upper back. One frequently seen cause of poor posture, which may result from lack of core body strength, is slipping while standing or sitting.

Myofascial pain, or pain of the muscles and / or ligaments that connect bone to bone may cause pain in the upper back. Normal degenerative processes of aging include osteoarthritis, which causes destruction of the cartilage that protects the joints of the vertebrae. In addition to causing pain as the cartilage wears down and bone rubs against bone, cartilage destruction can damage the bones themselves. Fractures may be caused by compression in people with demineralization of bone, such as occurs in osteoporosis, and these results in weakening of the bone and fracture with collapse of the vertebral body. Fracture may also be the result of injuries from falls or motor vehicle collisions.

The spinal column has a natural curvature and when patients have spinal deformities, they may include scoliosis, a sideways deformity of spinal column alignment, which leads to pain caused by the uneven distribution of the weight borne by the vertebrae. Another deformity of the spinal column is known as kyphosis, or widow's hump, which is characterized by a rounded hump of the upper back and may result in difficulty with lung expansion, resulting in respiratory problems. Some patients with kyphosis are unable to raise their heads.

Some degenerative diseases of the bones of the spinal include spinal stenosis, which is a narrowing of the central space in the vertebra, caused by degenerative bony changes or thickening of the ligaments. When this occurs, there is pressure on the spinal cord and the nerve roots that exit the spinal column. This can cause burning or throbbing pain, sensory changes, feeling of heaviness and even weakness in the muscles served by the portion of the spinal cord with the affected nerve roots. Spondylolisthesis refers to slippage of one vertebra on top of the one below, and can cause pressure on the spinal nerves or cord.

The most common cause of lower back pain is muscle strain from heavy lifting or trauma. This pain may radiate into the leg or foot, if the large sciatic nerve that supplies the lower body is involved.

Many causes of back pain can resolve with conservative treatment that includes rest, non-steroidal anti-inflammatory pain medications, analgesics and physical therapy that may include heat, ultrasound and massage, in addition to exercise to strengthen the muscles that support the back. In some cases, a spinal epidural injection may be performed by your physician, using a corticosteroid to relieve infection around the spinal nerve roots.

Some cases of back pain may be more serious, such as metastatic cancer, and pain is often felt in the back from internal organs and blood vessels, including aortic dissection or kidney stones.

Whatever the cause, unexplained back pain that does not resolve after a few days of conservative treatment should be diagnosed by a physician, particularly new onset of pain after the age of 50.

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Back Pain Linked to Excess Weight

Those who suffer chronic back pain may think that something is wrong with their spines. This is sometimes true, although pain often results from muscular strain or learned pain signaling by the nervous system. Whatever the location, it's important for pain patients to think beyond the immediate location of pain and consider possible systemic causes of pain. One of the most prevalent systemic causes of back pain is excess weight.

Weight and Pain

There are a number of ways in which your weight may be a causal factor in back pain. Note the following:

• Fat accumulated in the abdomen (a typical sign of metabolic disorder) can pull the lower back in, creating increased lordosis (inward curvature of the spinal) and anterior pelvic tilt. Anterior pelvic tilt is a type of postural dysfunction present when the pelvis is higher in the back than in the front and the buttocks sticks out. In this position, the web of muscles between the pelvis and lower back under altered lengths and tensions. Also, the spinal joints and discs experience increased pressure and compression. This, over time, can lead to joint and disc wear.

• Excess weight means extra work for the muscles, ligaments, tendons, joints and discs in the back. The lower back supports much of the body's weight; the more weight there is, the harder your soft tissues and joints have to work, and the more susceptible to wear and injury they are.

• Excess weight can cause changes through the back that result in widespread pain. In one study, found at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2821381/#!po=36.6667 , obese women exhibited reduced range of motion in the thoracic spinal in the upper back and in the shoulders. This stiffness may result in upper back, shoulder and neck pain along with lower back pain.

Part of back pain treatment for overweight patients, and particularly those with excess abdominal fat, is weight management. This is best done through a combination of diet and exercise. Those with back pain should incorporate a core strengthening segment into their exercise routine, which will help support the lower back.

Before embarking on an exercise plan with back pain, it's important to consult with a doctor and / or physical therapist to ensure you do not exacerbate any injury that may be present, and that you exercise with proper form, thereby preventing further pain.

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The Best Way to Use Foam Rollers for Various Muscle Groups

If you go to most fitness centers you'll find some pretty intricate and expensive exercise equipment. Often some of that equipment will have an “out of order” sign on it. It seems like the more bells and whistles this equipment has the more things that go wrong. Then there are the old standbys that can not break, and they can do some things that the best equipment can not do. One of those simple pieces of equipment that is being used by more people every day is the foam roller.

This very simple and inexpensive fitness tool should be a part of everyone's home gym, as it has multiple uses. They take up little storage space and despite the original investment is small, the cheaper quality products can degrade quite quickly. Many people use them to break down fibrous tissue, similar to what we get through a massage. Once you get a little experience on how to best use them they can be used to break up those knots that form in our muscles from overuse, stress and tension or injury.

Although many wait until knots and tightness to occur, they can be better used on a regular basis as part of the warm-up or cool-down process. Studies have shown, for instance that using a foam roller on the hamstring area can lead to a significant range in motion when used regularly. Here are some other parts of the body where foam rollers can be successfully utilized:

1. Loosing the quadriceps muscles. With the roller under the hip while in the plank position, basically roll yourself over the foam roller from the hip area to the top of the knee. Support will come from the elbows and feet, but you can increase the intensity by putting more weight on the roller. Also to concentrate on the hip flexors, use one end of the roller on just one side of the hip. This is great for loosing the hips.

2. Upper and lower back. Start by sitting on the floor, legs bent and feet flat on the floor. With the foam roller against the small of the back, transfer the weight from the buttocks to the foam rollers. Slowly roll across the back using your feet to propel you. You can also work either side by pivoting the weight onto one side and continuing the rolling motion.

3. Glutes. Start by sitting on the roller with knees bent. You can really tailor the workout by the way you position yourself on the foam roller. By leaving back more or pivoting onto one glute at a time you can provide as much pressure as you need.

4. Calf area. Sit down with the roller under the knees, lift your weight off your seat by pushing down with the hands and put all of your lower body weight on the calves over the foam roller. Maneuver it forward and backward to give your calves a good workout.

5. Ankles. You would not think the ankles need a lot of muscle massaging, but a great deal of flexibility can be gained in the ankles by working them with a foam roller. I'm sure by now you get the point on how to apply this great, inexpensive tool to your everyday workout.

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Catch-22: Diagnostic Procedures Contribute to Disc Degeneration

Certain diagnostic procedures for discogenic back pain come with a major catch-22: They can actually spur disc degeneration. Researchers have known that this is true of procedures requiring a needle puncture of the disc; now, they also know that the use of the popular anesthetics lidocaine and bupivacaine contribute to the acceleration of degeneration.

Two diagnostic procedures requiring disc injection are discography and discoblock. In the former, the disc is infected with fluids and pressurized to see if this incites pain; if it does, it indicates that the injected disc is indeed the source of back pain. In the latter procedure, the disc is infected with an anesthetic to see if it relieves pain, in which case the injured disc is the source of back pain. While discography involves inciting pain, it entitles the use of an anesthetic as well.

These diagnostic procedures are important; they are often the last step between a patient and surgery. Given the risks, cost and recovery time associated with even minimally-invasive back surgery, nobody wants to go through it without being as certain as possible that the targeted area is indeed the source of pain.

However, the fact that both needle puncturing and anesthetics put disks in danger of further degeneration is important to consider in the decision to go either discography or discoblock. Researchers recently took healthy cells of human nucleus pulposus – the gel-like substance at the center of spinal discs – and exposed them to lidocaine or bupivacaine. Low doses of the anesthetic caused the presence of dead cells in the cultures at 23% and 25% respectively. When doses were doubled, the percentage of dead cells almost doubled – to 42% for lidocaine and 48% for bupivacaine.

The researchers found that the anesthetics increased the presence of several types of caspase, enzymes that contribute to cell death. They also found that cell liability, or the amount of cell division and growth, decreased.

See more on this study at http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0092442 .

The researchers conclude, that that diagnostic procedures involving anesthetic should be avoided, but that, at the very least, medical professionals should take care to use the smallest doses possible to limit the amount of cell death and, along with it, disc damage that results.

Patients should always be aware of any risks involved not only in treatments but in diagnostic procedures as well. It is equally as important for the medical professionals treating them to be aware, so that they may take every preventative measure possible.

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Delaying Sciatica Surgery Doesn’t Worsen Prognosis

Generally when you have a health condition, early treatment is best. This is likely true for sciatica, a condition characterized by impingement of the sciatic nerve in the lower back. The sciatic nerve is the largest nerve in the body, extending from the lumbar vertebrae down the back of the leg to the foot on each side of the body.

The most common cause of sciatica is a herniated disc in the lumbar spine. Spinal discs are composed of a tough exterior and a gel-like center, similar to a jelly donut. Through wear and tear, improper body mechanics, excess weight or traumatic injury, the exterior of a disc can crack and the fluid center can leak out. This fluid contains inflammatory chemicals; if it makes contacts with the sciatic nerve exiting the spine, it can cause sciatica. Alternately, if the exterior of the disc weakens but does not crack, the fluid may be pressed to the weaker side of the disc, and the bulge it creates can press against the nerve.

Early Treatment: Surgery?

One common treatment approach for herniated discs is discectomy. This may consist in a minimally-invasive procedure, called a microdiscectomy, in which a small incision is made and small amounts of disc material are removed. Some people, however, have larger and more invasive procedures.

Should patients seek out surgery right away with sciatica? Typically, the rule of thumb concerned back surgery is to leave it as a last resort. However, patients may be worried that putting it off will worsen their prognosis. Fortunately, there has been research into this very question that can help patients make a decision.

Some research compares long-term results of conservative care versus surgery for sciatica; one study actually assesses whether duration of preoperative sciatica impacts outcomes.

A systematic review analyzed several studies that bought to compare long-term outcomes of surgery versus conservative / usual care, two of which had low bias risk. In one, patients who had severe sciatica for 6 to 12 weeks were randomized into early surgery or conservative care groups. Thirty-nine percent of the patients in the conservative care group went on to have surgery after 19 weeks. Patients who received early surgery had quicker pain relief than those who forewent surgery. However, at the one- and two-year follow-ups, both groups had similar, satisfactory outcomes.

Another, larger study with low bias risk justified similar concluding. At the two-year follow-up, patients who received surgery and those who did not have comparable improvement results on all measures. Forty-five percent of those originally placed in the conservative care group went on to have surgery. The two studies with high bias risk included in the review had similar results: no long-term differences in outcomes.

See more on these studies at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3065612/#CR22 .

Some patients in conservative care go on to have surgery. For these patients, does waiting harm their prognosis? A study released in 2014 concluded that it likely does not. Researchers categorized 240 patients according to whether their preoperative symptoms were present for more or less than one year. With a mean follow-up time of 33.7 months post-surgery, they found that the duration of symptoms prior to surgery had no significant impact on pain and disability outcomes. See more on this at http://www.ncbi.nlm.nih.gov/pubmed/24616807 .

The decision to have or delay surgery for sciatica should depend on how severe the symptoms are. Based on the state of the research, patients should not fear that delaying surgery will worsen their prognosis. This is all the more reason to pursue conservative treatments, including physical therapy and inversion therapy, whenever possible.

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Website Provides First-Person Data About Health Conditions, Treatments From Patients

The statistics, percentages and probabilities associated with chronic pain and other health conditions can make them seem rather abstract, but there's nothing abstract about living with a chronic condition. Often, patients seek out support groups and online forums to read stories and get advice from actual people with the same condition.

A website called PatientsLikeMe has been connecting patients for years. The site is a hybrid of social media and health data collection. Patients can share detailed information about their experience with a health condition such as symptoms over time and about the treatment options that they have tried. The data collected on the site can be used by the pharmaceutical industry and other treatment providers to improve their services.

PatientsLikeMe has already contributed to over 40 studies with its collected data. There are currently more than 250,000 patients using the site. Patients can receive treatment guidance from the published studies as well as patient-reported effectiveness and side effects of various treatments.

Some medical professionals suggest that caution should be taken when interpreting or relying on information from a site like PatientsLikeMe. The data collected is not high-quality evidence, such as would result from a blinded placebo-controlled trial. In a blinded placebo-controlled study, either the patient or the patient and the doctor / researcher does not know whether the patient has received the real intervention or placebo. Thereafter the data collected after is free of bias and the treatment's efficiency can be assessed against the placebo effect.

Another shortfall of the site is that it does not give a randomized selection. Some people choose to use the site, while others do not. Some people choose to give certain data but not all data. Are patients more inclined to report on certain treatments if they work than if they do not? Or is the opposite true? Is the representation equal? How could we know? See http://www.technologyreview.com/news/418874/patients-social-network-predicts-drug-outcomes/page/1/ for more on these critisms.

These are legitimate criticisms and concerns associated with relying on patient-offered data for studies and decision-making. However, reading first-person accounts of conditions and treatments is valuable to the chronic pain patient. Also, the data provides a good starting point for designing studies – for example, if a number of patients on the site report a specific side effect associated with a medication, researchers may design a study to test for its presence in a study population, or a developer may begin to reconcile the medication.

PatientsLikeMe is part of a movement towards patient-centered medical care in which the patient, his preferences and the value of his insights are as important as statistics, percentages and probabilities. By providing a venue for patients to share their experience with health conditions, symptoms and treatments, the site provides a wealth of individualized information for researchers to use in designing and testing different treatment methods.

Learn more at http://news.patientslikeme.com/press-release/patientslikeme-launches-data-good-campaign-encourage-health-data-sharing-advance-medic .

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New Diagnostic Tool and Treatment Guidelines More Effective Than Usual Care for Back Pain

Clinical guidelines for the treatment of lower back pain do exist. However, not all doctors follow them, and those that do not always steered in the right direction. Clinical guidelines for back pain treatment, as reported in the October 2007 issue of Annals of Internal Medicine , may not offer enough attention to the patient as an individual and to psychological factors associated with chronic pain.

Current clinical guidelines emphasize the importance of a physical examination, an attempt to determine whether the cause is related to a musculoskeletal or neurological issue, the frugal use of imaging technology, the use of NSAIDs for pain relief and self-care education. If these efforts fail, then physical therapy, chiropractic care and other treatment options are recommended.

For many patients, these guidelines do not amount to effective or efficient treatment. In the interest of improving back pain treatment, researchers developed a new diagnostic tool called STaRT Back. The tool is a survey of nine questions for back pain patients to answer. Answers allow physicians to categorize patients into low-, medium- and high-risk groups. The group patients fall into determinate their course of treatment.

Five out of the nine questions on the survey assessment psychological factors, the importance of which in chronic pain is becoming more and more evident in research each year.

Patients who fall into the low-risk group are given self-care advice. Those in the medium-risk group are referred to physical therapy. High-risk patients receive a referral to both a physical therapist and psychotherapeutic intervention, such as cognitive behavioral therapy.

The use of these specific and well-rounded guidelines yielded positive results in a 2011 study that compared disability scores of patients using the STaRT Back tool with the scores of those pursuing a typical treatment course in the UK The study found those in the STaRT group to have significantly greater improvements in disability scores, as well as modest cost savings over the typical intervention group. See more on this study at http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(11)60937-9/abstract .

More recently, a study found patients who used the STarT Back tool to spend 50% less time off work and to take less medication. Researchers found that those who fell into the high-risk category saw the largest reduction in disability scores. See more on this study at http://www.annfammed.org/content/12/2/102.full .

Given the non-stellar track record of usual care and diagnostic procedures for lower back pain and the promising results of research into the STarT Back survey and treatment guidelines, doctors have reason to seriously consider implementing the latter in their practice. If you are a back pain patient seeking efficient, targeted treatment, try to find a physician who knows about or is willing to learn about the STarT Back survey and treatment guidelines.

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Back Pain – Treatments For Lower Back Pain

I can remember some time back being lectured to about factors that do not bode well with man as the ultimate species within the evolutionary cycle.

These factors do confer advantages but unfortunately have at the same time introduced serious weaknesses which do result in back pain.

Factor 1 . Man, by virtue of his evolution from being a four-legged animal to a two-legged and upright one has imparted weaknesses on the body especially in the lower back region. Any mishap there often results in back-pain.

Factor 2. Man is bilaterally symmetrical. That means that s / he has a body form that is divided into matching equal right / left halves. We can get to this symmetry by drawing an imaginary line from head to toes. This would result in the right half being the mirror image of the left.

The salient point here is that this factor has again introduced weaknesses.A good example of the effects of this symmetry will suffice here and it goes like this:

The spine lies very centrally between the 2 sides of the body at the back and is ably supported by muscles, bones etc. Any extra work by muscles on the right side would make that side stronger and be much more developed than the other side.

This inequality in the spine-body parts creates pressure which when applied on the spine causes strain. This results in back pain. For proper functioning of the body, an equilibrium must be maintained between the two sides. Any interference of that equilibrium results in lower back pain.

As stated above, most of us will suffer from back-pain at some time of our lives. We do suffer from lumbago which is one of the most common and painful back-ache conditions.

Over-exertion of the body causes lumbago, and so does poor posture when both standing and sitting and also when lifting heavy objects improperly.

Sciatica is another and a much more serious occurrence. It is a very crippling condition resulting in serious disabilities that on occasions necessitates surgery.

Sciatica is basically a symptom of damage to the sciatic nerve which runs from the lower back (lumbar region) to the toes. This damage is due to (i) a decompression in one or more of the spinal inter-vertebral discs and (ii) a pinched sciatic nerve. Of course we as sufferers do know the excruciating pain that normally ensues.

It is very important that if you do suffer from such pain that you do know what you can do to ease the aches.

1. Anti-inflammatory medication is used to lower the swelling of the affected muscles. Reducing the swelling results in the reduction of the pain.

2. Injecting the affected area with cortisone and the use of electrical stimulation therapy are common treatments.

3. Exercise : You must do this for the relief of long-term pain.

4. Back stretches: When you do these, you will strengthen your lower back muscles. You must avoid any movement that puts undue pressure on the lower back and joints.

5. Hot and cold treatments: Use ice and hot packs alternately to apply heat and cold to the affected area.

What now follows are treatment that you can do at home.

Home remedies.

It is necessary to point out that such remedies only help you manage the pain and are not cures for the condition.

i. Celery and potatoes . Both of those foods are good at preventing and managing back pain.

ii. Ayurveda : According to Ayurvedic principals, gas is one of the major causes of pain. The remedy here is to use raw garlic to help to expel gas.

iii. Massage : You must massage the affected area with a mixture of vegetable oil and garlic.

iv. Sleeping arrangement s: Use a comfortable mattress to sleep on.

v. Sitting arrangements : If your job involves sitting for extended periods of time, you must use a comfortable chair that accommodates the natural curves of your spine

What I tried to give you are some of the many treatments that are available both within the world of medicine and your home.

Little things like adopting good postures when sitting and standing and even when lifting objects are practices that you must always use. You must also practice regular exercise and eating healthily.

Putting many of those practices into force would go very far towards ensuring that you do live a comfortable and pain-free or pain-controlled life.

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What to Do If You Have Back Pain – What Every Doctor and Patient Needs to Know

The Truth About Back Pain

Most people who experience mechanical low back pain will get better without any medical treatment or intervention.


  • 30% of people will experience a recurrent episode within 6 months
  • 40% of people will experience a recurrent episode within 12 months

So it is something we need to think more about and consider what we CAN do to manage our pain AND help to prevent recurrence or at least be more prepared with what to do when we get it again.

5 Questions To Help Understand Your Back Pain

The following questions have been taken from an evidence-based tool referred to at the end of this article. The purpose of these questions is to help you and your provider properly assess your condition – these answers will guide you in how to manage it.

  1. Where is your pain the worst? Back or Leg?
  2. Is your pain constant or intermittent?
  3. Does bending forward increase your typical back pain?
  4. Have you had any unexpected accidents with your bowel or bladder function since this episode of your low back / leg pain started?
  5. If age of sunset <45, are you experiencing morning stiffness in your back> 30 minutes?

Now what?

These questions will help your provider make sure you have mechanical low back pain and not something more serious like an infection, tumor or cancer. What's SO important to understand is that this is a very common condition and there are things you can do during the time you are in pain AND to help prevent recurrence. Yes, exercise is part of this … but so is simply keeping up your daily activities (in otherwords keep moving – bed rest is not recommended for the majority of people). This does not mean go run a marathon – it means try to slowly get back to daily routine or daily movements. Think “Motion is Lotion.”

Ensuring you better understand what aggravates and what alleviates your pain is very important – your provider can help determine this using the above 5 questions. See the video and CORE Tool referred to and links at the end of this article. Keep in mind – not everyone has the same type – so what works for your friend, co-worker or neighbor may not be what will work for you. We call these different types – 'patterns'.

Preventing and Strengthening

When your back pain is gone, keeping active in general will help manage recurrence. Strengthening your core muscles should be an important part of your routine. Keeping up with the exercises that help you when you have Low Back Pain will also help.

What does this mean for me?

The key message for those suffering with Low Back Pain that is mechanical (based on the questions above) is simple …

  • Diagnostic imaging (MRI, CT or x-ray) is rarely needed / warranted with mechanical LBP
  • There are things you can do to alleviate your pain (sometimes pain medication, exercise, treatment like chiropractic or massage)
  • From the questions above, red flags will be Ruled out BUT if your symptoms are still present after 6 weeks make an appointment with a health care provider
  • If your mood changes or you are more anxious than usual this could be a result of your condition and you should make an appointment with a health care provider

* This information is not intended to substitute the advice of a licensed health care provider. It is offered to help navigate the resources available to you.

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Mineral Water Bath May Help Relieve Back Pain

Physical therapy is a standard form of back pain treatment, but on its own it is not always enough to remedy the pain. Many patients seek out alternative therapies to supplement more conventional methods.

Balneotherapy, certainly not one of the more popular forms of alternative medicine, has shown promising results in research into its effects on lower back pain. While there are not a plethora of studies to attest to its effectiveness, the few studies out there may be enough for some patients to consider balneotherapy a potential supplement pain relief method.

Balneotherapy essentially consists of soaking in mineral water. It's common in some countries, including Turkey and Romania. Soaking in warm water may seem like an obvious temporary pain relief method, since warm water soothes the muscles, but proponents of balneotherapy claim that mineral water has additional therapeutic benefits as the minerals absorb into the skin and promote healing.

In a recent small study, a group of researchers bought to compare the effects of physical therapy plus balneotherapy to the effects of physical therapy alone in patients with chronic lower back pain. A number of measures, including pain, functionality, disability, flexibility and quality of life scores, were taken at baseline and after three weeks of assigned intervention. All scores improved after treatment for both groups, but those in the balneotherapy group saw greater improvements in pain, quality of life and functionality than those who received physical therapy alone.

Read more about this study at http://www.ncbi.nlm.nih.gov/pubmed/24599676 .

While there were only 81 participants in this study and blinding was impossible, some patients may consider balneotherapy a worthwhile given the lack of risks and side effects associated with it. However, one might legitimately question whether the positive effects of the therapy are attributed solely to warm water and not the fact that practitioners use mineral water.

This has also been studied. Again, the study is small, but its design is superior to the one above in that it is single-blinded, meaning participants did not know either they were getting mineral water treatments or “placebo” tap water treatments. Researchers compared scores from each group at baseline and three months after treatments. Both groups saw significant improvements in pain scores in the short-term, but only the group receiving mineral water balneotherapy had longer-lasting improvements defined as results at three months. The latter group also had improvements in spinal mobility, a reduction in muscle spasms and alleviation of local tenderness. These positive changes were still evident at three months.

Learn more about this study at http://www.ncbi.nlm.nih.gov/pubmed/16137981 .

While there is not enough research to conclude that balneotherapy is a definite, or even likely, remedy for back pain, the state of the research and the safety of the approach suggest that it may be worth a try for many patients whose pain is resisting the therapies of conventional medicine.

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Can Doing Pushups Relieve My Back Pain?

I admit I have always been in love with push ups. Even as a youngster this was my first body building exercise. But can do push ups relieve an aching back? The answer is maybe. Five years ago I injured my back at work and after months of physical therapy underwent back surgery. During the six months after my accident I stopped doing all forms of weight training. But what I did did were specific exercises designed to stretch and strengthen my back.

After two months on this program and combined with daily walking, I felt ready to add weight bearing exercises. The first exercise I added were push ups. I started with a modified version and gradually added more repetitions. Occasionally, I was able to do the standard military version and a variety of different push ups designed to build core strength.

Here are the steps I used to restore my health, strength and eliminate my aching back.

  1. First got my doctor's approval.
  2. Then I started slow with very low reps (5) and slowly increased the repetitions.
  3. I started with wall push ups to minimize the strain on my back muscles.
  4. Slowly I progressed to knee push ups and then to more demanding military and other harder variations.
  5. My routine was limited to twice a week. This brave my body plenty of time to rest.
  6. I paid attention to form and listened to my body. If I felt tired or sore I just skipped the weight bearing exercises and only did my stretches.

Now obviously everyone is different and every back problem may not respond well to push ups. It is critical to first identify exactly what is causing your aching back. See your doctor and follow his recommendations. I am a big advocate about the power of the body to heal itself and the benefits of doing specific exercises that correct and eliminate back pain. Once you have accomplished these things then starting a strength building program that includes pushups can really make a difference in how you feel and how you look.

Need more reasons why this is such a great exercise? Consider these facts.

  1. They can be done anywhere.
  2. They require no special equipment.
  3. Most of us know how to do them and there are plenty of free videos online to help.
  4. There are so many different variations that you will never get bored.
  5. You will build core strength.
  6. Following the steps above you will treat and eliminate back pain.

Today at 67 1/2 years old they remain my favorite body weight exercise. Why, because in my humble opinion they work! So can they work for you? As I said earlier maybe, but if you start slow I do believe push ups can be an important part of your exercise program. I hope these suggestions work for you. Building and maintaining a strong, healthy and painfree body is a life time practice, but one which can reap many benefits.

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Training Safely and Effectively With A Slipped Disc

What is a Deleted Disc?

A slipped disc, also known as a herniated disc, is a condition where one of the discs in the spinal ruptures and the gel inside leaks out, this can cause acute or chronic back pain, as well as pain in other areas of the body.

The spell consists of 24 irregularly shaped bones, stacked on top of one another, known as vertebrae. To help cushion these vertebrae, there are protective, circular pads of connective tissue in between them, these are the discs and they help to cushion the vertebrae when you move around in day to day life. They have a tough fibrous outer case, and a softer gel like inside.

How Does a Slipped Disc Occur?

A slipped disc occurs when the outer outer shell of the disc ruptures and the gel inside starts protruding out of the disc, in the same way as a hernia would act in the abdominal wall for example. Running through your spinal is the Spinal Cord, it contains nerves and nerve cells that connect to the brain and all parts of the body, a ruptured disc can actually cause the herniation to press against the whole spinal cord or a single spinal root. This unfortunately means you might not just be left with pain in your back, but also pain where the nerve is connected to!

Age is one of the largest reasons that a disc will rupture, as you start losing your water content inside the disc, making it less flexible and more liable to rupturing. However apart from that little is known about why a disc may rupture. Although performing exercises with bad form is a sure fire way to increase the chance.

What Happens After I Have A Disc?

It is very important to keep active, this will keep your back mobile and speed up your recovery. In fact a recent study showed that patients with lower back pain who followed an exercise routine to strengthen all the muscle groups in their body, experienced a 40% reduction in lost work days. Strengthening your back and core muscles, whilst loosing the muscles in your glutes, hamstrings and calves can take virtually all the pressure off your spine, allowing your ruptured disc to heal more effectively.

So How Do I Train With A Slipped Disc?

When training a client with a herniated disc, we follow a few basic simple steps as a guideline.

1. Improve tissue health and mobility. A tightness or immobility in one muscle group, will cause others to overcompensate, for example your lower back might be overcompensating for the fact your hamstrings are tight. We look at stretching the fascia in the glutes, hamstrings and calves, you can do this by incorporating advanced stretching techniques, consistently foam rolling and performing exercises that help elongate the said muscle groups.

2. Before any lower body exercises, we activate the clients core and lats, a great exercise for this is the side plank with rotation, it activates your core, lats and quadratus lumborum, 3 muscle groups vital to spinal stability.

3. Keep to low impact exercises, definitely no running. Walking, swimming, and resistance based exercises are great to incorporate in programs. We also limit the number of unilateral leg exercises we do, a squat should be replaced with a split squat and a deadlift with a single leg deadlift for example.

4. Whereas we normally teach clients to lift with a slower negative portion of the exercise and a faster, snappier concentric phase. This is not beneficial for someone suffering with a slipped disc, you should be lifting with a very slow and controlled eccentric and concentric phase.

5. There are 168 hours in a week, if you work out for 4 of them that still leaves 164 hours where you need to concentrate on keeping your lower back healthy. Make a conscious effort to maintain a lordotic (inward curve of the lumbar spine) post while driving, sitting at your disc, on the sofa, where you may be. To help with this you may find it easier to roll up a towel and place it behind your back.

The most important thing we do with our clients to start off very slow and cautiously, adjusting the training week by week on how the client is feeling and the injury is progressing. The last thing you want to do is make this sometimes agonizing injury even worse.

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