Your core muscles—not just your abdominals, but the muscles that wrap around your midsection—support your spine and lower back. And your core, hips, glutes, and hamstrings together form one big stability machine, so weakness in any one of those muscles forces the others to take up the slack. If you have weak hip and gluteal muscles, for example, as they become fatigued during a run, your lower back is forced to work harder to keep you upright and stable, and you become vulnerable to injury.
The use of injections and procedures in and around the spine is limited as such treatments often provide only temporary relief. However, they can be important in helping diagnose structural causes in pain and assisting the physical rehabilitation when other methods have failed. The various injection procedures are costly and have potential side effects, which should be discussed in detail before proceeding. Often, a pain specialist or back specialist will also employ rehabilitation and counseling by non-physician personnel such as therapists, counselors, and patient educators.
Lumbar strain (acute, chronic): A lumbar strain is a stretch injury to the ligaments, tendons, and/or muscles of the low back. The stretching incident results in microscopic tears of varying degrees in these tissues. Lumbar strain is considered one of the most common causes of low back pain. The injury can occur because of overuse, improper use, or trauma. Soft-tissue injury is commonly classified as "acute" if it has been present for days to weeks. If the strain lasts longer than three months, it is referred to as "chronic." Lumbar strain most often occurs in people in their 40s, but it can happen at any age. The condition is characterized by localized discomfort in the low back area with onset after an event that mechanically stressed the lumbar tissues. The severity of the injury ranges from mild to severe, depending on the degree of strain and resulting spasm of the muscles of the low back. The diagnosis of lumbar strain is based on the history of injury, the location of the pain, and exclusion of nervous system injury. Usually, X-ray testing is only helpful to exclude bone abnormalities.
Chill it. Ice is best in the first 24 to 48 hours after an injury because it reduces inflammation, says E. Anne Reicherter, PhD, PT, DPT, associate professor of Physical Therapy at the University of Maryland School of Medicine. "Even though the warmth feels good because it helps cover up the pain and it does help relax the muscles, the heat actually inflames the inflammatory processes," she says. After 48 hours, you can switch to heat if you prefer. Whether you use heat or ice -- take it off after about 20 minutes to give your skin a rest. If pain persists, talk with a doctor.
Ongoing pain can wreak havoc on your life, affecting your cherished relationships, finances, and your ability to get stuff done at work and at home. It can also interrupt your sleep and affect your mood. Because many other problems commonly occur along with chronic lower back pain, anything you can do for yourself that is a natural anti-depressant will help.
Start on all fours. Lower onto your forearms with shoulders directly over elbows. Step feet back into a plank position. Draw your shoulders down and back—not hunched. Engage abdominal muscles tight to keep hips in line with shoulders so your body forms a long, straight line. Squeeze legs and glutes for support. Hold this position for 45 to 60 seconds. Gradually add time as your core gets stronger. Repeat for 3 to 5 reps.
Physical therapists often recommend aquatic therapy — including exercises done in warm, therapeutic pools — for back pain. The buoyancy of the water helps alleviate strain on the joints to encourage strengthening and gentle stretching of the muscles. Even floating in warm water can help relax muscles and release tension as well as increase circulation, according to the Arthritis Foundation. With home whirlpool baths, try aiming the jets directly at your sore spots for a soothing underwater massage.
Few people need surgery for back pain. If you have unrelenting pain associated with radiating leg pain or progressive muscle weakness caused by nerve compression, you might benefit from surgery. Otherwise, surgery usually is reserved for pain related to structural problems, such as narrowing of the spine (spinal stenosis) or a herniated disk, that hasn't responded to other therapy.
An ancient mind-body practice, meditation has been found to increase pain tolerance and promote management of chronic pain in a number of small studies. In addition, a number of preliminary studies have focused specifically on the use of meditation in the management of low back pain. A 2008 study published in Pain, for example, found that an eight-week meditation program led to an improvement of pain acceptance and physical function in patients with chronic low back pain. The study included 37 older adults, with members meditating an average of 4.3 days a week for an average of 31.6 minutes a day.
Research shows that certain forms of magnesium can be effective for pain relief and muscle relaxation, as well as nerve pain. Many people in our society are magnesium deficient, so it may be a good idea to supplement. Magnesium glycinate is known to be a highly bioavailable form. Magnesium citrate can be used by those who tend toward constipation, as it has an additional effect of loosening the bowels.
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Most back pain can be successfully treated without surgery. If conservative back pain treatment fails, or if you have difficulty standing or walking, you may be a candidate for surgery. Dr. Stieber is a leader in the use of minimally-invasive surgical techniques with advanced expertise in restoring mobility to the back and helping his New York patients return to activity and an improved quality of life.
Research is being conducted on certain treatments that stimulate nerves to reduce chronic back pain. Your doctor may consider adding acupuncture to your treatment plan if you aren't finding relief with more conservative care. Another method your doctor might suggest is transcutaneous electrical nerve stimulation (TENS), during which mild electric pulses are delivered to the nerves to block incoming pain signals.
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