Is your back out of whack?

Low back pain affects 60-80% of U.S. adults at some time during their lives, and it is estimated that up to 50% have back pain within a given year. Back pain symptoms are among the 10 leading reasons for visits to emergency rooms and physicians’ offices. Although symptoms are usually acute and self-limited, low back pain often recurs, and in 5-10% of patients, low back pain becomes chronic. Back pain is the most common disability for persons under age 45. Costs for low back pain and disability exceed an estimated $55 billion annually. Many back injuries are occupational in nature, being related to lifting and various repetitive motion activities.

Causes of Back Pain

The causes of more than 80% of back pain cases are often unknown. In most individuals, pain stems from an injury, after lifting a heavy object, poor flexibility or making an abrupt movement.

1. Poor Posture

Weaknesses in the muscles of the abdominals, hip flexors, hamstrings and low back can alter your hip position, increasing the natural curvature of your low back and generating pain.

Low back pain is usually defined as either acute or chronic. Pain is typically diagnosed as acute if lasting less than a month and not caused by serious medical conditions. Most cases clear up in a few days, although recurrence after a first attack is common.

Pain is typically diagnosed as chronic when is persists beyond six months. This constitutes less than 5% of all low back pain cases.

Obesity increases weight on the spine and pressure on the disks. A large stomach pulls the spine forward and out of alignment, increasing the chances of back strain. The greater the weight, the greater the risk of back pain.

2. Sciatica

The nerve most likely to cause pain is the sciatic nerve, affecting up to 40% of individuals. Pain is caused by compression of this nerve, which branches out from the spinal cord at the lumbar and sacral areas. Sciatica usually occurs when the nerve is stretched or pinched.

The sensation of sciatica can vary widely from a mild tingling to severe immobilizing pain. Pain may be experienced in one part of the leg or hip, with numbness in other parts. It typically increases after prolonged standing or sitting and can be aggravated by sudden movements. Sciatica can also be caused by piriformis syndrome, the entrapment of the sciatic nerve deep in the glutes by the piriformis muscle.

3. Disc Abnormalities

A herniated disc is sometimes the most common cause of severe sciatica. A disc in the lumbar area becomes herniated when it ruptures or when the gel-like substance within the disc protrudes outward. Many individuals have protruding or bulging discs without incidence of back pain. If this abnormality is able to press against the nerve, sciatic pain can occur.

4. Spinal Stenosis

Spinal stenosis or the narrowing of the spinal canal is usually caused by bone overgrowth, which occurs mostly in the elderly who have degenerative osteoarthritis, but it can sometimes be caused by other problems, including infection and birth defects. Pain from spinal stenosis can occur in both legs.

5. Osteoporosis

Osteoporosis is a bone disease where they lose calcium to the point where the bones become fragile and are prone to fracture. Spinal fractures can occur as a result of pressure that compresses the vertebra together, triggering pain.

6. Osteoarthritis

Osteoarthritis occurs in joints where the cartilage is damaged and then destroyed. As a result of this destruction, the associated bones within that joint develop abnormalities. When osteoarthritis affects the spine, it may damage the cartilage in the discs or the moving joints of the spine. The nerves may become pinched, causing pain and perhaps numbness and muscle weakness.

Back Strengthening Exercises

The best thing you can do to prevent back pain in the future is to exercise today. The American Academy of Family Physicians recommends “back-conditioning exercises” for persons aged 19-64 years who are at increased risk for low back injury because of past history, body composition or inactivity.

1. Begin slowly. Your back muscles may be weak and susceptible to injury if you’re out of shape. Pace yourself. As you get stronger, work up to 15 minutes of exercise a day.
2. Choose your exercises carefully. If you have had back problems in the past, choose low-impact exercises, which are less stressful on your joints. Examples include swimming, stationary bikes and elliptical trainers.
3. Avoid high-risk moves. People who’ve had previous back attacks should beware of movements that cause an exaggerated stretch of the back muscles. Sports that involve a lot of twisting (like golf), quick stops and starts (like tennis, racquetball and basketball) and contact sports (like football and wrestling) pose the greatest risks to your back. If you want to participate in such activities, practice modifying risky moves. The following exercises can help stretch and strengthen your back and supporting muscles. As little as 15 minutes of exercise a day can help. If you already have back problems, consult your doctor before you begin any routine.

View exercises in pdf document

Choose to see a doctor if you experience numbness, tingling, or weakness down the leg, or if you feel ill as a result of the back pain.

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  June 2010

  Abdominal Workouts: Frequency, Intensity, and Duration

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  4 large eggs
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  2 tablespoon Dijon mustard
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  1/4 teaspoon freshly ground pepper
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