Extreme Lower Back Pain - Causes and Treatment

Extreme lower back pain can be a very debilitating and frustrating condition. There can be several causes for this.

Increasing age

Ageing means the deterioration in the strength and flexibility of the muscles and bones. The discs in the spinal column lose their fluid and elasticity, which adversely affects their ability to provide support and cushion to the spine.

Lifting heavy objects

When a weak or an old person tries to lift or pull anything that is too heavy for his strength, his muscles experience strain, sprain or spasm, which leads to pain in the back.

Degeneration of bones

Degeneration of the bones may lead to bone diseases like arthritis, osteoporosis, viral infections in the joints and some other abnormal conditions in the spinal column.

Weight gain

Weight gain due to obesity or pregnancy may cause posture problems and exert pressure on the muscles of the back and cause strain on them.

All these factors cause extreme lower back pain.

Treatment

Lower back pain can be treated by do-it-yourself efforts, if it is at its initial stage and has been caused by simple activities such as lifting heavy weights, etc.

1. Rest

The pain can be relieved by lying in a posture that provides rest to the stressed back. This can be done by lying on the back on the floor and putting one or two pillows below the knees. This arrangement raises the hip slightly upwards and places the lower back flatly on the floor. A day or two of rest is likely to relieve the pain.

2. Exercises

Some simple exercises that stretch the lower back can also bring relief.

One exercise is to stretch the back by arching it. To do this, first lie with your face on the floor, put your hands on the floor and lift your upper body upwards so that it forms a slight arch. This will stretch your lower back. Stay in this position for 10-15 seconds and come back to the earlier position. Repeat this exercise 5-10 times.

Swimming, walking, yoga also helps to cure the extreme lower back pain.

Hot packs, massage with balm or taking over-the-counter pain killers like aspirin also helps to relieve the back pain.

If these simple steps do not show results, consult your doctor.

The Secret to Get Relief From Lower Back Pain - Causes, Symptoms and Treatment Options

How is your lower back feeling?

Do you have problems with your back currently?

1.) Introduction

4 out of 5 people have dealt with back troubles of some kind. All of these individuals want to know the secret to get relief from lower back pain. Sometimes the back pain hurt enough and it has gone long enough that one of the only things you can focus on is getting relief. That back pain may be dull or it might be quite severe. Low back pain is generally broken down into two categories, acute and chronic.

Back pain that affects the lower back area and is acute, typically lasts for a short period of time, a couple of days to a couple of weeks. Individuals who have chronic, lower back pain have been suffering for at least 3 months, with the pain occurring on and off or with a dull consistency.

2.) Causes and Factors To Consider

Several factors could contribute to low back pain including incorrect posture positions, back strains that may occur as a result of heavy lifting or an overly intense workout, or a herniated disk. Other conditions that may cause pain in the lower back but are not related to the neurological system include:

Pregnancy which places additional stress on the spine because of the baby's weight and position
Kidney related conditions such as stones and infections that may produce tenderness and inflammation
Enlargement complications associated with the ovaries like cysts and fibroids

While the underlying source is important in terms of finding a permanent way to eradicate the problem, the cause is not the only issue; the one that is most important to those who are suffering is how long it will take to get relief from the lower back pain. The secret to getting that respite can be as simple as using a lower back brace.

Many types of back braces exist in the market. There is even a huge selection of back supports online. The particular brace that works best for you will be the one that most reduces your back pain and facilitates the healing process.

In the process, they work to reduce pain, as protection against a more serious affliction, and to promote healing of the damaged areas. When in doubt about the correct brace to use, you should consult your trusted back brace provider. These individuals are known as orthotists because they specialize in "orthotics". (This is the field of bracing.) These individuals are the ones that should provide you with medical advice on bracing.

Arthritis and Low Back Pain

The first thing I wish to impress upon you if you have been diagnosed as having 'arthritis' of your lower back, is do not worry! Arthritis in the lower back is something everyone will endure, from as young as our late twenties or early thirties (depending upon which research you read).

Therefore, if you have received the results of your X-ray and have subsequently been told the cause of your low back pain is arthritis (or wear and tear as it is sometimes called), do not be too concerned and think there is nothing which can be done for your pain.

As we get older and suffer wear and tear of any joint, this only means that the chances of us developing pain from that joint have increased, it is not a foregone conclusion however. As the wear and tear takes place, physical changes occur about that joint in response to the increased stresses being placed across it. It is how our body adapts to these changes which is the biggest indicator as to whether or not you will suffer pain, not the changes themselves.

Some people are very fortunate, whereby you may look at their X-ray and there will be a high degree of wear & tear present, yet they may be suffering very little or no pain at all. On the other hand, another person may not be so fortunate and have an X-ray where the arthritic changes present are relatively small, yet they will be in quite severe pain.

The main difference between these two individuals is not relative to the amount of wear and tear present, but rather how their own body's have responded to that wear and tear.

The most significant thing which arthritis does to a joint is it sensitises the structures involved, consequently increasing the likelihood of perceiving pain.

Consequently, if you can reduce these stresses across the joints concerned, by either stretching or strengthening the appropriate structures which have an influence over the arthritic joint, there is every chance the pain being felt can be resolved.

Therefore, if you are suffering with low back pain as a result of arthritis, do not give up hope. Although it may be a little more difficult, it does not mean for definite there is nothing which can be done for you. I have treated many patients who have been diagnosed with arthritis of their spine, yet they have gone on to make a 100% recovery.

In addition to this, it is important I add that the arthritis shown by the X-ray may be a complete red herring and have nothing at all to do with your pain!

Bearing in mind the majority of us will show signs of arthritis in our spine as we pass through our late twenties/thirties, if you were to X-ray 100 people within this age group who were suffering with no pain whatsoever, there is a very high likelihood that some of these individuals will be showing sign of arthritis of their spine... so how comes they are not suffering with low back pain?

The reason is just as I have explained above, arthritis increases the likelihood of you getting pain, it does not mean you are going to suffer pain. Even though you may be showing signs of arthritis on your X-ray, there maybe another very simple reason for your pain which is not due to that.

Therefore, in summary, all I am saying is that if you have been told you are suffering with arthritis of your low back, do not be too alarmed. It is something everyone suffers with as they get older and may have nothing at all to do with the pain you are currently suffering.

Even if it is contributing towards your pain though, it still doesn't mean there is nothing which can be done.

Lower Back Pain: The Causes and Treatment of Low Back Pain

Causes & Treatment of Lower Back Pain

Whilst there are a host of things that can be going on in your lower back, for the purposes of this article we'll stick to the back musculature which is usually where the problems originate.

Your back should have a natural curve in the lower back area which means that you could easily experience a back spasm just from bending over to pick something up.

However the actual cause of the spasm is not exactly clear & often difficult to figure out exactly what caused it - it could have been the weight of the object as well as the way you bent over to lift it because not taking the weight & stress through your spine could be a likely cause.

It is always best to bend your legs slightly & absorb the weight through your thighs whilst isolating your back so that it doesn't bear the brunt of lifting the object.

So generally to treat lower back spasms, the first thing to do is to ice the affected area of the back - heat can also be applied to the back muscles.

Medication in the form of anti-inflammatories often have an immediate effect in alleviating the back pain & make movement easier.

The sacroiliac joint in your back can be another culprit in contributing to back pain however strengthening your back muscles is often the best way to ensure that your spine remains flexible, healthy & pain free.

More on Treating Lower Back Pain

Lastly if basic treatment for your back does not alleviate the pain you should see a physician as the pain could be the result of a herniated disc, for example, which is not going to respond to basic treatment.

It's also interesting to note that lower back spasms affect up to 90% of Americans at some point in their lives.

Also, back pain is second only to the common cold as a cause of lost days at work & is one of the most common reasons for going to the doctor.

Furthermore the causes of recurring back pain is frequently the result of inadequate muscle strength, shortened muscles, poor posture, being overweight & poor bending and lifting techniques.

Apart from injuries, these are all factors that can be controlled & relief from back pain can be achieved as the body usually responds very well to treatment especially with muscle balance therapy.

Common Causes of Lower Back Pain

Back pain is one of the most common health complaints among adults, but it can have a wide variety of causes, not all related to spinal health. Read more about some potential causes of your back pain, and then go see your doctor or an orthopedic specialist to help create a healing plan and solution for your back pain.

Injury of Overuse of Muscles

If you work out frequently, lift objects with your back, or have been in an automotive accident, the muscles in your low back may be unhappy with you. You may want to speak with a physical therapist about muscle strengthening exercises for your back if daily activities like work or exercise are causing the muscles in your low back to ache. If you've been in an accident, you may also find physical therapy helpful, but you definitely want to speak to your doctor first to eliminate any other possible causes of your pain.

Fracture

Any kind of excessive force to your back can potentially cause fractures to occur in your vertebrae. Accidents, direct blows, and falls can all cause fractures. To diagnose for certain that a fracture is causing you pain, you'll need to see your family doctor or an orthopedic specialist.

Herniated Disc

Your spine consists of bone and cushioning discs that are filled with a jelly-like substance. A herniated disc happens when the jelly-like substance is forced out of its normal state and ends up pushing against a nerve root.

Age-Related Diseases

Osteoarthritis and Osteoporosis are two age related, degenerative diseases that can cause you back pain. Osteoarthritis affects the small joints in the spine, making them weak and able to cause you pain. Osteoporosis can lead to hairline fractures along your spine due to the weakening and demineralization of bone.

Spinal Deformities

You may not have ever realized it, but your spine may not be perfectly straight. If it's not, your body may compensate by putting more weight on certain areas than others. Two technical terms for spinal deformities are scoliosis, where the spine curves abnormally from side to side instead of being straight, and kyphosis, another curving of the spine which causes bowing or rounding of the back.

Referred Pain

Often, our backs will "feel" pain that is actually occurring in another part of our bodies. This is known as referred pain. Your lower back tends to sense the pain felt by organs in your abdomen. Intestinal pain, aneurysms, kidney disease, bladder infections, appendicitis, and uterine and ovarian disorders can all be felt as referred pain in your lower back. Your doctor or orthopedic specialist will keep the possibility in mind that your back pain could be symptomatic of pain actually occurring elsewhere in your body.

Help! My Low Back Pain and Sciatica Are Killing Me!

The pain in your low back drops you to your knees again. All you did was bend over to pick up the pen you dropped on the floor. This time is different, though. It's worse than it's been in the past. This time you feel pain shoot down the back of your leg. A white-hot dagger is stabbing you in the rear end and you feel numbness and tingling in your leg, perhaps all the way down to your foot. You can't straighten up to walk and you are limping along like you've been shot. You remain still and pray the pain goes away...but it doesn't go away. In fact, it's getting worse. Your thoughts come in rapid-fire succession, "what is happening to me, what should I do, who do I call, should I go to the emergency room, will I need surgery?" Good questions.

If you are experiencing any combination of these symptoms, chances are you have a herniated disc in your lower back, one of the causes of mechanical back pain. The swelling from inflammation or the disc itself can cause an impingement or "pinching" of the spinal nerve root. The lower lumbar nerve roots eventually form the sciatic nerve in your leg. Inflammation of this nerve is commonly known as sciatica. "Mechanical low back pain is one of the most common patient complaints expressed to emergency physicians in the United States accounting for more than 6 million cases annually. Approximately two-thirds of adults are affected by mechanical low back pain at some point in their lives, making it the second most common complaint in ambulatory medicine and the third most expensive disorder in terms of health care dollars spent, surpassed only by cancer and heart disease." 1

But just because you have these symptoms, doesn't necessarily mean that you need to rush to the surgeon. According to a landmark study published in the medical journal Spine, "an operation should not be performed if other treatment will give equivalent results within an acceptable period of time...the patient with low back pain and sciatica should not automatically be referred to the surgeon." 2 If that's the case, then what are some of your other options? If you are like most people, the first place you will think to visit will be your family doctor's office (or an emergency room, if you are really in a panic). Traditionally, medical doctors will prescribe medications, such as pain killers, muscle relaxers, anti-inflammatories or any combination of these. There are three problems with taking medication, if this is all that is done.

1. Medication only treats the symptoms.


2. Medication only provides temporary relief.


3. Medication has many unhealthy side-effects. Take the time to read the warning insert with any of these medications and you will know what I'm talking about.

By contrast, chiropractic care has been shown to be more effective in treating chronic low back pain than traditional medical care. In one study published in the Journal of Manipulative Physiological Therapeutics (JMPT), it concluded that "...the improvement for chiropractic patients was 5 times greater [than for medical patients]. Patients with chronic low-back pain treated by chiropractors show greater improvement and satisfaction at 1 month than patients treated by family physicians." 3

Are there times when surgery is necessary? The answer is, most definitely, yes. Absolute signs for surgical intervention are those patients with cauda equina syndrome (which is rare), in the presence of severe motor deficits resulting from a large extruded or migrated disc fragment, and in patients with intractable pain. Unless one of these conditions is present, chiropractic care for the treatment of discogenic or mild to moderate sciatic pain from intervertebral disc herniation has been proven to be safe and effective. One study shows that chiropractic treatment (in this case in the cervical spine) is 100 times safer than using Non-Steroidal Anti-Inflammatory Drugs like asprin, ibuprofen, naproxen, etc. 4 Another study shows patients had an 86% improvement in chronic low back pain after a course of chiropractic care. 5

As a side note, let me also say that medical care and chiropractic care are not mutually exclusive ways to treat mechanical low back pain and sciatica. In my experience, I have seen great results with the most severe cases when managing these conditions cooperatively with a patient's primary care doctor or pain management specialist. In these cases the medication is useful or necessary in order for the patient to tolerate conservative care; for example, when it is extremely difficult for the patient to move or to be moved.

Lastly, not every case of sciatica is caused by a herniated disc. A condition called piriformis syndrome can cause impingement of the sciatic nerve as it exits the pelvis. Basically, the piriformis muscle attaches at the sacrum, passes through the greater sciatic notch of the pelvis, and attaches to the top of the femur (the upper leg bone). Atheletes who participate in sports where they are sitting, such as rowing or cycling are particularly vulnerable to strains of the piriformis. Runners who overpronate are also susceptible to piriformis injury. When the muscle is injured, it causes swelling due to inflammation, which can then irritate or compress the sciatic nerve as it exits the pelvis. It is important to rule out spinal injury as the cause of sciatica, but the following video will demonstrate a stretch for the piriformis muscle. If your symptoms resolve after performing the stretch for a week or two, then you probably had piriformis syndrome and should continue this stretch as part of your daily routine to help prevent future injury. However, if you are still experiencing the same symptoms or if they intensify, seek professional help as soon as possible.

1. Kinkade S. Evaluation and treatment of acute low back pain. Am Fam Physician. Apr 15, 2007;74(8):1181-8.


2. Weber H. Lumbar disc herniation: a controlled prospective study with ten years of observation. Spine 1983;8:131-40.


3. Nyiendo J, Haas M, Goodwin P. Patient characteristics, practice activities, and one-month outcomes for chronic, recurrent low-back pain treated by chiropractors and family medicine physicians: A practice-based feasibility study. JMPT 2000 May;23(4):239-245.


4. Hurwitz EL, Aker PD, Adams AH, Meeker WC, Shekelle PG. Manipulation and mobilization of the cervical spine. A systematic review of the literature. Spine 1996 Aug 1/21(15):1746-59.


5. Harrison DE, Cailliet R, Harrison DD, Janik TJ, Holland B. Changes in sagittal lumbar configuration with a new method of extension traction: nonrandomized clinical controlled trial. Archives of Physical Medicine and Rehabilitation 2002 Nov;83(11):1585-91.

Low Back Pain When Leaning Backwards

There are many, many diagnoses available for those suffering with low back pain, and they can all present with very similar signs & symptoms. One such symptom is pain when leaning backwards. Two typical examples for this type of pain, which would dictate completely different treatment procedures, would be facet joint pain and a disc bulge.

If facet joint pain is your problem, this would be due to the joints in your back being 'forced against' one another as you lean backwards. The aim of treatment here would be to elicit any muscle imbalance about your lower back and look to stretch and strengthen as appropriate. In addition to this, gently mobilising the joints will also help to take some stress from them, therefore encouraging the healing process. A simple exercise to get you started may be lying on you back and then gently hugging your knees to your chest.

Alternatively, if it is a disc bulge which is causing your pain, this is likely to be a result of the disc being 'pinched' as you lean backwards, therefore causing you pain. The irony of it is, if this is the case, some kind of extension (leaning backwards) exercise will form the basis of your treatment. This is likely to begin with you simply lying on your stomach little and often throughout the day. From here, you may well progress to gentle extension exercises while lying on your front.

The important thing to note here is, what may appear to be similar problems due to them both causing pain when leaning backwards, will actually need completely different treatment techniques to resolve the problem.

If you were to perform the exercises intended for a facet joint problem on a disc bulge, or vice versa for that matter, you will only succeed in making your pain worse.

No treatment or exercise programme should make your pain worse, if it does, something needs to be changed. It maybe you are performing the correct exercises, but are just being a bit to vigorous to begin with. However, it may also be that you are simply performing the incorrect exercises for your problem.

Either way, if things are making your pain worse, you need to change what you are doing, either by easing off or trying a different exercise altogether.