Notes

Back Pain

Back pain is one of the most common reasons people go to the doctor or miss work, and it is a leading cause of disability worldwide. Most people have back pain at least once.Signs and symptoms of back pain can include:Muscle acheShooting or stabbing painPain that radiates down your legPain that worsens with bending, lifting, standing or walkingPain that improves with recliningEncyclopedia Entry for Back Pain :Back pain - returning to work. Exercise helps to prevent future back pain: Exercise a little every day. Walking is a good way to keep your heart healthy and your muscles strong. If walking is too hard for you, work with a physical therapist to develop an exercise plan that you can do. Keep doing the exercises you have been shown to strengthen your core muscles, which support your back. A stronger core helps lower your risk for further back injuries. If you are overweight, ask your health care provider about ways you can lose some weight. Carrying around extra weight adds stress to your back no matter what kind of work you do. Long car rides and getting in and out of the car can be hard on your back. If you have a long commute to work, consider some of these changes: Adjust your car seat to make it easier to enter, sit in, and get out of your car. Bring your seat as far forward as possible to avoid bending forward when you are driving. If you drive long distances, stop and walk around every hour. DO NOT lift heavy objects right after a long car ride.Know how much you can safely lift. Think about how much you have lifted in the past and how easy or hard that was. If an object seems too heavy or awkward, get help to move or lift it. If your work requires you to do lifting that may not be safe for your back, talk with your boss. Try to find out the most weight you should have to lift. You may need to meet with a physical therapist or occupational therapist to learn how to safely lift this amount of weight. Follow these steps when you bend and lift to help prevent back pain and injury: Spread your feet apart to give your body a wide base of support. Stand as close as possible to the object you are lifting. Bend at your knees, not at your waist. Tighten your stomach muscles as you lift the object up or lower it down. Hold the object as close to your body as you can. Lift slowly, using the muscles in your hips and knees. As you stand up with the object, DO NOT bend forward. DO NOT twist your back while you bend to reach the object, lift the object up, or carry the object. Squat as you set the object down, using the muscles in your knees and hips. Some providers recommend using a back brace to help support the spine. A brace may help prevent injuries for workers who have to lift heavy objects. But, using a brace too much can weaken the core muscles that support your back, making back pain problems worse.If your back pain is worse at work, it may be that your work station is not set up correctly. If you sit at a computer at work, make sure that your chair has a straight back with an adjustable seat and back, armrests, and a swivel seat. Ask about having a trained therapist assess your workspace or movements to see if changes, such as a new chair or a cushioned mat under your feet, would help. Get up and move around during the workday. If you are able, take a 10 to 15 minute walk in the morning before work and at lunchtime. If your work involves physical activity, review the needed motions and activities with your physical therapist. Your therapist may be able to suggest helpful changes. Also, ask about exercises or stretches for the muscles you use most during work. Avoid standing for long periods. If you must stand at work, try resting one foot on a stool, then the other foot. Keep switching off during the day. Take medicines as needed. Let your boss or supervisor know if you need to take medicines that make you sleepy, such as narcotic pain relievers and muscle relaxant medicines.Nonspecific back pain - work; Backache - work; Lumbar pain - work; Pain - back - chronic; Low back pain - work; Lumbago - work.Barr KP, Concannon LG, Harrast MA. Low back pain.Encyclopedia Entry for Back Pain :Back pain - when you see the doctor. Questions your provider may ask include: Is your back pain on one side only or both sides? What does the pain feel like? Is it dull, sharp, throbbing, or burning? Is this the first time you have had back pain? When did the pain begin? Did it start suddenly? Did you have an injury or accident? What were you doing just before the pain began? For example, were you lifting or bending? Sitting at your computer? Driving a long distance? If you have had back pain before, is this pain similar or different? In what way is it different? Do you know what caused your back pain in the past? How long does each episode of back pain usually last? Do you feel the pain anywhere else, such as in your hip, thigh, leg or feet? Do you have any numbness or tingling? Any weakness or loss of function in your leg or elsewhere? What makes the pain worse? Lifting, twisting, standing, or sitting for long periods? What makes you feel better? You will also be asked if you have other symptoms, which may point to a more serious cause. Tell your provider if you have had weight loss, fever, a change in urination or bowel habits, or a history of cancer. Your provider will perform a physical exam to try to find the exact location of your pain, and determine how it affects your movement. Your back will be pressed on at different spots to find where it hurts. You will also be asked to: Sit, stand, and walk Walk on your toes and then your heels Bend forward, backward, and sideways Lift your legs straight up while lying down Move your back in certain positions If the pain is worse when you lift your legs straight up while lying down, you may have sciatica, especially if you also feel numbness or tingling going down the same leg. Your provider will also move your legs into different positions, including bending and straightening your knees. A rubber hammer is used to check your reflexes and to see if your nerves are working properly. Your provider will touch your skin in many places, using a pin, cotton swab, or feather. This reveals how well you can feel or sense things.Dixit R. Low back pain.Encyclopedia Entry for Back Pain :Back pain and sports. Although bicycling strengthens the muscles of your legs, it does not do much for the muscles around your spine. Bending your lower spine forward while arching your upper back for long periods can strain your back and neck muscles. Mountain biking on uneven surfaces can cause jarring and sudden compressions (squeezing) on the spine. Tips to help make bicycling easier on your back include: Avoid mountain biking. Ride a bike that fits you properly. Staff at a good bike shop can help you get fitted. Remember not only to push down on the pedals, but also to pull up on them. Wear biking gloves and use a handlebar cover to reduce jarring in your upper body. Put shock absorbers on the front wheel. A more upright bike can have less pressure on your lower back and neck. Recumbent bikes place less stress on your back and neck. The muscles that bring your leg up toward your abdomen are called flexors. They are used a lot when you ride a bicycle. Keeping these muscles stretched out is important because it will help keep the proper balance in the muscles around your spine and hips.Weightlifting can put a lot of stress on the spine. This is especially true for people who are middle-aged and older because their spinal disks may dry out and become thinner and more brittle with age. Disks are the 'cushions' between the bones (vertebrae) of your spine. Along with muscle and ligament injuries, weightlifters are also at risk for a type of stress fracture in the back called spondylolysis. To prevent injuries when weightlifting: Do some aerobic exercise and stretch well before lifting to warm up your muscles. Use training machines rather than free weights. These machines place less stress on your spine and do not require a spotter. Training machines are also easier to learn how to use compared to free weights. Do more repetitions instead of adding more weight when you are trying to build strength. Lift only as much as you can safely lift. DO NOT add too much weight. Learn the proper lifting techniques from someone who is well-trained. Technique is important. Avoid certain weightlifting exercises that are more stressful on your spine. Some of these are squats, clean-and-jerks, snatches, and dead-lifts. Ask your provider or trainer whether a weightlifting belt would be helpful for you.The golf swing requires forceful rotation of your spine, and this puts stress on your spinal muscles, ligaments, joints, and disks. Tips to take the stress off your back include: Ask your physical therapist about the best posture and technique for your swing. Warm up and stretch your muscles in your back and upper legs before starting a round. Bend with your knees when picking up the golf ball. On the course, use a push cart (trolley) to wheel your golf bag. You can also drive a golf cart.The disks and the small joints in the back are called facet joints. Running causes repeated jarring and compression on these areas of your lumbar spine. Tips to help reduce the stress on your spine include: Avoid running on concrete and uneven surfaces. Instead run on a padded track or soft, even grassy surfaces. Wear high-quality running shoes with good cushioning. Replace them when they become worn. Ask your physical therapist about the best running form and motion. Most experts suggest a forward motion, leading with your chest and keeping your head balanced over your chest. Before taking off on a longer run, warm up and stretch the muscles in your legs and lower back. Learn exercises that strengthen the core muscles deep inside your abdomen and pelvis that support your spine.Motions that place stress on your spine while playing tennis include overextending (arching) your back when serving, constant stopping and starting motions, and forceful twisting of your spine when taking shots. A tennis coach or your physical therapist can show you different techniques that can help reduce the stress on your back. For example: Bend your knees. Keeping your abdominal muscles tighter will reduce stress on your spine. Ask about the best ways to serve to avoid overextending your lower back. Before playing, always warm up and stretch the muscles in your legs and lower back. Learn exercises that strengthen the core muscles deep inside your abdomen and pelvis, which support your spine.Before skiing again after a back injury, learn exercises that strengthen the core muscles deep inside your spine and pelvis. A physical therapist may also help you to build strength and flexibility in the muscles that you use when you twist and turn while skiing. Before you start skiing, warm up and stretch the muscles in your legs and lower back. Make sure you only ski down slopes that match your skill level.Although swimming can strengthen the muscles and ligaments in your spine and legs, it can also stress your spine by: Keeping your lower back extended (arched) when doing strokes on your stomach, such as the crawl or the breaststroke Turning your neck back every time you take a breath Swimming on your side or back can avoid these movements. Using a snorkel and mask may help decrease the neck turning when you breathe. Proper technique when swimming is also important. This includes keeping your body level in the water, tightening your abdominal muscles somewhat, and keeping your head on the surface of the water and not holding it in a lifted position.Bicycling - back pain; Golf - back pain; Tennis - back pain; Running - back pain; Weightlifting - back pain; Lumbar pain - sports; Sciatica - sports; Low back pain - sports.Lauerman W, Russo M. Thoracolumbar spine disorders in the adult.