Lower back pain or low back pain is quite common among the adult population of Western countries and about 80% suffer from it sooner or later. This disorder is due to the fact that this part of the back (called the lumbar spine) must support the trunk when running, walking and sitting; the resulting pressure has a negative impact on the joints, intervertebral discs, ligaments and nerves. Lower back pain can vary in intensity, from mild to very severe, but typically lasts a few days to a few weeks. It is possible to manage these episodes at home, although medical intervention is required in severe cases.
Steps
Method 1 of 3: Manage Lower Back Pain at Home
Step 1. Rest and be patient
The spine is a complex part, where there are many joints, nerves, muscles and blood vessels. Therefore, there are several structures that can cause pain if you move the wrong way, suffer trauma or over-stress the area. However, low back pain (even when it is severe) goes away quickly without any treatment - often within a few days. The human body has the powerful ability to heal and most back pain is caused by a situation of "imbalance" and not by real damage. If you have lower back pain, be patient, stop any activity that worsens your physical condition and see if it goes away on its own.
- In most cases of low back pain, bed rest is no longer recommended. Doctors agree that practicing at least some light exercises (walking, climbing stairs) is useful against this type of discomfort, because it stimulates blood circulation, as well as allowing to "unblock" the vertebral joints and the irritated spinal nerves.
- If the pain is caused by physical activity in the gym, you may have been training too hard or the wrong way - ask the instructor for some advice.
- If it is related to your job role, discuss it with your manager or boss about relying on lighter tasks or changing your workplace - for example, installing a cushioning mat on the floor or providing you with a chair with lumbar support.
Step 2. Use cold therapy for acute pain
As you rest and be patient for a few days, consider using cold therapy. Applying an ice pack or frozen gel pack for acute musculoskeletal disorders (sudden or new) is an effective remedy, because it numbs the sensation of pain and reduces inflammation. You should apply crushed, cubed ice, a frozen gel pack, or a pack of frozen vegetables to your lower back for 10-15 minutes every hour until the pain begins to dissipate. When the situation improves, reduce the frequency to three times a day.
- Always wrap the source of cold in a thin cloth before placing it on your back, to avoid chilblains and skin irritation.
- By compressing the compress on the back with an elastic bandage or a lumbar belt, you can prevent inflammation from increasing.
- Remember that cold therapy is generally not suitable for chronic (lasting) pain, as it aggravates symptoms - moist heat offers greater benefits in these cases.
Step 3. Apply moist heat when low back pain is chronic
If you are constantly experiencing pain that has disappeared and returned for several months or years, it is best to use heat, as it promotes blood supply to the area, relaxes tight muscles and other soft tissues. A good source of moist heat is herbal bags to warm in the microwave, especially those infused with relaxing aromatherapy products, such as lavender essential oil. Place a bag in the microwave for a couple of minutes and then place it on your lower back while sitting or lying down for about 20 minutes. Cover the bag with a cloth to insulate it and prevent it from cooling too quickly.
- Alternatively, soak in a warm Epsom salt bath for at least 20 minutes, several times a day, until symptoms subside. Epsom salt contains magnesium which relaxes muscles and controls swelling.
- Make sure the water isn't too hot to burn you and remember to always keep yourself well hydrated - a salt bath draws the fluids out of your skin and dehydrates you.
- It is not recommended to apply moist heat or take a hot salty bath when suffering from acute low back pain, as it increases blood supply and promotes inflammation.
Step 4. Take over-the-counter medicines
Non-steroidal anti-inflammatory drugs (NSAIDs) on sale, such as ibuprofen (Brufen, Moment), naproxen (Aleve) or aspirin, are effective short-term solutions for acute cases because they fight inflammation and pain. Chronic pain, on the other hand, responds better to taking over-the-counter pain relievers, such as acetaminophen (Tachipirina), because they alter the brain's perception of pain.
- NSAIDs can be harmful to the stomach and kidneys if taken for a long time and in high dosages (more than a couple of months); so be careful and read the leaflet carefully.
- Paracetamol does not cause major damage to the stomach and kidneys, but it can have repercussions in the liver; use it in moderation.
- Another way to find pain relief without irritating the stomach, liver or kidneys is to apply a cream or gel that contains NSAIDs, acetaminophen, or natural pain relievers such as menthol and capsaicin.
Step 5. Change your sleeping position
The posture you assume in bed and / or the environment in which you sleep can contribute to or cause lower back pain. For example, sleeping prone causes the lumbar spine to arch too much, compressing and irritating both nerves and joints. The best positions to sleep without aggravating low back pain are reclining (lateral, similar to fetal, but with the hips and knees bent) and supine (on the back and with the legs raised on a pillow). Both relieve pressure on the lower back joints while minimizing the chances of irritation and pain.
- Changing the environment in which you rest usually means making sure that the mattress and the slatted base support the spine. In general, beds that are too soft tend to promote low back pain, while orthopedic ones, which are harder, reduce the incidence of back pain.
- Each individual is slightly different, so a good way to evaluate your bed is to check if you wake up sore or not. If you wake up in the morning suffering from joint pain, the position when you sleep or the environment are a factor that aggravates the situation. If, on the other hand, you feel more pain in the evening, it is more likely that work, physical activity, or the tasks you do are responsible.
- Remember that most foam mattresses and those with springs last a maximum of 10 years of constant use, although body weight also plays a role. Turn and flip the mattress regularly (every time you wash the sheets) to increase its durability.
Step 6. Improve your posture
A too hunched position while sitting or standing increases the strain on the lower back, causing irritation or pain. By optimizing your posture, you are able to reduce the weight on your back and find relief from existing pain; this way you can also minimize relapses. However, it is a difficult task that requires daily commitment and dedication.
- Strengthening the core muscles is a perfect strategy for improving posture. These are the lumbar muscles, lower abdomen and pelvis which are all connected to the spine or pelvis itself and contribute in some way to maintaining an upright position.
- To hold the correct position while standing: distribute your body weight on both feet and avoid locking your knees; contract your abs and glutes to keep your back straight; wear footwear that offers good support and relieves muscle fatigue by resting periodically on one foot or stool.
- To keep the correct position while sitting: choose a sturdy chair, preferably with armrests; keep your back straight and shoulders relaxed; put a small pillow behind your back to maintain the natural curvature of the lumbar region; put your feet flat on the floor and use a footrest if necessary.
Step 7. Make sure you are following the correct weight lifting techniques
While there is some disagreement as to which method is best, as it varies according to the circumstances, there are a number of ground rules that you should try to stick to.
- Evaluate the weight so that you are not surprised by a load that is too heavy or unstable. If the weight is too much for your abilities, ask for help.
- Get as close to the load as possible before lifting it and continue to hold it close to your body as you carry it.
- Do not twist, stretch or rotate the waist; if you have to turn around, move your whole body.
- The suitable positions for lifting a weight are: the squatting one (bending the knees and hips while the spine remains straight), the bending one (keeping the legs straight and bending the torso forward at the level of the waist without hunching the back) and the "freestyle" (semi-squatting that allows you to rest the load on your thighs).
Method 2 of 3: Alternative Treatments
Step 1. Make an appointment with a chiropractor
It is a specialist, sometimes a doctor, who focuses primarily on the care of the spine and other joints. He is qualified to treat back problems with natural methods, for example through spinal manipulation. This is a technique, sometimes referred to as spinal alignment, which allows you to unblock or reposition joints in the spine that are slightly misaligned and cause acute pain, as well as inflammation.
- A single manipulation session can have great benefits against low back pain, but it usually takes three to five treatments to really feel better.
- Chiropractors also use elaborate therapies to treat muscle tears and ligament sprains; these techniques may be more appropriate for your problems. Muscle electrostimulation, ultrasound and TENS treatments are all therapies that fall into this category.
- In some cases it is possible to treat the pain by subjecting the back to a traction or a stretch with an inversion bench. Some professionals use this tool that allows you to recline the upper body, so that the force of gravity decompresses the vertebrae.
Step 2. Get a lower back massage
As previously described, not all back injuries are related to the joints. In some cases the pain is caused by muscle strains or tears. Stretching occurs when small muscle fibers tear causing pain, inflammation, spasms, and poor posture to protect the injury. A deep tissue massage is perfect for mild to moderate stretches because it calms contractions, reduces inflammation and promotes relaxation. Start with a 30-minute massage performed by a licensed physiotherapist, ask him to focus on the pelvis and lumbar part of the back.
- A half hour session may be enough to ease the pain, but it often takes more sessions to notice significant results. When the pain is chronic, consider getting a one-hour massage, including some treatments on the middle back and legs.
- Drink plenty of plain water after a massage to get rid of the inflammatory byproducts released from the body. If not, you may experience muscle aches, headaches, and mild nausea.
- As an alternative to a professional massage, place a tennis ball under your lower back and move slowly on it for 15 minutes, a few times a day until the pain subsides.
Step 3. Try acupuncture
It is an ancient Chinese healing technique that involves inserting fine needles into specific points on the skin to reduce pain and inflammation. Acupuncture can prove to be really helpful in low back pain, especially if it's done when the symptoms are acute (relatively new). It seems that this technique works by triggering the release of certain substances, including serotonin and endorphins, which reduce the painful sensation.
- There is some research showing the effectiveness of acupuncture against chronic lower back pain; however, the results are variable.
- The points that provide relief from low back pain are not all located near the painful area; some can also be found in parts of the body that are quite distant, such as the hand.
- Acupuncture is practiced by many health professionals, including doctors. However, as it is not part of traditional medicine and is not yet well regulated, only consult a reputable professional.
Step 4. Consider Cognitive Behavioral Psychotherapy (TCC)
This therapeutic approach seeks to identify the patient's negative beliefs and thoughts and replace them with positive ones. Specifically, CBT used to treat low back pain should focus on how you respond to or feel pain. It has been shown to be effective in reducing chronic pain and stress in many patients.
- TCC may be the "last resort" for lower back pain when no other solution has yielded the desired results.
- Ask your family doctor, psychologist or, if you have private health insurance, the insurance agent who deals with your policy for advice to get some names of therapists who apply TCC in the city where you live. Consider interviewing a couple of professionals before deciding which one to contact.
Method 3 of 3: Medical Care
Step 1. Make a doctor's appointment
If patience, home remedies, and alternative therapies have not been helpful for lower back pain, you should make an appointment at the doctor's office. Your doctor will see you to see if the pain is caused by a severe spinal problem, such as a herniated disc, a pinched nerve, a bone infection (osteomyelitis), osteoporosis, a stress fracture, stage arthritis advanced or cancer. Your doctor may prescribe NSAIDs or stronger pain relievers to control the pain.
- X-rays, bone scans, magnetic resonance imaging, computed tomography, and nerve conductivity studies can be used to observe and diagnose spinal problems.
- Your doctor may request a blood test to make sure you don't have rheumatoid arthritis or a spinal infection (meningitis or osteomyelitis).
- You may also be referred to a specialist (orthopedist, neurologist, or rheumatologist) to pinpoint the problem more clearly.
Step 2. Get the name of a good physical therapist
If your low back pain is chronic (you have been in pain for many months or years), is related to muscle weakness, poor posture and / or a degenerative condition (wear-and-tear osteoarthritis), you should consider spinal physiotherapy - in all likelihood you will need a referral from the doctor. The physiotherapist can teach you specific exercises to stretch and strengthen the lower back which, over time, will alleviate the pain. It is generally recommended to undergo three sessions per week for 4-8 weeks, to obtain appreciable results against chronic low back pain.
- To perform a spinal rehabilitation, physiotherapists usually use several Swiss balls, medicine balls with different weights, resistance bands, electrical muscle stimulation and / or ultrasound devices.
- The exercises that are effective to strengthen the lower back muscles and that you can do on your own are: swimming, some yoga poses, back extensions and rowing training.
Step 3. Try myofascial node or trigger point therapy
Low back pain could be due to a muscle injury or a tear at a trigger point that causes pain directly in the area or pain that extends to another part of the body. For this reason, even if you have pain in the lower back, the trigger point may be in another area.
Find a doctor who can diagnose and treat myofascial pain. He can use a variety of techniques to dissolve the trigger point
Step 4. Consider treating low back pain with steroid injections
If prescription strong pain relievers and / or rehabilitation aren't effective, corticosteroid injections done directly into your lumbar joint, muscles, tendons, or ligaments can quickly reduce pain and inflammation, allowing you to move more smoothly. Corticosteroids are made up of natural human hormones that have fast-acting anti-inflammatory properties. The most common that are used by doctors are prednisolone, dexamethasone and triamcinolone. Your family doctor will most likely recommend an orthopedist to undergo these injections if they find them useful.
- Potential side effects are: local infections, excessive bleeding, weakening of tendons, muscle wasting, nerve irritation or damage, and decreased immune system function.
- The relief provided by steroid injections can last anywhere from a few weeks to many months. Doctors are typically likely to perform more than two injections per year.
- If corticosteroid injections aren't great for low back pain, either, you should discuss surgery with your doctor (there are many different procedures) as a last resort.
Advice
- Rolling a piece of hard foam on top is a good technique for massaging the lower back and relieving pain. Ask your yoga teacher, physical therapist, or chiropractor to lend you a foam roll, or buy one from sporting goods stores or the superstore.
- In addition to the foam roll, you can use a simple tennis or lacrosse ball to work the muscle knots in your lower back. Place a ball under the lower back and roll it until you find the sore spot. Leave it there for a few seconds and then move on to the next painful area. Repeat this exercise every day until the pain subsides.
- Relaxation practices such as meditation, Pilates, and breathing exercises help prevent or relieve lower back pain.
- Stop smoking, as this habit impairs blood circulation by reducing the supply of oxygen and nutrients to the lower back and other muscles.
- Try to keep yourself relatively fit, as lower back pain is more common among the overweight or out of shape population.
Warnings
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Go to the family doctor immediately if the pain:
- It extends from the back towards the leg;
- Worsens when you lean forward or bend your knees
- It gets worse at night;
- It is accompanied by an unexplained fever and sudden weight loss;
- It occurs in conjunction with sudden urinary and fecal incontinence;
- It is associated with numbness or weakness in the legs.
