Chronic Pain – Low Back Pain

Sometimes stress causes muscle pain between my shoulder blades or lower back. I also get lower back pain if I sit on the floor too long without back support. Many of the most serious forms of back pain are caused by injury or illness.

Chronic Low Back Pain

Getting Moving Will Help Your Back Pain
from Health.com

Back pain can send sufferers crawling to the nearest couch or bed, but it’s better to attack the pain with over-the-counter medications and limited exercise.

“In the past we used to tell patients with back pain to stay at strict bed rest,” says Jeffrey Goldstein, MD, Director of the Spine Service at the New York University Hospital for Joint Diseases. “We know now that staying in strict bed rest can actually exacerbate pain, so we essentially tell patients to take it easy and move as much as tolerated.”

Turns out your back needs exercise to heal. “The disks in your spine don’t have much blood supply or neural supply,” says Joel Press, MD, medical director of the Spine and Sports Rehabilitation Centers at the Rehabilitation Institute of Chicago. “Instead they get their nutrition from movement. Fluid squishes in and squishes out—if you don’t have movement the disks in your back don’t get the nutrition they need to be healthy.”

Exercise can include careful stretching, mild activity such as walking, and, as the pain improves, progressive stretching routines such as yoga (strengthening muscles helps relieve stress on the spine). Relaxation techniques are also helpful, teaching you how to systematically relax each muscle in the body. Stress, which can tighten muscles, is probably a cause of some low back pain.

“I see a correlation with stress,” says Jane Jones, 56, of Overland Park, Kansas. “When I’m going through a busy time at work or a stressful time with family, my back hurts.” Stress relief techniques, including exercise, can help with prevention as well as treatment.

The Three Types of Low Back Pain
content provided by Healthwise

The course of low back pain depends both on its cause and on how well you treat your back.

• Most low back pain lasts less than 3 months. Overall, 60% of low back pain goes away within 1 week, 90% within 6 weeks, and up to 95% recover within 12 weeks. Over 98% of low back pain is gone within 1 year.
• Once you have hurt your back, you are more likely to hurt your back again. Many people who recover from low back pain will have a repeat episode within a year. Most people will have it again sometime during their lives.
• Long-lasting (chronic) pain not only makes you tired, irritable, and less productive and active, but it can trigger other problems. If your back pain causes you to use your body in different ways (for example to limp or to sit differently), pain can develop in other areas of the body. Pain can also cause biochemical changes in your body that tend to keep the pain going. Without specialized treatment, chronic pain syndrome can become disabling.

Exercises to reduce low back pain

Low back pain is very common among adults and is often caused by overuse and muscle strain or injury. Treatment can help you stay as active as possible, and it will help you understand that some continued or repeated back pain is not surprising or dangerous.

Most low back pain can get better if you stay active, avoid positions and activities that may increase or cause back pain, use ice, and take nonprescription pain relievers when you need them.
When you no longer have acute pain, you may be ready for gentle strengthening exercises for your stomach, back, and legs, and perhaps for some stretching exercises. Exercise may not only help decrease low back pain, but it may also help you recover faster, prevent reinjury to your back, and reduce the risk of disability from back pain.

Exercises to reduce low back pain are not complicated and can be done at home without any special equipment.

It’s important that you don’t let fear of pain keep you from trying gentle activity. You should try to be active soon after noticing pain, and gradually increase your activity level. Too little activity can lead to loss of flexibility, strength, and endurance, and then to more pain.

What exercises may reduce low back pain?

Exercises that may help reduce or prevent low back pain include:

• Aerobic exercise, to condition your heart and other muscles, maintain health, and speed recovery.
• Strengthening exercises, focusing on your back, stomach, and leg muscles.
• Stretching exercises, to keep your muscles and other supporting tissues flexible and less prone to injury.

Some exercises can aggravate back pain. If you have low back pain, avoid:

• Straight leg sit-ups.
• Bent leg sit-ups or partial sit-ups (curl-ups) when you have acute back pain.
• Lifting both legs while lying on your back (leg lifts).
• Lifting heavy weights above the waist (standing military press or bicep curls).
• Toe touches while standing.

How do I exercise to reduce low back pain?

Most people who have back pain naturally feel better by doing certain motions. Some feel better sitting (their back and hips are flexed), while others feel better standing (back and hips are extended). Exercise that moves you toward your more comfortable position is usually more successful in treating your back pain. For example, if you are more comfortable sitting down, exercises that bend you forward—such as partial sit-ups (curl-ups) and knee-to-chest exercises—may help you.

Talk to your health professional before you start an exercise program, and only do exercises that do not increase your symptoms.

The most effective exercise programs for chronic low back pain are designed specifically for you and are supervised. For example, a physical therapist might instruct you in a home exercise program; then you would see the therapist every so often to check on your progress and advance your program.

Talk to your doctor or physical therapist if you are unsure how to do these exercises or if you feel any pain as you are doing the exercises.

• Try to exercise a little bit every day.
• Get some type of aerobic exercise, such as walking, every day. Even a couple of minutes will be helpful, and you can gradually increase your time.
• Choose a couple of stretching and strengthening exercises that you enjoy doing, or vary them from day to day.
• Ask your doctor or physical therapist whether there are additional exercises that will work best for you.

Stretching and strengthening exercises include:

• Extension exercises, which stretch tissues along the front of the spine, strengthen the back muscles, and may reduce pain caused by a herniated disc. These are generally a good choice for people whose back pain is eased by standing and walking.
• Flexion exercises, which strengthen stomach and other muscles, and stretch the muscles and ligaments in the back. These are generally a good choice for people whose back pain is eased by sitting down.
• Aerobic exercise includes walking, swimming, running, and biking. Non–weight-bearing exercise, such as swimming, tends to be a better choice if you have back pain. Walking in water up to your waist or chest is also good aerobic exercise.

You should keep taking easy, short walks when you have low back pain. You can likely start more intense aerobic exercise within 1 or 2 weeks after symptoms of back pain start. Begin with 5 to 10 minutes a day and gradually work up to 20 to 30 minutes of continuous activity per day.

You’ll find exercises to reduce low back pain with links to illustrations about how to do each exercise here.

Even if you have no back pain daily stretching exercises will help keep your back and spinal column healthy.