What is low back pain?
Low back pain is pain and stiffness in the lower back. It
is one of the most common reasons people miss work.
How does it occur?
Low back pain is usually caused when a ligament or muscle
holding a vertebra in its proper position is strained.
Vertebrae are bones that make up the spinal column through
which the spinal cord passes. When these muscles or
ligaments become weak, the spine loses its stability,
resulting in pain. Because nerves reach all parts of the
body from the spinal cord, back problems can lead to pain or
weakness in almost any part of the body.
Low back pain can occur if your job involves lifting and
carrying heavy objects, or if you spend a lot of time
sitting or standing in one position or bending over. It can
be caused by a fall or by unusually strenuous exercise. It
can be brought on by the tension and stress that cause
headaches in some people. It can even be brought on by
violent sneezing or coughing.
People who are overweight may have low back pain because of
the added stress on their back.
Back pain may occur when the muscles, joints, bones, and
connective tissues of the back become inflamed as a result
of an infection or an immune system problem. Arthritic
disorders as well as some congenital and degenerative
conditions may cause back pain.
Back pain accompanied by loss of bladder or bowel control,
difficulty in moving your legs, or numbness or tingling in
your arms or legs may indicate an injury to your spine and
nerves, which requires immediate medical treatment.
What are the symptoms?
Symptoms include:
- pain in the back or legs
- stiffness and limited motion.
The pain may be continuous or may occur only in certain
positions. It may be aggravated by coughing, sneezing,
bending, twisting, or straining during a bowel movement.
The pain may occur in only one spot or may spread to other
areas, most commonly down the buttocks and into the back of
the thigh.
A low back strain typically does not produce pain past the
knee into the calf or foot. Tingling or numbness in the
calf or foot may indicate a herniated disk or pinched nerve.
Be sure to see your health care provider if:
- You have weakness in your leg, especially if you cannot
lift your foot, because this may be a sign of nerve
damage.
- You have new bowel or bladder problems as well as back
pain, which may be a sign of severe injury to your spinal
cord.
- You have pain that gets worse despite treatment.
How is it diagnosed?
Your health care provider will review your medical history
and examine you. He or she may order x-rays. In certain
situations a myelogram, CT scan, or MRI may be ordered.
How is it treated?
The early stages of back pain with muscle spasms should be
treated with ice packs for 20 to 30 minutes every 4 to 6
hours for the first 2 to 3 days. You may lie on a frozen
gel pack, crushed ice, or a bag of frozen peas.
The following are ways to treat low back pain:
- After the initial injury, applying heat from a heating
pad or hot water bottle.
- Resting in bed on a firm mattress. Often it helps to lie
on your back with your knees raised. However, some
people prefer to lie on their side with their knees bent.
- Taking aspirin, ibuprofen, or other anti-inflammatory
medications; muscle relaxants; or other pain medications if
recommended by your health care provider.
- Having your back massaged by a trained person.
- Having traction, if recommended by your provider.
- Wearing a belt or corset to support your back.
- Talking with a counselor, if your back pain is related to
tension caused by emotional problems.
- Beginning a program of physical therapy, or exercising on
your own. Begin a regular exercise program to gently
stretch and strengthen your muscles as soon as you can.
Your health care provider or physical therapist can
recommend exercises that will not only help you feel
better but will strengthen your muscles and help avoid
back trouble later.
When the pain subsides, ask your health care provider about
starting an exercise program such as the following:
- Exercise moderately every day, using stretching and
warm-up exercises suggested by your provider or physical
therapist.
- Exercise vigorously for about 30 minutes two or three
times a week by walking, swimming, using a stationary
bicycle, or doing low-impact aerobics.
Participating regularly in an exercise program will not only
help your back, it will also help keep you healthier overall.
How long will the effects last?
The effects of back pain last as long as the cause exists or
until your body recovers from the strain, usually a day or
two but sometimes weeks.
How can I take care of myself?
In addition to the treatment described above, keep in mind
these suggestions:
- Use an electric heating pad on a low setting (or a hot
water bottle wrapped in a towel to avoid burning yourself)
for 20 to 30 minutes. Don't let the heating pad get too
hot, and don't fall asleep with it. You could get a
burn.
- Try putting an ice pack wrapped in a towel on your back
for 20 minutes, one to four times a day. Set an alarm to
avoid frostbite from using the ice pack too long.
- Put a pillow under your knees when you are lying down.
- Sleep without a pillow under your head.
- Lose weight if you are overweight.
- Practice good posture. Stand with your head up, shoulders
straight, chest forward, weight balanced evenly on both
feet, and pelvis tucked in.
Pain is the best way to judge the pace you should set in
increasing your activity and exercise. Minor discomfort,
stiffness, soreness, and mild aches need not interfere with
activity. However, limit your activities temporarily if:
- Your symptoms return.
- The pain increases when you are more active.
- The pain increases within 24 hours after a new or higher
level of activity.
When can I return to my sport or activity?
The goal of rehabilitation is to return you to your sport or
activity as soon as is safely possible. If you return too
soon you may worsen your injury, which could lead to
permanent damage. Everyone recovers from injury at a
different rate. Return to your sport will be determined by
how soon your back recovers, not by how many days or weeks
it has been since your injury occurred. In general, the
longer you have symptoms before you start treatment, the
longer it will take to get better.
It is important that you have fully recovered from your low
back pain before you return to your sport or any strenuous
activity. You must be able to have the same range of motion
that you had before your injury. You must be able to run,
jump and twist without pain.
What can I do to help prevent low back pain?
You can reduce the strain on your back by doing the
following:
- Don't push with your arms when you move a heavy object.
Turn around and push backwards so the strain is taken by
your legs.
- Whenever you sit, sit in a straight-backed chair and hold
your spine against the back of the chair.
- Bend your knees and hips and keep your back straight when
you lift a heavy object.
- Avoid lifting heavy objects higher than your waist.
- Hold packages you carry close to your body, with your
arms bent.
- Use a footrest for one foot when you stand or sit in one
spot for a long time. This keeps your back straight.
- Bend your knees when you bend over.
- Sit close to the pedals when you drive and use your seat
belt and a hard backrest or pillow.
- Lie on your side with your knees bent when you sleep or
rest. It may help to put a pillow between your knees.
- Put a pillow under your knees when you sleep on your
back.
- Raise the foot of the bed 8 inches to discourage sleeping
on your stomach unless you have other problems that
require that you keep your head elevated.
To rest your back, hold each of these positions for
5 minutes or longer:
- Lie on your back, bend your knees, and put pillows under
your knees.
- Lie on your back, put a pillow under your neck, bend your
knees to a 90-degree angle, and put your lower legs and
feet on a chair.
- Lie on your back, bend your knees, and bring one knee up
to your chest and hold it there. Repeat with the other
knee, then bring both knees to your chest. When holding
your knee to your chest, grab your thigh rather than your
lower leg to avoid over flexing your knee.
Developed by Phyllis G. Cooper, RN, MN, and McKesson Health Solutions LLC.
This content is reviewed periodically and is subject to
change as new health information becomes available. The
information is intended to inform and educate and is not a
replacement for medical evaluation, advice, diagnosis or
treatment by a healthcare professional.
Copyright © 2003 McKesson Health Solutions LLC. All rights reserved.