Learn about common causes of lower back pain. The most common causes of low back pain are: Injury or overuse. This can include sprains or strains of soft tissues. Cunha, DO, FACOE. Pain is an unpleasant sensory and emotional experience. Acute pain results from disease, inflammation, or injury to. Back pain is pain felt in the back. Episodes of back pain may be acute, sub-acute, or chronic depending on the duration. The pain may be characterized as a dull ache.
Myths About Back Pain Debunked. Do you have lower back pain? If not, you probably will, and sooner than you think.
It’s one of the most common afflictions in the U. S., with roughly 8. Back pain is also the second most common reason for seeing a doctor in the U. S., following coughs and other respiratory infections. These statistics are similar in other countries. That means that the exact cause is usually elusive and cannot be attributable to an identifiable condition (such as infection, tumor, arthritis, or inflammation, which are specific cases, and the minority).
With non- specific low back pain (LBP) being so common and so elusive, it has become a big business with Americans spending at least $5. That can be a problem.
Anytime you talk about an amount of money that large, you’re bound to attract experts – both legitimate and those who are, well, full of it – who claim they a) know the exact cause of your lower back pain, and b) have the cure for it. You shouldn’t believe them – at least, not right away. Consider this: Back pain is most commonly blamed on things like herniated (slipped) lumbar discs, poor postural alignment, lack of core strength, tight hamstrings or hip flexors, and being overweight. And it’s these factors that many popular treatment and prevention strategies claim to improve (or cure). These “truths” are held as indisputable to the practitioners who promote them.
They base their expertise on personal experience and anecdotal results. It’s human nature: If someone you know benefited from seeing a chiropractor, they will always (loudly) proclaim their chiropractor a genius. Same for your friends who got positive results from a doctor, physical therapist, acupuncturist, massage therapist, or personal trainer. So what’s the problem?
When you look at the research with a cold eye, the scientific validity for many of the common claims of low back pain causes and treatments is questionable. To say the least.
What does that mean for you – especially if your back hurts? It means that just because a certain practitioner claims a certain cause is your problem, and they have the perfect treatment, their cause may not be the real cause. Their cure may not be what ultimately makes your pain go away.
In some cases, paying a lot of money for these treatments may not be the best option. Here are some of the common causes of lower back pain, research that dispels many myths surrounding them, and . A 2. 00. 1 study in the Journal of Bone and Joint Surgery showed that MRI scans were not predictive of the development or duration of LBP and that individuals with the longest duration of low- back pain did not have the greatest degree of anatomical abnormality. What does that mean? You can have disc abnormalities and have no pain.
And if you have a bulging disc and back pain? The disc may not be the cause. FRACTURED VERTEBRA: Two 2. New England Journal of Medicine found that vertebroplasty, a risky procedure that injects an acrylic cement into bones in the spinal column to stabilize fractures caused by osteoporosis, to be no better at creating pain relief than a placebo. SPINAL STENOSIS: While this condition has historically been thought to be an inevitable cause of LBP, a 2. Archives of Physical Medicine and Rehabilitation found that a narrowed spinal canal does not (alone) cause back pain. THE TAKEAWAY: You are not doomed by your MRI.
Many people with abnormal results are pain free. According to a 2. The Lancet, clinicians should refrain from routine, immediate lumbar imaging in patients with LBP without features suggesting a serious underlying condition. For you, that means asking your doctor about what other diagnostic avenues he or she will use besides an MRI. Especially if you’re hearing about your MRI results and the word “surgery” comes up. SPINAL CURVES: A 2.
Journal of Manipulative and Physiological Therapeutics looked at more than 5. According to Eyal Lederman, Ph. D., an osteopath and author of several manual therapy textbooks and research papers, “There is no correlation between pelvic obliquity/asymmetry and the lateral sacral base angle and LBP. But there may be an association between severe scoliosis and back pain.”PELVIC TILT: Many health professionals believe that anterior pelvic tilt and increased lumbar lordosis indicate abdominal weakness and overly strong (or tight) hip flexors. But, according to a 2. Internet Journal of Allied Health Science and Practice, there is no relationship between lumbar lordosis and isometric strength of the trunk flexors, trunk extensors, and hip flexors and extensors. Several other studies have also had similar findings.
It can take weeks and cost tens of thousands of dollars — and thus remains out of reach for most patients with chronic pain.
LEG LENGTH ASYMMETRY: According to Dr. Lederman, “Although some earlier studies suggest a correlation, more relevant are prospective studies in which no correlation was found between leg length inequality and LBP. Even patients who have acquired their leg length differences later in life as consequence of disease or surgery had a poor correlation between leg- length inequality, lumbar scoliosis and low- back disorders several years after the onset of the condition.”THE TAKEAWAY: Many people with poor postural alignment or asymmetry have zero pain while others with better alignment suffer from chronic pain. So, automatically blaming these factors is misguided since physical imperfections seem to be normal variations, not pathology. As Mark Comerford, author of Kinetic Control: The Management of Uncontrolled Movement puts it, “There’s a big difference between dysfunction and simply a variation on normal.”It’s more accurate to find the specific body positions (if any) that cause back pain, like standing or sitting slouched forcing your back muscles to remain contracted.
Also, pain or no pain, we all tend to sit too much. Increasing glute strength and in our mid- back muscles, which are lengthened when we sit, can help us to fight the negative effects of sitting and slouching. A helpful preventative strategy: Adding barbell and dumbbell rowing variations to your regular workout, along with squats and deadlifts, as long as you can do them pain- free. Photo Credit gpointstudio/i.
Stock/Getty Images. CORE STABILITY: According to Comerford, “The Transverse Abdominis (Tv. A) has never been shown to be off or weak, even in patients with LBP.
It’s only been shown to activate 5. LBP. We know through the research that the Tv. A timing delay is NOT the cause of the pain, but a symptom of it.” Additionally, Stuart Mc.
Gill, Ph. D. Focusing on a single muscle generally results in less stability.”CORE STRENGTH: According to Dr. Mc. Gill, “The differences between those with chronic, recurring back issues and matched asymptomatic controls,” or, people in the studies who have no pain, “have been shown to be variables other than strength or mobility.” In other words, in this research, core strength was not the cause of the sufferers’ pain.
Diarrhea can be caused by viruses (rotavirus, norovirus), bacteria (food poisoning, E coli, salmonella, C diff), parasites, intestinal disorders, medications. Chronic pain is pain that lasts a long time. In medicine, the distinction between acute and chronic pain is sometimes determined by an arbitrary interval of time.
THE TAKEAWAY: There’s no need, nor is it recommended to “draw in” your belly button during exercise or sporting activities. Core strengthening may or may not help you relieve or prevent LBP. As Comerford says, “If all back pain was due to weakness, than the strongest athletes in the world would never have pain, but they do.” It never hurts to strengthen your core muscles along with the rest of your muscles simply for better health and performance of daily activities. But if you have lower back pain, removing certain core- centric exercises may speed your recovery.
Children and adolescents with chronic abdominal pain pose unique challenges to their caregivers. Affected children and their families experience distress and anxiety.
Mc. Gill says, “The first step in any exercise progression is to remove the cause of the pain. For example, flexion- intolerant backs are very common. Eliminating spinal flexion exercises (like sit- ups, crunches, and burpees), particularly in the morning when the disks are swollen after bed rest, has proven very effective with this type of issue.”Also, improving the quality and efficiency of how you move versus just improving strength can help you to avoid overusing your back. In other words, exercise technique and form matters, especially if you have LBP. PSOAS: Scientific literature reveals that psoas major is a very misunderstood muscle. In his “Myths and Misconceptions about Psoas Major: Where is the Evidence?” Comerford states, ”There is almost no evidence for psoas being short; it does not produce significant movement in the spine; it has a significant stability role for the lumbar spine, the sacroiliac joint, and the hip; and, like the Tv.
A, the psoas has been shown to have delayed activation in the presence of LBP.” So again, delay in psoas activation is a symptom of back pain, not a cause. HAMSTRINGS: A 2. 01. Journal of Electromyography and Kinesiology concluded there is no evidence to recommend passive hamstring stretching as a means of reducing LBP during prolonged standing. Many studies have shown hamstring tightness to be related to LBP as a symptom, not the cause. According to Carl De. Rosa, Ph. D. But, their hamstrings are not tight, their CNS (central nervous system) is causing them to contract their hamstrings to minimize unwanted stress and to protect their spine.
You could make someone more symptomatic by stretching their hamstrings.”Additionally, according to Dr. Mc. Gill, “The best performers in athletics have tighter hamstrings then their competitive counterparts. The typical tightness people feel in their hamstrings is actually a neural tightness, not a purely soft- tissue phenomenon.”THE TAKEAWAY: Attempts to “release” or inhibit the Psoas through manual techniques is misguided. Stretching your hip flexors (illiacus, rectus femoris) is okay, but doing so isn’t stretching your psoas.
Also, remember that tight hip flexors have not been shown to be associated with excessive lumbar lordosis, anterior pelvic tilt, or as a cause of LBP. Dr. Mc. Gill recommends “strengthening the core muscles responsible for protecting the spine instead of stretching our hamstrings.