Do you know what to do when you have back pain?
Did you wake up one morning with back pain?
Did your back "go out?"
Did you pick something up or move in a certain way and have a sharp or shooting pain in your back, hip or leg?
If you just answered yes to one of the above questions, or have back pain right now then this is one of the most important articles you will ever read.
Back pain affects over 85% of people at some point in their life and it is the most common reason people miss work and are on disability. Most episodes of back pain resolve within 3 months if you do nothing at all. Your pain and symptoms are not necessarily related to any findings on an MRI, such as arthritis, disc herniation, disc bulge or stenosis. These are all common findings with people who do not have low back pain. Your pain is not usually related to the pathology discovered in an MRI or X-Ray as many people have no pain, when a diagnostic image will show pathology or "problem."
Studies show that 40 out of 100 people with no pain or symptoms will have a positive finding from an MRI. The American College of Physicians came out with a recent report stating that diagnostic imaging, which includes MRI's, CT Scans and X-Rays are "indicated for patients with low back pain only if they have severe progressive neurologic deficits or signs or symptoms that suggest a serious or specific underlying condition." Research also shows that once a person with low back pain has an MRI they are much more likely to have surgery, spinal fusion or decompression. These procedures are expensive, invasive and come with a huge risk and do not always resolve your pain and symptoms.
Most episodes of back pain are related to the imbalance, pull and spasm of muscles in your body. Typically the pain you experience is caused by a muscle spasm initiated when you move out of your body's comfort zone and it is either bracing you so you do not move, or because of fatigue of the muscle which is fighting to hard to maintain your posture. Findings also suggest that physical therapy is the most conservative, safest and more effective treatment for low back pain than surgery or medications.
What to do when you have low back pain.
The #1 most important thing to do if you have low back pain is to continue with your normal daily activities and exercise. Over 80% of Americans experience low back pain at some point in their life. For many people it will resolve itself within 3 months and continuing to work and exercise is vital. If you have bowel or bladder dysfunction or genital numbness you should make an appointment with your physician.
Move your body safely. This means to lift heavy objects close to you, kneel to get on the floor, stretch gently, move and rotate your back and stop any activity or exercise that does not feel right or produces any sharp or shooting pain. Be sure that you are not exercising, moving or working through any sharp shooting pain. This is not therapeutic pain. You can exercise, work and move with discomfort or stiffness. Getting your body to move helps it let go.
I teach my patients a modified sequence of yoga poses to help them move their back and bodies safely. To start, you can kneel down on the floor on all fours or stand and put your hands on your countertop. Slowly arch your back while lifting your head and your tailbone. Then slowly round your back, drop your head and tuck your tailbone under. Your head and belly button go in opposite directions. Then repeat this 3-5 times slowly. These poses are Cat and Cow. Next, lay on your side, either on the floor or your bed. Stretch your top leg in front of you and your top arm behind you. Look behind you and take a deep breath. This should be a nice gentle spinal twist.
Yoga is an excellent form of exercise, which combines strength with flexibility and balance. Many people find relief of their low back pain with a consistent yoga practice that is at least 2-3 times a week. You should start with a group class or private instruction until you are comfortable practicing yoga at home on your own. Then I recommend people take a class 1-2 times a week and practice at home for at least 30 minutes 2-3 times a week. Always let your instructor know what challenges you are working with, sit out or do child's pose during any poses when you do not feel safe in your body and be sure to ask for modifications if something does not feel right.
Walking is also a great exercise for low back pain and it helps strengthen your back muscles and activates your core in a reciprocal fashion. Your goal should be to work up to walking briskly a minimum of 30 minutes 5 days a week, which has many other tremendous health benefits.
Help your muscles to let go. This is as important as moving safely. Pain creates bracing and chronic bracing patters create muscular tightness, fascia restrictions and trigger points. Start with a tennis ball and lay down on the floor or lean against a wall with the ball in the painful muscle. Find the right spot and stay there for 3-5 minutes, until you feel multiple releases of the tissue. You can use a tennis ball, inflated rubber ball, dryer ball, dog toy (like a Kong) or other firm but flexible ball or toy to release the muscles and tissues almost anywhere on your body where you have pain or that feels tight, hard or tender.
These techniques are gentle, sustained and relaxing. It does not need to hurt to work and "no pain no gain" does not always apply to healing your body. You should allow yourself to move and adjust as you feel your body letting go, however, moving back and forth over the tender area is not necessarily the goal of this self-treatment technique.
These areas may feel tight, tender, or like "the spot" and the techniques should feel good. Spend 3 to 5 minutes in each area to allow your body to release and let go. If you are on the ground, slowly roll on your side to reposition or to stand up.
When do you need to be seen by a physical therapist?
If you have questions, concerns or doubt, or if you have other medical conditions that you are concerned about or something just does not "feel right," please see a physical therapist who will create a customized exercise and therapy program for you. In North Carolina you can see a physical therapist first, without needing to wait days or weeks for a referral or prescription from a physician. This is called Direct Access and it allows you to see a physical therapist directly. Your physical therapist will be able to determine if physical therapy is appropriate for you and will give you a diagnosis and plan to help you return to the activities you enjoy. Call the physical therapy clinic of your choice and ask to schedule an evaluation. In many cases you can be seen the same day and typically within 24-48 hours. A physical therapist will know if you need to be seen by your physician or another medical provider, however, physical therapy is the most effective and cost efficient treatment for low back pain.
Dr. Aaron LeBauer PT, DPT, LMBT is a physical therapist, father, husband, competitive cyclist and owner of LeBauer Physical Therapy in Greensboro, NC.
Did your back "go out?"
Did you pick something up or move in a certain way and have a sharp or shooting pain in your back, hip or leg?
If you just answered yes to one of the above questions, or have back pain right now then this is one of the most important articles you will ever read.
Back pain affects over 85% of people at some point in their life and it is the most common reason people miss work and are on disability. Most episodes of back pain resolve within 3 months if you do nothing at all. Your pain and symptoms are not necessarily related to any findings on an MRI, such as arthritis, disc herniation, disc bulge or stenosis. These are all common findings with people who do not have low back pain. Your pain is not usually related to the pathology discovered in an MRI or X-Ray as many people have no pain, when a diagnostic image will show pathology or "problem."
Studies show that 40 out of 100 people with no pain or symptoms will have a positive finding from an MRI. The American College of Physicians came out with a recent report stating that diagnostic imaging, which includes MRI's, CT Scans and X-Rays are "indicated for patients with low back pain only if they have severe progressive neurologic deficits or signs or symptoms that suggest a serious or specific underlying condition." Research also shows that once a person with low back pain has an MRI they are much more likely to have surgery, spinal fusion or decompression. These procedures are expensive, invasive and come with a huge risk and do not always resolve your pain and symptoms.
Most episodes of back pain are related to the imbalance, pull and spasm of muscles in your body. Typically the pain you experience is caused by a muscle spasm initiated when you move out of your body's comfort zone and it is either bracing you so you do not move, or because of fatigue of the muscle which is fighting to hard to maintain your posture. Findings also suggest that physical therapy is the most conservative, safest and more effective treatment for low back pain than surgery or medications.
What to do when you have low back pain.
The #1 most important thing to do if you have low back pain is to continue with your normal daily activities and exercise. Over 80% of Americans experience low back pain at some point in their life. For many people it will resolve itself within 3 months and continuing to work and exercise is vital. If you have bowel or bladder dysfunction or genital numbness you should make an appointment with your physician.
Move your body safely. This means to lift heavy objects close to you, kneel to get on the floor, stretch gently, move and rotate your back and stop any activity or exercise that does not feel right or produces any sharp or shooting pain. Be sure that you are not exercising, moving or working through any sharp shooting pain. This is not therapeutic pain. You can exercise, work and move with discomfort or stiffness. Getting your body to move helps it let go.
I teach my patients a modified sequence of yoga poses to help them move their back and bodies safely. To start, you can kneel down on the floor on all fours or stand and put your hands on your countertop. Slowly arch your back while lifting your head and your tailbone. Then slowly round your back, drop your head and tuck your tailbone under. Your head and belly button go in opposite directions. Then repeat this 3-5 times slowly. These poses are Cat and Cow. Next, lay on your side, either on the floor or your bed. Stretch your top leg in front of you and your top arm behind you. Look behind you and take a deep breath. This should be a nice gentle spinal twist.
Yoga is an excellent form of exercise, which combines strength with flexibility and balance. Many people find relief of their low back pain with a consistent yoga practice that is at least 2-3 times a week. You should start with a group class or private instruction until you are comfortable practicing yoga at home on your own. Then I recommend people take a class 1-2 times a week and practice at home for at least 30 minutes 2-3 times a week. Always let your instructor know what challenges you are working with, sit out or do child's pose during any poses when you do not feel safe in your body and be sure to ask for modifications if something does not feel right.
Walking is also a great exercise for low back pain and it helps strengthen your back muscles and activates your core in a reciprocal fashion. Your goal should be to work up to walking briskly a minimum of 30 minutes 5 days a week, which has many other tremendous health benefits.
Help your muscles to let go. This is as important as moving safely. Pain creates bracing and chronic bracing patters create muscular tightness, fascia restrictions and trigger points. Start with a tennis ball and lay down on the floor or lean against a wall with the ball in the painful muscle. Find the right spot and stay there for 3-5 minutes, until you feel multiple releases of the tissue. You can use a tennis ball, inflated rubber ball, dryer ball, dog toy (like a Kong) or other firm but flexible ball or toy to release the muscles and tissues almost anywhere on your body where you have pain or that feels tight, hard or tender.
These techniques are gentle, sustained and relaxing. It does not need to hurt to work and "no pain no gain" does not always apply to healing your body. You should allow yourself to move and adjust as you feel your body letting go, however, moving back and forth over the tender area is not necessarily the goal of this self-treatment technique.
These areas may feel tight, tender, or like "the spot" and the techniques should feel good. Spend 3 to 5 minutes in each area to allow your body to release and let go. If you are on the ground, slowly roll on your side to reposition or to stand up.
When do you need to be seen by a physical therapist?
If you have questions, concerns or doubt, or if you have other medical conditions that you are concerned about or something just does not "feel right," please see a physical therapist who will create a customized exercise and therapy program for you. In North Carolina you can see a physical therapist first, without needing to wait days or weeks for a referral or prescription from a physician. This is called Direct Access and it allows you to see a physical therapist directly. Your physical therapist will be able to determine if physical therapy is appropriate for you and will give you a diagnosis and plan to help you return to the activities you enjoy. Call the physical therapy clinic of your choice and ask to schedule an evaluation. In many cases you can be seen the same day and typically within 24-48 hours. A physical therapist will know if you need to be seen by your physician or another medical provider, however, physical therapy is the most effective and cost efficient treatment for low back pain.
Dr. Aaron LeBauer PT, DPT, LMBT is a physical therapist, father, husband, competitive cyclist and owner of LeBauer Physical Therapy in Greensboro, NC.
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