Lower Back Pain
168 Case Studies
9 Member Stories

Lumbar strain is the most common cause of severe low back pain. A thorough diagnosis is important before any therapy is considered. There are occasions when natural treatments and holistic remedies for lower back pain might be beneficial such as Chiropractic,  Acupuncture, or Yoga. At other times, more invasive therapies may be required.

What is lower back pain?

It may be a limited musculoskeletal symptom or caused by an assortment of diseases and disorders that affect or extend from the lumbar spine. Low back pain is occasionally accompanied by overtraining, which can be pain that entails the sciatic nerve and can be felt in the lower back, the buttocks, the backs and sides of the thighs, and the calves. More serious causes of LBP may come with fever, night pain that awakens someone from sleep, loss of bladder or bowel control, numbness, burning urination, swelling or sharp pain. In many cases complementary holistic therapies for lower back pain can provide pain relief.

Types of lower back pain

Low back pain is a symptom which affects 80 percent of the general United States population at some point in life having sufficient severity to cause lack of work. As mentioned, it is the second most common reason for visits to primary care physicians, and is estimated to cost the American economy $75 billion annually. One third of the nation's disability associated costs are associated with LBP, a condition primarily affecting individuals between the ages of 45-60.

The structures of the typical lumbar area of the spine contain the spinal nerves, discs between each vertebrae, ligaments, tendons, muscles and muscle tissues, the spinal cord inside the fascia and nerves extending outward from the backbone through vertebral foramina (openings in the bone). The lumbar vertebrae are different from the cervical (neck area) and thoracic (upper back) vertebrae, being normally thicker for increased weight bearing aid, and resting atop the sacrum, the triangular shaped bone involving the buttocks. The discs between either side of the spine cushion and absorb the shock that might otherwise be transmitted via the spine. Sometimes, the disks may "rupture" or herniate external through their fibrous sheath, or covering, putting pressure on the nerves. Nerve pain from other local organs might also be causative, in which case identification and therapy is far more involved, usually a whole lot more serious, and may indicate a life threatening illness.

 

Hazards for low back pain are raised with fracture and osteoporosis, narrowing of the spinal canal in the fascia (stenosis), spinal curvatures, fibromyalgia, osteoand rheumatoid arthritis, pregnancy, smoking, stress, age greater than 30, or disorder or illness of the organs of the lower abdomen.

In addition to dividing low back pain into three categories based on length of symptoms--acute, sub-acute or chronic--lower back pain may be described as:

• Localized. In localized pain that the patient will feel discomfort or distress when the physician palpates, or presses on, a specific surface area of the lower spine.

• Diffuse. Diffuse pain is spread over a larger area and comes from deep tissue layers.

• Radicular. The pain is caused by irritation of a nerve root and radiates from the region. Sciatica is a good illustration of radicular pain.

• Referred. The pain is sensed at the lower spine, but actually is brought on by disease or inflammation elsewhere, like the kidneys or other constructions of or near the lower abdomen including the intestines, appendix, bladder, uterus, ovaries or the testes.

Lower back pain causes

The lower spine where back pain occurs comprises the five vertebrae (referred to as L1-L5) in the lumbar region, which supports a lot of the weight of the upper body. The distances between the vertebrae have been maintained through round, rubbery pads known as intervertebral disks which act like shock absorbers throughout the spinal column to cushion the bones as the body moves. Bands of tissue called ligaments hold the vertebrae in place, and tendons attach the muscles to the spinal column. Thirty-one pairs of nerves have been suspended into the spinal cord and they control body movements and transmit signals from the body to the brain. [National Institute of Neurological Disorders and Stroke, National Institutes of Health]


Acute and sub-acute pain

Lumbar strain or anxiety is the most common cause of severe low back pain. It is pain that doesn't usually stretch to the leg and usually happens over 24 hours of heavy lifting or overuse of the back muscles. The pain is usually localized, and might be accompanied by muscle aches or soreness to touch. The patient usually feels better when resting. Acute strain may follow a sudden motion, particularly a lifting and simultaneous twisting motion, nevertheless injury is usually preceded by overuse or lack of exercise and tone particularly of the opposing muscles (the abdominals, by way of instance), improper use, long periods of sitting or standing in one place, inferior vertebral alignments or ailments compromising nutrition of the supportive structures. Acute low back pain due to lumbar strain (roughly 60 percent of victims ) usually concludes with a week using conservative treatments, such as reducing but not eliminating activity. Subacute pain is connected with a duration of 6--12 months, by that time 90 percent of men suffering low back pain and injury return to work. This class accounts for one third of all disability related costs. LBP persisting past three months is deemed chronic. Symptoms of acute LBP might be accompanied by stiffness (guarding), constipation, bad sleep and trouble finding a comfortable position, problems walking and other limits on normal selection of movement.


Chronic lower back pain

Persistent low back pain has a lot of different potential causes.

a) Mechanical. Chronic pressure on the muscles of the lower back could be brought on by obesity, pregnancy, or jobrelated stooping, bending, or other stressful postures. Construction, truck driving accompanied by vibration, jack hammering, sand blasting and other resources of chronic injury and strain to the trunk or nerve pressure additionally contribute.

 

b) Malignancy or other condition: Low back pain at night which isn't relieved by lying down might be caused by a tumor in the cauda equina (the roots of the spinal nerves controlling atmosphere in and motion of the thighs ), or metastasized cancer which has spread to the spine from the prostate, breasts, or lungs.

 

The pain is made worse by sitting or lying down, and improves when the individual gets up. It is most commonly seen in males between the ages of 16 and 35. Ankylosing spondylitis is frequently confused with mechanical back pain in its early phases. Other signs include morning stiffness, a positive family history, and positive laboratory results for HLA-B27 antigen (an autoimmune mark ) and an elevated sedimentation rate of blood. This illness may have food allergy associated elements, like an allergy to wheat, worsened by drinking beer.

 

D) Herniated Spinal Disk: Disk herniation is a disorder where a spinal disk begins to bulge outward between the vertebrae. Herniated or ruptured disks are a frequent cause of chronic low back pain in adults. Pressure imposed on adjacent nerves results in pain which may worsen on movement, with coughing, sneezing or intra-abdominal strain, and be accompanied by tingling of the skin at the area served by the nerve (dermatome). Deep tendon reflexes (DTRs) can be reduced, and the straight leg raising test may be positive. The crossed straight leg raising test, which can be more specific to herniated disk, which may also be positive.

 

 

E) Psychogenic: Back pain that is out of proportion to a slight injury, or that's unusually prolonged, might be related to a somatoform disorder or other psychological disturbance. Psychosocial factors such as lack of job, job dissatisfaction, legal issues, financial compensation issues are a few of the'non-organic' variables which may be related or causative. Indicators of low back pain in this configuration are usually diffuse, non-localized, and might consist of other stress related symptoms. A group of five evaluations called the Waddell tests may be used to diagnose LBP of psychogenic origin.

 

F) Low back pain with leg involvement

Low back pain which radiates down the leg usually indicates involvement of the sciatic nerve. The nerve can be pinched or irritated with herniated discs, tumors of the cauda equina (the ending portion of the backbone ), abscesses at the distance between the spinal cord and its covering, spinal stenosis, and compression fractures. Some patients experience weakness or numbness of the legs, in addition to pain. There might be spasming of those muscles otherwise stimulated by the nerve, and a positive leg raising test.

Natural lower back pain treatments

A thorough differential diagnosis is important before any therapy is considered. There are occasions when natural treatments and holistic therapies for lower back pain might be beneficial, and other times when more invasive therapies are necessary.

 

Chiropractic therapy

Chiropractic treats patients by manipulating or adjusting sections of the backbone. It's one of the most common types of alternative treatment in the USA for relief of back pain caused by straining or lifting injuries, and continues to be demonstrated through many randomized trials to be advantageous. Added recommendations of shoe orthotics, exercise, cold packs to reduce and inhibit swelling immediately following injury followed one to two weeks later by hot packs and cold packs to stimulate healing, hydrotherapy, and life style adjustments may be recommended. Nutritional supplements known to be beneficial to joint reduction and ethics, hydration support, and wound repair may also be advocated, including glucosamine sulfate, with or without chondroitin, MSM,, along with a variety of mineral and vitamin cofactors.

 

Acupuncture (Traditional chinese medicine)

Practitioners of traditional Chinese medicine treat low back pain with acupuncture, massage, acupuncture, and the use of herbal poultices. They may also use a technique called moxibustion that involves the usage of glass cups, and heated atmosphere derived use of a burning braid or stick of herb with a distinctive aroma.

 

Herbal medicine and anti-inflammatory enzymatic therapy

Herbal medicine can utilize a variety of anti inflammatory and sedative herbs to help relieve low back pain due to spasm. For this purpose and readily available at a local healthfood store are herbs like chamomile (Matricaria recutita), hops (Humulus lupus), passion flower (Passiflora incarnata), valerian (Valeriana officinale), and cramp bark (Viburnum opulus). Bromelain from pineapples has anti-inflammatory action. Intake of fresh grape juice, preferably made from from dark grapes, on a daily basis at a time other than mealtime has also been found to be helpful. Minor backaches might be relieved with the application of a heating paste of ginger(Zingiber officinale) powder and water, allowed to sink for 10 minutes, and followed by an eucalyptus rub.

Aromatherapy with soothing essential oils of blue chamomile, birch, rosemary, or lavender could be effective when rubbed into the affected area after a hot bath.

 

Homeopathy

Other remedies may be recommended depending on the symptoms presented by the individual.

 

Body yoga and work

Massage and the numerous other body work techniques can be very helpful in treating low back pain. Yoga, practiced regularly and performed properly, can be used with meditation or imagery to both treat and prevent future episodes of lower back pain.

Prevention of lower back pain

Low back pain due to muscle strain can be prevented by natural therapies, lifestyle choices, including regular physical exercise and weight control, avoiding smoking, and learning the correct techniques for lifting and moving heavy items. Exercises designed to strengthen the muscles of the lower back and the opposing abdominals are also suggested. Simple actions may also help prevent low back pain, like putting a little, firm pillow supporting the lower back when sitting for long periods, using a soft pillow for sleep which supports the lower neck without producing an unnatural angle for shoulder and head rest, employing a swiveling desk chair with a postural support or stool which maintains the knees at a higher level than the hips, standing on flexible rubber mats to avoid the effect of concrete flooring at areas of employment by way of example, and wearing supportive, soft soled shoes, avoiding the use of high heels.

References

1. National Institute of Neurological Disorders and Stroke, National Institutes of Health

 2. Gayle Encyclopedia of Alternative Medicine

3. Esses, Stephen I. “Low Back Pain.” In Conn’s Current Therapy, edited by Robert E. Rakel. Philadelphia: W. B. Saunders Company, 1998.
4. Hellman, David B., “Arthritis & Musculoskeletal Disorders.” In Current Medical Diagnosis & Treatment 1998, edited by Lawrence. Tierney, Jr., et al. Stamford, CT: Appleton & Lange, 1998.
5. McKenzie, Robin. Treat Your Own Back. Waikanae, New Zealand: Spinal Publications New Zealand Ltd., 1997. 
6.  .
Low Back Pain. Medinfo. Arboris, Ltd. Reviewed October 2, 2002. [Cited May 28, 2004]. .
7. Low Back Pain. American Academy of Orthopaedic Surgeons. Reviewd 2000. [Cited May 28, 2004]. .
8. Shiel Jr., M.D., FACP, FACR, William C. Lower Back Pain (Lumbar Back Pain). MedicineNet. Reviewed April 16, 2004. [Cited May 28, 2004]. .
9. Kathleen Wright Katherine Nelson, N.D.


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