Low Back Disorders


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Numbness may be felt in the leg or foot. Walking, running, climbing stairs, straightening the leg, and sometimes coughing or straining worsens the pain, which is relieved by straightening the back or standing. Often, the pain goes away on its own. Resting, sleeping on a firm mattress, taking over-the-counter acetaminophen or nonsteroidal anti-inflammatory drugs NSAIDs , and applying heat and cold may be sufficient treatment.

For many people, sleeping on their side with the knees bent and a pillow between the knees provides relief. Stretching the hamstring muscles gently after warming up may help. Occasionally, other treatments are used, depending on the cause of sciatica. Treatments may include physical therapy, corticosteroids injected into the back, anticonvulsants, tricyclic depressants, and, for severe and persistent pain, surgery.

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Lumbar spinal stenosis is narrowing of the spinal canal which runs through the center of the spine and contains the spinal cord in the lower back. It is a common cause of low back pain in older people. Spinal stenosis also develops in middle-aged people who were born with a narrow spinal canal. It is caused by such disorders as.

Rheumatoid arthritis. Ankylosing spondylitis. Paget disease of bone.

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Spinal Conditions from A - Z

Spondylolisthesis is partial displacement of a vertebra in the lower back. It usually occurs in people who have a common bone birth defect spondylolysis that weakens part of the vertebrae. Usually, during adolescence or young adulthood often in athletes , a minor injury causes a part of the vertebra to fracture.


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The vertebra then slips forward over the one below it. If it slips far, pain can result. Spondylolisthesis can also occur in older adults. People with spondylolisthesis are at risk of developing lumbar spinal stenosis.

Fibromyalgia is a common cause of body pain, sometimes including low back pain. This disorder causes chronic widespread diffuse pain in muscles and other soft tissues in areas outside the lower back. Strengthening abdominal muscles, as well as back muscles, helps support the spine and prevent low back pain. A bulge aneurysm in the large artery in the abdomen abdominal aortic aneurysm. Certain digestive disorders, such as diverticulitis. Certain urinary tract disorders, such as kidney infections , kidney stones , and prostate infections. Certain disorders involving the pelvis, such as ectopic pregnancy , pelvic inflammatory disease , and cancer of the ovaries or other reproductive organs.

Less common causes also include shingles and several types of inflammatory arthritis, such as ankylosing spondylitis. The doctor aims to identify any serious disorders. Because low back pain is often caused by several problems, diagnosing a single cause may not be possible. Doctors may only be able to tell that the cause is a musculoskeletal disorder and how serious it is likely to be.


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  6. In people with low back pain, certain symptoms and characteristics are cause for concern. They include. Use of drugs that suppress the immune system , HIV infection or AIDS , use of injected drugs , recent surgery, or a wound—conditions that increase the risk of infection. Numbness, weakness in one or both legs, difficulty emptying the bladder retention of urine , or loss of bladder or bowel control urinary incontinence or fecal incontinence —symptoms that suggest nerve damage.

    Difficulty breathing, paleness, light-headedness, sudden sweating, a racing heartbeat, or loss of consciousness—symptoms that suggest an abdominal aortic aneurysm. Vomiting, severe abdominal pain, or stool that is black or bloody—symptoms that suggest a digestive disorder.

    Difficulty urinating, blood in the urine, or severe crampy pain on one side radiating into the groin—symptoms that suggest a urinary tract disorder. People should see a doctor immediately if they have fever or symptoms suggesting nerve damage, an abdominal aortic aneurysm , a digestive disorder, or a urinary tract disorder. People with most other warning signs should see a doctor within a day.

    If pain is not severe and people have no warning signs other than pain for more than 6 weeks, their need to see a doctor is not as urgent. Doctors first ask questions about the person's symptoms and medical history. Doctors then do a physical examination. What they find during the history and physical examination often suggests a cause and the tests that may need to be done see Table: Some Causes and Features of Low Back Pain.

    Pain in an area that is tender to the touch and is worsened by changes in position or weight bearing is usually local pain. Pain that radiates down the leg, such as sciatica, is usually caused by compression of a spinal nerve root. Pain that is moderate or severe, is not affected by changes in position of the back, and is not accompanied by tenderness may be referred pain.

    Pain that is constant, severe, progressively worse, and unrelieved by rest, particularly if it keeps the person awake at night, can be a disk herniation but may indicate cancer or an infection. The physical examination focuses on the spine and on evaluation of the nerves to the groin and legs to look for signs of nerve root compression. Signs of nerve root compression depend on which nerve roots are involved and include weakness of one of the muscle groups in a leg, abnormal reflexes tested by tapping the tendons below the knee and behind the ankle , decreased sensation in an area of the leg, and, very rarely, retention of urine , and incontinence of urine or stool fecal incontinence.

    Doctors may ask the person to move in certain ways to determine the type of pain. For example, they may ask the person to lie flat, then lift the leg without bending the knee, and then stand and bend over. Doctors may also check a person's abdomen for tenderness or a mass and the pulses, particularly in people over 55, who may have an aortic aneurysm. They may examine the prostate in men by doing a digital rectal examination and the internal reproductive organs in women by doing a pelvic examination. Common causes.

    Sprains and strains.

    *CHRONIC* Low Back Pain fixed by FULL BODY Chiropractic Adjustment

    Osteoarthritis , sometimes with compression of a spinal nerve root. Usually in people who are older or who have osteoporosis. A herniated disk, usually with compression of a spinal nerve root see A Herniated Disk.

    Low Back Disorders | Pinnacle Orthopaedics

    Midline back pain that usually. Often in adolescents associated with a fracture and in adults associated with degeneration two different processes. Less common causes. Ankylosing spondylitis inflammation of the spine and large joints. In the vertebrae osteomyelitis. Around the spinal cord spinal epidural abscess. Often in people who have had back surgery, who have an immune disorder, who take drugs that suppress the immune system, or who use IV drugs. Features mentioned, including pain, are typical but not always present. Usually, no tests are needed because most back pain results from osteoarthritis, strains and sprains, or other minor musculoskeletal disorders and resolves within 6 weeks.

    Imaging tests are often needed if. People who did not respond to initial treatment or those whose symptoms have worsened or changed may also undergo testing. X-rays of the lower back show only the bones. They can help detect degenerative changes due to osteoarthritis , compression fractures , spondylolisthesis , and ankylosing spondylitis. However, magnetic resonance imaging MRI or computed tomography CT provides clearer images of bones and, particularly MRI, can show soft tissues including disks and some nerves. MRI or CT is usually necessary when doctors are checking for disorders that cause subtle changes in bone and disorders of soft tissue.

    These tests can also indicate whether nerves are being compressed. If compression of the spinal cord is suspected, MRI is done immediately. Rarely, if cancer or infection is suspected, removal of tissue biopsy is necessary. Occasionally, electromyography and nerve conduction studies are done to confirm the presence, location, and sometimes duration and severity of nerve root compression. The most effective way to prevent low back pain is to exercise regularly. Aerobic exercise and specific muscle-strengthening and stretching exercises can help.

    Aerobic exercise, such as swimming and walking, improves general fitness and generally strengthens muscles. Specific exercises to strengthen and stretch the muscles in the abdomen, buttocks, and back core muscles can help stabilize the spine and decrease strain on the disks that cushion the spine and the ligaments that hold it in place. Muscle-strengthening exercises include pelvic tilts and abdominal curls.

    GUIDELINE FOCUS

    Stretching exercises include the knee-to-chest stretch. Stretching exercises can increase back pain in some people and therefore should be done carefully. As a general rule, any exercise that causes or increases back pain should be stopped. Exercises should be repeated until the muscles feel mildly but not completely fatigued.

    Breathing during each exercise is important. People who have back pain should consult a doctor before beginning to exercise. Lie on the back with the knees bent, the heels on the floor, and the weight on the heels. Press the small of the back against the floor, contract the buttocks raising them about half an inch from the floor , and contract the abdominal muscles.

    Hold this position for a count of Repeat 20 times. Lie on the back with the knees bent and feet on the floor. Place the hands across the chest. Contract the abdominal muscles, slowly raising the shoulders about 10 inches from the floor while keeping the head back the chin should not touch the chest. Then release the abdominal muscles, slowly lowering the shoulders.

    Do 3 sets of Lie flat on the back. Place both hands behind one knee and bring it to the chest. Hold for a count of Slowly lower that leg and repeat with the other leg. Do this exercise 10 times. Exercise can also help people maintain a desirable weight. Weight-bearing exercise can help people maintain bone density. Thus, exercise may reduce the risk of developing two conditions that can lead to low back pain— obesity and osteoporosis. Maintaining good posture when standing and sitting reduces stress on the back. Slouching should be avoided. Chair seats can be adjusted to a height that allows the feet to be flat on the floor, with the knees bent up slightly and the lower back flat against the back of the chair.

    If a chair does not support the lower back, a pillow can be used behind the lower back. Sitting with the feet on the floor rather than with the legs crossed is advised. People should avoid standing or sitting for long periods. If prolonged standing or sitting is unavoidable, changing positions frequently may reduce stress on the back. Sleeping in a comfortable position on a medium mattress is recommended. People who sleep on their back can place a pillow under their knees. People who sleep on their side should use a pillow to support their head in a neutral position not tilted down toward the bed or up toward the ceiling.

    They should place another pillow between their knees with their hips and knees bent slightly if that relieves their back pain. Learning to lift correctly helps prevent back injury. The hips should be aligned with the shoulders that is, not rotated to one side or the other. People should not bend over with their legs nearly straight and reach out with their arms to pick up an object.

    Instead, they should bend at the hips and knees. Bending this way keeps the back straighter and brings the arms down to the object with the elbows at the side. Then, keeping the object close to the body, they lift the object by straightening their legs. This way, the legs, not the back, lift the object. You might avoid back pain or prevent its recurrence by improving your physical condition and learning and practicing proper body mechanics. Because back pain is so common, numerous products promise prevention or relief. But there's no definitive evidence that special shoes, shoe inserts, back supports, specially designed furniture or stress management programs can help.

    In addition, there doesn't appear to be one type of mattress that's best for people with back pain. It's probably a matter of what feels most comfortable to you. Our patients tell us that the quality of their interactions, our attention to detail and the efficiency of their visits mean health care like they've never experienced. See the stories of satisfied Mayo Clinic patients. After years of chronic back pain, Guy Gottschalk was not optimistic that he would ever find relief. But a visit to Mayo Clinic not only significantly reduced his pain, it gave him the motivation to make important lifestyle changes that dramatically improved his health.

    When he had his first appointment in Mayo Clinic's Division of [ Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission. This content does not have an English version. This content does not have an Arabic version. Overview Back pain is one of the most common reasons people go to the doctor or miss work, and it is a leading cause of disability worldwide. Request an Appointment at Mayo Clinic.

    More Information Tarlov cysts: A cause of low back pain? Infographic: Back Pain. While I am showing the form of the three exercises, it is not advisable for your to do these without first reading his instructions! McGill describes who is able to do which variations safely before going on to describe how to modify these exercises for more capable spines. This review is not intended to be a replacement for reading the book!

    Once you have worked through the relevant chapters of Low Back Disorders , you will be forced to review your own intentions.

    Challenges of lower back pain

    When you work your spine in your asana practice: what do you intend? Are you trying to become healthier or are you trying to reach a particular flexibility goal? These are not the same things. Understanding the difference between health and performance may change your practice significantly. And that may make this the best book on yoga that you will have ever read, despite the fact that yoga is mentioned but once in the whole book. Return to Newsletter Low Back Disorders.

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