Low Back Pain
|Bones of the Lower Back|
|Copyright © Nucleus Medical Media, Inc.|
Muscle strains or ligament sprains in the area (most common cause of back pain), such as from:
- Heavy lifting or lifting incorrectly
- Sudden unusual movement
- Herniated (ruptured) disc —the cushions between the bones of the spine bulge out of place
- Disc degeneration —caused by aging or arthritis
- Spinal stenosis —narrowing of the spinal canal
- Spondylolisthesis —slippage of a bone in the lower back
- Fractures due to trauma and/or osteoporosis
- Fibromyalgia —a condition that causes muscle aches and fatigue
- In rare cases:
When Should I Call My Doctor?
- Is severe or gets significantly worse
- Has not started to improve within about a week
- Causes difficulty walking, standing, or moving
- Is worse at night or worse when you lie down
- Spreads down your legs
- Comes with pain or throbbing in your abdomen
- Is new and you are over age 50
Is associated with:
- Numbness, weakness, or tingling in your buttocks, genitals, or legs
- Loss of bowel or bladder control
- Difficulty with urination
- Fever, unexplained weight loss, or other signs of illness
- Blood tests
- Urine test
- Over-the-counter pain relievers, such as acetaminophen (Tylenol), aspirin (Bayer), or ibuprofen (Motrin, Advil)
- Muscle relaxants for muscle spasm—These medicines are not used in cases where you need to be alert, such as driving or operating machinery.
- Antidepressants—These may also be prescribed for chronic low back pain.
- Applying hot or cold packs
- Doing stretching, strengthening, and balance exercises for back and stomach muscles
- Participating in an aerobic exercise program (eg, walking, swimming)
- Learning how to cope with back problems
- Getting massage therapy
- Begin a safe exercise program with the advice of your doctor.
- Maintain a healthy weight .
- If you smoke, quit .
- Practice good posture to reduce pressure on your spine.
- Avoid sitting or standing in one position for long periods of time.
- If you must remain standing for long periods, rest one foot at a time on a small stool to relieve pressure on your lower back.
- When lifting, hold the object close to your body, keep your back straight, and use your leg muscles to rise slowly.
- Avoid aggravating activities, for example bending, twisting, and sudden movements.
- Consider job retraining if your work requires a lot of heavy lifting or sitting.
- If you have back pain during pregnancy, try wearing a BellyBra. This is a special bra to support your back and abdomen.
American Academy of Orthopaedic Surgeons http://orthoinfo.aaos.org/
American Academy of Family Physicians http://www.familydoctor.org/
Canadian Orthopaedic Association http://www.coa-aco.org/
Canadian Orthopaedic Foundation http://www.canorth.org/
Acute low back pain. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed . Updated December 3, 2012. Accessed December 6, 2012.
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Chronic low back pain. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/ . Updated November 28, 2012. Accessed December 6, 2012.
Dahm KT, Brurberg KG, Jamtvedt G, Hagen KB. Advice to rest in bed versus advice to stay active for acute low-back pain and sciatica. Cochrane Database Syst Rev . 2010 Jun 16;(6):CD007612.
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9/16/2008 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/ : Kalus SM, Kornman LH, Quinlivan JA. Managing back pain in pregnancy using a support garment: a randomised trial. BJOG. 2008;115:68-75. Epub 2007 Nov 12.
12/16/2008 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/ : Furlan AD, Imamura M, Dryden T, Irvin E. Massage for low-back pain. Cochrane Database Syst Rev. 2008;CD001929.
1/30/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/ : Yuan J, Purepong N, Kerr DP, Park J, Bradbury I, McDonough S. Effectiveness of acupuncture for low back pain: a systematic review. Spine. 2008;33:E887-900.
2/17/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/ : Bigos SJ, Holland J, Holland C, Webster JS, Battie M, Malmgren JA. High-quality controlled trials on preventing episodes of back problems: systematic literature review in working-age adults. Spine J. 2009;9:147-168.
2/17/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/ : Chou R, Fu R, Carrino JA, Deyo RA. Imaging strategies for low-back pain: systematic review and meta-analysis. Lancet. 2009;373:463-472.
2/24/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/ : Sahar T, Cohen M, Ne'eman V, et al. Insoles for prevention and treatment of back pain. Cochrane Database Syst Rev. 2009;(1):CD005275.
9/2/2009 DynaMed Systematic Literature Surveillance http://www.ebscohost.com/dynamed/ : Urquhart D, Hoving J, Assendelft W, Roland M, van Tulder M. Antidepressants for non-specific low back pain. Cochrane Database Syst Rev. 2009;(3):CD001703.
11/12/2010 DynaMed's Systematic Literature Surveillance http://www.ebsochost.com/dynamed/ : US Food and Drug Administration. FDA clears Cymbalta to treat chronic musculoskeletal pain. US Food and Drug Administration website. Available at: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm232708.htm . Published November 4, 2010. Accessed November 12, 2010.
12/17/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/ : Andersen LL, Christensen KB, Holtermann A, et al. Effect of physical exercise interventions on musculoskeletal pain in all body regions among office workers: a one-year randomized controlled trial. Man Ther. 2010;15(1):100-104.
10/21/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/ : Chan CW, Mok NW, Yeung EW. Aerobic exercise training in addition to conventional physiotherapy for chronic low back pain: a randomized controlled trial. Arch Phys Med Rehabil. 2011 ;92(10):1681-1685.
11/29/2011 DynaMed's Systematic Literature Surveillance http:www.ebscohost.com/dynamed/ : Gatti R, Faccendini S, Tettamanti A, Barbero M, Balestri A, Calori G. Efficacy of trunk balance exercises for individuals with chronic low back pain: a randomized clinical trial. J Orthop Sports Phys Ther. 2011;41(8):542-552.
- Reviewer: Brian Randall, MD
- Review Date: 11/2012 -
- Update Date: 11/26/2012 -