Low Back Pain
- Denise M. Goodman, MD, MS; Alison E. Burke, MA; Edward H. Livingston, MD
- JAMA | April 24, 2013 JAMA 2013; 309(16):1738. doi:10.1001/jama.2013.3046. April 24, 2013. Vol 309, No. 16
Your back is made up of bones (the vertebrae, or spinal column, which protects your spinal cord) and muscles. The vertebrae are stacked like blocks; the spinal cord runs down the middle, and between the vertebrae nerves extend from the spinal cord to the left and right. The disks lie between the vertebrae and form spongy shock absorbers between each bone. Several layers of muscle cover the back, and ligaments and tendons support the vertebrae, supporting posture and giving the body flexibility. Back pain can be caused by problems with the muscles, the bones, or the nerves in the back.
CAUSES OF LOW BACK PAIN AND SYMPTOMS
Often, the cause of back pain is unknown. Back pain can be caused by a strain of the muscle. This type of back pain can vary; it can be dull or sharp and may get worse with sitting, standing, walking, or other movement. Lying down often helps. Muscle pain does not extend down your leg toward your foot.
Sometimes the disk can bulge out, putting pressure on the nerve that is exiting between the vertebrae. Signs of a pinched nerve may include pain that radiates down your leg, numbness, or tingling. More rarely, it can cause problems with controlling your bowels or bladder. Signs of underlying disease requiring immediate medical attention include back pain accompanied by unexplained weight loss or fever.
Arthritis or degeneration of the bony vertebrae can also cause back pain.
Most back pain is uncomplicated and self-limited. If your pain does not get better in a few days or weeks, if you have fever or weight loss, or if you have signs of nerve involvement, you should call your doctor. A medical history and physical examination will allow the doctor to make appropriate treatment recommendations. Imaging (x-rays, magnetic resonance imaging [MRI], orcomputed tomography [CT]) is not recommended for uncomplicated low back pain. Imaging is used if you have had trauma, evidence of nerve involvement, sometimes for those older than 70 years, or if symptoms are very prolonged. It is also used if your doctor suspects another disease, such as infection or cancer.
Many treatments are available for low back pain. Often exercises and physical therapy can help. Some people benefit from chiropractic therapy or acupuncture. Sometimes medications are needed, including analgesics (painkillers) or medications that reduce inflammation. Surgery is not usually needed but may be considered if other therapies have failed.
Exercise and good posture can maintain good back health. Your back and abdominal muscles work to maintain posture and need exercise. It is important to use proper technique with strenuous activities such as lifting heavy objects and shoveling snow. This includes bending your knees so you use your legs and buttocks as well as your back to lift, and turning your whole body so you don’t twist just your back.
For More Information:
- Agency for Healthcare Research and Quality
- American College of Physicians
- National Institute of Neurological Disorders and Stroke
- American Academy of Orthopaedic Surgeons
Backpack Misuse Leads to Chronic Back Pain
Back pain is very common American adults, but a new and disturbing trend is on the rise. Young children are suffering from back pain much earlier than previous generations, and the use of overweight backpacks is a contributing factor, according to the American Chiropractic Association (ACA). In fact, the U.S. Consumer Product Safety Commission reports that backpack-related injuries sent more than 7,000 people to the emergency room in 2001 alone.
This new back pain trend among youngsters isn’t surprising when you consider the disproportionate amounts of weight they carry in their backpacks – often slung over just one shoulder. According to Dr. Bautch, a recent study conducted in Italy found that the average child carries a backpack that would be the equivalent of a 39-pound burden for a 176-pound man, or a 29-pound load for a 132-pound woman. Of those children carrying heavy backpacks to school, 60 percent had experienced back pain as a result. According to Dr. Bautch, preliminary results of studies being conducted in France show that the longer a child wears a backpack, the longer it takes for a curvature or deformity of the spine to correct itself. “The question that needs to be addressed next is, ‘Does it ever return to normal?'” Dr. Bautch added. The results of these types of studies are especially important as more and more school districts – many of them in urban areas – remove lockers from the premises, forcing students to carry their books with them all day long.
What Can You Do?
The ACA offers the following tips to prevent back pain in children:
- Your child’s backpack should weigh no more than 5 to 10 percent of his or her body weight. If he or she is bending forward to support the weight on his or her back, then the backpack is too heavy.
- The backpack should never hang more than four inches below the waistline. This will prevent leaning forward during walking.
- A backpack with individualized compartments helps in positioning the contents & rest on your child’s back properly.
- Bigger is not necessarily better. The more room there is in a backpack, the more your child will carry, hence heavier backpack.
- Urge your child to wear both shoulder straps. Lugging the backpack around by one strap can cause the disproportionate shift of weight to one side, leading to neck and muscle spasms, as well as low-back pain.
- Wide, padded straps are very important to prevent digging in your child’s shoulders.
- The shoulder straps should be adjustable so the backpack can be fitted to your child’s body. Loose straps can cause the backpack to dangle uncomfortably and cause spinal misalignment and pain.
- If the backpack is still too heavy, talk to your child’s teacher. Ask if your child could leave the heaviest books at school, and bring home only lighter hand-out materials or workbooks.
Use of rollerpacks – or backpacks on wheels – has become popular in recent years. ACA is now recommending that they be used cautiously and on a limited basis by only those students who are not physically able to carry a backpack. Some school districts have begun banning the use of rollerpacks because they clutter hallways, resulting in dangerous trips and falls.
If you or your child experiences any pain or discomfort resulting from backpack use, call your chiropractor. Doctors of chiropractic are licensed and trained to diagnose and treat patients of all ages and will use a gentler type of treatment for children. In addition, doctors of chiropractic can also prescribe exercises designed to help children develop strong muscles, along with instruction in good nutrition, posture and sleeping habits.
Before you rev up the lawnmower or reach for your rake this fall, consider the possible consequences: upper or lower-back strain, neck strain and pain in the shoulders.
Just as playing football or golf can injure your body, the twisting, turning, bending, and reaching of mowing and raking can also cause injury if your body is not prepared. Like an athlete, if you leap into something without warming up or knowing how to do it, the chances of injury are greater.
What Can You Do?
The American Chiropractic Association (ACA) offers the following tips to help prevent the needless pain yard work may cause.
- Do stretching exercises, without bouncing, for a total of 10 to 15 minutes spread over the course of your work. Do knee-to-chest pulls, trunk rotations, and side bends with hands above your head and fingers locked. Take a short walk to stimulate circulation. When finished with the yard work, repeat the stretching exercises.
- Stand as straight as possible, and keep your head up as you rake or mow.
- When it’s still warm outside, avoid the heat. If you’re a morning person, get the work done before 10 a.m. Otherwise, do your chores after 6 p.m.
- When raking, use a “scissors” stance: right foot forward and left foot back for a few minutes, then reverse, putting your left foot forward and right foot back.
- Bend at the knees, not the waist, as you pick up piles of leaves or grass from the grass catcher. Make the piles small to decrease the possibility of back strain.
- When mowing, use your whole bodyweight to push the mower, rather than just your arms and back.
- If your mower has a pull cord, don’t twist at the waist or yank the cord. Instead, bend at the knees and pull in one smooth motion.
- Drink lots of water, wear a hat, shoes and protective glasses. And, to avoid blisters, try wearing gloves. If your equipment is loud, wear hearing protection. If you have asthma or allergies, wear a mask.
- Try ergonomic tools, too. They’re engineered to protect you when used properly.
- If you do feel soreness or stiffness in your back, use ice to soothe the discomfort. If there’s no improvement in two or three days, see your local doctor of chiropractic.
Chicken Pot Pie
Ingredients for Crust:
- 1/2 cup melted grass-fed butter
- 2 organic eggs
- 1/4 tsp sea salt
- 3/4 cup coconut flour
- 1-3 TBS raw honey
- Preheat oven to 400 degrees. In a medium bowl beat butter, eggs, honey and salt together with a fork. Then add coconut flour. Stir until dough holds together.
- Gather the dough into a ball then pat into a 9″ greased pie pan. Prick the dough with a fork.
- Bake for 9 minutes then let cool in the fridge.
Ingredients for Filling:
- 6 TBS organic coconut oil or butter
- 1 small minced organic onion
- 2 cloves minced organic garlic
- 2 chopped organic celery stalks
- 2 sliced organic carrots
- 3 TBS organic dried parsley
- 1-1/2 tsp organic dried oregano
- ½ tsp organic dried rosemary
- 1 tsp organic dried celery seed
- 2 cups chicken stock
- 2 cubed organic Yukon gold potatoes
- 1 cup organic peas
- 1-1/2 cups organic cubed chicken
- 3/4 cup organic heavy cream
- 5 TBS organic sprouted flour
- Salt & pepper to taste
- In a sauce pan over medium heat, melt 2 TBS butter, add onion, carrots, celery, garlic, parsley, oregano, rosemary and celery seeds. Cook until the vegetables are soft and onions are slightly translucent.
- Add 2 cups of chicken stock & cubed potatoes. Allow to cook over medium heat until stock is bubbling and the potatoes are tender (not too soft). Remove from heat and add in peas.
- In another sauce pan over medium heat, melt the remaining 4 TBS butter, add, chicken, 4 TBS of sprouted flour. Coat the chicken with flour and butter and allow it to cook for one minute. Then add in cream, mix until it begins thickening, then remove from heat.
- Add the chicken/flour mixture to the stock and vegetables, stir until combined and stock thickens.
- Using a large baking dish, ladle in chicken pot pie filling. Remove the pie crust from the fridge, place over the filling, and cut slits into the top allowing steam to escape.
- Bake in preheated 452 degree oven for 15minutes, then lower the temperature to 350 degrees and cook for an additional 15 minutes or until crust is golden brown.
- Allow to set for 5 minutes before serving. Enjoy!
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While I know myself as a creation of God, I am also obligated to realize and remember that everyone else and everything else are also God’s creation – Maya Angelou