Back pain is one of those mysterious pain conditions that can come seemingly out of nowhere and prevent you from living a full life. What is back pain? Where does it come from?
Although back pain can sometimes be caused by internal organs referring their pain to the skin, or caused by direct trauma or injury, back pain usually indicates a very different type of pain altogether. This is because pain nerves can alert you to an active problem, but they can also send pain signals to the brain if the body believes that it is unstable.
Most back pain is not due to acute injury, but rather instability. If the low back does not think that it is capable of bearing the load of the body itself, it will send pain signals to the brain in order to tell the body about the problem. When the brain interprets the pain, your body will react accordingly. You might stop your motion or you might lay down, and in both cases you have relieved the back of its sudden load. The pain signals have done their job: they've alerted you to a problem.
This is why so much low back pain results from the simple act of bending over. Bending over does not cause acute injury or a ligament tear, but it does increase the load on your spinal discs and muscles by a very large amount. If the back believes itself to be unstable, then it will tell you, and you will feel back pain. This is why so many patients will say, "I was just bending over to pick up something from the floor, and it wasn't even heavy. Why do I hurt?" You hurt because your back doesn't think it's strong enough to continue.
This is why, when a patient has back pain, often nothing definitive can be seen on an X-ray or MRI. If there is no structural problem, nothing will be positively identified on imaging. Sometimes doctors will even say, "Nothing seems to be wrong." The bones are fine, the muscles are fine, the nerves are fine... but something is still wrong. Or, even worse, "You might just be imagining the pain." No, the pain is very real, and the question is: What is wrong? Answer: The perceived stability of your low back.
In this case, the best thing you can do for your back is to continue to strengthen it, and continue to use it. This advice sounds counterintuitive, because normally when we feel pain we think it's best to rest. However, we need to strengthen and stabilize unstable backs, and this requires work, effort, and normal motion.
This understanding of back pain and its origins has been around for the last twenty years or so, but it is starting to make an impression on the medical community. Fox News reports that a new book is out with much of this information, as well. I have not read the book and cannot review it, but this news article contains solid information:
Many Americans try to alleviate back pain with prescription pain medications, which can lead to dependence and other health problems. [Neurosurgeon Dr. Patrick] Roth believes taking pain medication may cause more harm than good.
Also, make sure you visit your chiropractor in Peoria, particularly if you are already susceptible to low back pain. The chiropractic adjustment can help to stabilize your back by adding proper motion to the joints in the region. If you did nothing, the back pain might go away on its own, yes, but the recurrence rate for low back pain is higher than for any other condition. It is likely that the low back pain will return, partly because the conditions that made the back unstable are still present and have not yet been resolved. Remember that the absence of pain does not mean that the condition is gone.
Your Peoria chiropractor can also advise you on the best exercises for your back, given your age and physical abilities. You don't have to go through low back pain on your own, and it certainly isn't all in your head.
Sometimes when people have low back pain, they also have associated leg pain. Usually, we refer to this leg pain as sciatica. But is leg pain always sciatica?
Technically speaking, sciatica only refers to pain that travels down the leg via the sciatic nerve, which is really a superhighway of nerves that exits your low back on both sides and then travels down your buttock, the back of the thigh, the calf, and even into the foot. Often the pain associated with sciatica will travel down the leg and to the calf, ankle, or foot. Sciatica can be caused by irritation of the nerve at the low back or buttock (in what is called piriformis syndrome) due to compression, inflammation, spinal stenosis, disc herniation, etc.
However, there are other nerves that travel from the low back into the leg, and these nerves can also be irritated by similar circumstances. Here are two examples:
1) There's a nerve called the "lateral femoral cutaneous nerve" that can cause numbness and tingling at the outside of the thigh. That's the only place that will feel numb in this condition, called meralgia paresthetica. This condition is usually caused by compression of the nerve at the front of the thigh, groin, or low back.
You can sometimes solve meralgia paresthetica by yourself. If the nerve compression is being caused by having too many objects in your front pants pockets, for example, then simply removing the items from your pocket may relieve your symptoms. The compression can also be caused by obesity: the extra weight gain can put pressure on the nerve as it passes through the groin. In this case, weight loss will usually relieve the pain. Other causes, such as low back misalignment, will need to addressed by a few visits to your chiropractor.
2) The sacroiliac joints, if inflamed or immobile, can irritate nearby nerves and cause pain that radiates to the thighs, as well. The classic case of sacroiliac radiculitis involves low back pain that causes radiating pain to the outside of the thigh but usually stops at or above the knee. In other words, this radiating pain generally does not travel into the lower leg or foot the way that sciatica usually does.
The sacroiliac joints generally require chiropractic care to regain their proper function. Stretches and exercises can help to establish core strength in the low back and abdominal areas, but the sacroiliac joints usually need chiropractic adjustments to re-establish lumbar and pelvic biomechanical stability.
Radiating pain can affect many different nerves and result in many different presentations of pain, numbness, and tingling. It is important to remember that not all radiating pain is sciatica, and not all radiating pains require the same treatment.
If you are experiencing radiating pain, consult your chiropractor to obtain a proper diagnosis. Only when the correct diagnosis is established can the proper treatment be advised.
As traveling increases during the holiday season, it's important to recognize that everyone knows that getting into a car accident can cause whiplash, neck pain, and even low back pain. So please be careful on the roads out there! But did you know that driving can cause low back pain all by itself? Even without crashing into anything?
It is well-established that a sedentary lifestyle can cause low back pain and even earlier death. Naturally, when driving or riding in a car, we're prolonging the amount of time we sit and reducing the amount of time we're standing or being active. Additionally, car seats rarely allow you to sit properly with the correct low back and neck curvature, so usually you'll end up slumped in your low back and neck with your shoulders rounded forward. This posture increases the pressure and load in the ligaments and discs of the low back and neck. So simply by sitting in a car seat, we're inviting trouble!
This is nothing new. Even back in in the late 1980s, research studies were beginning to correlate driving with low back pain and sciatica.
City bus drivers also face potential low back pain due to the amount of time that they remain seated, as well as the whole body vibration that they experience when bouncing around large vehicles.
Truckers also face potential low back pain, and not only because of the time spent in the cab. Often, truckers will have to jump out of their truck in order to unload the back of the truck. Unless the trucker is able to walk around for a few minutes prior to lifting anything heavy, it is possible that his/her low back will not be stable enough to withstand the pressures and load of lifting immediately after prolonged sitting.
In order to prevent car-related low back pain:
- Keep your car seat as upright as possible.
- Make sure that your low back is not slumped. Use a cushion or lumbar support if necessary. Often, pre-installed lumbar supports are not sufficient or are poorly placed for your body.
- Sit with your rear end as far back in the seat as possible, to avoid additional low back slumping.
- Squeeze your shoulder blades together as you drive. This keeps your shoulders back and helps maintain proper neck posture.
- Lean your head back against your head rest, if possible. This eases the tension on the muscles at the front of your neck. If your seat is as upright as possible, you'll still easily be able to see the road. If your seat is reclined, it is more difficult to rest your head and neck, which may well cause tension headaches.
- On long trips, stop frequently and walk around your car to re-engage your back and leg muscles.
- Don't be upset if you have to park a long way from the front door at shops, stores, and malls. A little extra walking can only help stimulate your low back and leg muscles.
- Make sure to keep your spine neutral as you get into and out of your car.
- Don't keep your hands at 10 and 2! That's no longer recommended. Try these tips instead.
- Ask your chiropractor for more postural advice that's specific to your car and your situation.
There's a fascinating concept called "nonexercise". Have you heard of it? If not, it's roughly reverse to the concept of "catching up on sleep."
You'll often hear people say that they didn't sleep very well during the week, but they're going to try to catch up on sleep during the weekend. Their idea is that a solid ten hours of sleep will refresh them and undo the damage done by a recent lack of sleep. Unfortunately, sleep scientists have shown time and again that catching up on sleep doesn't work.
In the same way, office workers are becoming more and more aware of the dangers of a sedentary lifestyle and the damage that eight hours a day in a chair can do. Office workers are becoming more agreeable to the ideas of exercising and working out. But exercising for an hour or two a week cannot undo the damage inflicted by sitting to the discs, ligaments, and muscles of the low back.
This is where the idea of "nonexercise" comes in. Nonexercise is all the daily activities that you do which give support to your low back, and can be as simple as standing for a while. These are the postures and activities that truly prevent low back pain and disc damage. In other words, simply remaining active during a day can be more beneficial than exercising regularly.
Unless otherwise attributed, all content is written by Kyle Johnson, DC, of Johnson Family Chiropractic of Peoria.
All images used are under Creative Commons license.
Although every effort has been made to provide an accurate description of our chiropractic care and its benefits, the information given on this website and blog is not intended to be, nor should it be interpreted as, medical advice for any condition.
If you have any questions regarding your condition, you should seek the help of Dr. Johnson in person, so that he may properly assess your condition.
This blog is provided by Johnson Family Chiropractic of Peoria, S.C., proudly located in Peoria, IL.