Self-Care for Lower Back Pain

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It must have been that super-strenuous spin class I took last week, when my mind fooled me into believing I was 35 but my body stubbornly acted its age. Energized but exhausted, I continued this self-deception by joining a friend after class in some challenging new ab work. She showed me new moves she’d recently learned. I struggled to keep up with her, but my body protested until I graciously bowed out.

What happened the next day wasn’t pretty. The minute I got out of bed I knew something was wrong. Pain shot through my right leg and then the leg buckled, threatening to throw me to the ground. And at frequent intervals throughout that day, that strange sensation threw me into fits of grimacing and grabbing onto the closest thing within reach to steady myself. Fortunately, I was in my house working, and no one except my dog could see my twisted expressions (and it didn’t seem to faze her one bit”she’s old; what can I say?) Except, that is, when hubby returned from work that night. “That’s just not normal!” he said, the first time he witnessed my sudden near-collapse. “There’s something wrong!” he insisted.

I figured I’d injured myself the day before and this is what I got … but then I guess his worry became contagious and suddenly seized my more sensible thoughts. Nasty contemplations ran through my head: A blood clot? Some rare neurological disease? A bone/circulation/muscular disorder?

I called my doctor the next day and described what was happening. “It’s most likely your lower back,” he said. That’s common. I decided to wait a few days for it to improve. And the next morning, when I got out of bed, my lower back was sore”but the leg only buckled once or twice. And by the day after that  voila! My leg stayed as steady as the proverbial rock.

I’m sure you can relate to lower back pain; if you can’t, you’re in the minority. Up to 80 percent of us experience it at one point or another. It’s so prevalent that it is estimated to cost Americans at least $50 billion each year in the quest for relief, and comes in second (behind headaches) as the most common neurological complaint in the United States.

Fortunately, I’m pretty much on the mend now, my back feeling (almost) back to normal. But I realize I’m lucky: many lower back aches take much longer to go away. Mine was caused by a sports injury, most likely pushing myself beyond my limit for that day, or positioning myself incorrectly on the bike. Others might experience back pain after lifting something too heavy, gardening or an event as innocent as sneezing, coughing or just turning around too quickly. Or a degenerative condition like arthritis may be to blame. And then there’s always another cause”that “A” word. Aging. Our bone strength and muscle tone elasticitydecrease with age; discs begin to lose their cushioning fluid and flexibility.

But back pain does not have to equal surgery. Most people do recover, in time, with some self-care.

Ice or heat:

Compresses may help reduce pain and inflammation. Time matters: As soon as possible, apply a cold pack or cold compress to the tender spot for up to 20 minutes several times daily; a bag of ice or even a bag of frozen peas wrapped in a towel will work. After two to three days, switch over to heat to relax muscles and increase blood flow to the area. And there’s nothing more soothing than a warm, relaxing bath.

Rest:

I remember long ago when bed rest was the standard treatment for back pain. I don’t know about you, but I feel much better when I’m up and about; things seem to stiffen up when I sit or lay flat. And studies have backed that up, finding that people who continue with their activities tend to appear to have better back flexibility than those who rested in bed for a week. Caution: there are some instances where rest is necessary and the preferred treatment. And when you do rest, lying on your side with a pillow between your knees can take some of the pressure off your muscles; or try lying on your back with a pillow beneath your knees.

Exercise:

Gentle exercises can speed recovery and keep flexibility at its peak. This may include swimming, walking and movement therapy, which can develop better posture and coordination. Yoga and gentle stretching also might be effective ways to manage lower back pain. And there’s a lot to be said, psychologically, for feeling like you’re in control and actively doing something to help yourself. (Don’t get overzealous, though: If you feel pain that goes beyond mild and lasts more than 15 minutes during exercise, stop what you’re doing. Don’t push yourself to do something that causes even more pain. Stay within your limit and listen to your body.)

Alternative treatments: 

Needles may sound scary, but these tiny, hair-thin flexible needles (in fact, it’s hard to really call them “needles” in the conventional sense) can trigger the release of endorphins, the body’s naturally occurring pain relievers. Acupuncture dates back centuries, but studies have shown it to be superior to medications or physical therapy in treating chronic back pain. Although acupuncture is controversial among many Western scientists and physicians, others support it. The WHO (World Health Organization) has found it effective in treating 28 conditions.

In addition, some people (about 22 million Americans visit them annually) swear by chiropractors, who gently manipulate and align the spine and may also incorporate other treatments such as ultrasoundmassage,biofeedback and nutritional therapy.

Therapeutic touch and Reiki are “energy-based” techniques that don’t involve direct physical contact. They are thought to help activate the body’s own self-healing capacities. The jury is mixed on their efficacy, though, for many, they may help ease the a***y associated with pain and thus might relieve muscle spasms associated with stress.

Medications:

 Many people find they are able to manage their pain with over-the-counter remedies like ibuprofen, aspirin or naproxen. Prescription drugs like muscle relaxers, opioids, anticonvulsants and even some antidepressants are sometimes recommended to manage moderate to severe pain. (But please remember to always check with your doc before taking drugs to manage pain; even over-the-counter medications can be unsafe in certain instances and can conflict with other medications or herbal supplements you might be taking.)

And then, there’s more:

More approaches to treat back pain include injections of local anesthetics, steroids or narcotics into affected areas; traction, TENS (transcutaneous electrical nerve stimulation) and ultrasound.

Spinning class will have to do without me for now, although I must admit, I miss the challenge. Perhaps the next time I go, I’ll forgo the after-class exercises with my friend and instead use that time for some gentle stretching and catching up.

Maintaining good posture, using natural and alternative therapies, getting exercise, losing weight and relieving stress are different ways to reduce back pain.

Posture

Maintaining good posture can help reduce stress and ease discomfort in your back. Here are some techniques to try.

When Sitting

  • Keep stomach muscles pulled in, and maintain the proper curve in your lower back. You can do this by tightening your stomach and buttocks.
  • Place a small cushion behind your lower back to help maintain the natural curve of the back.
  • Keep your knees slightly higher than your hips. Use a footstool or book under your feet if necessary.
  • Don’t sit for long periods of time. Stand up and move around periodically to stretch tight muscles and give them a chance to relax.

When Standing

  • Stand with your weight equally distributed on both feet.
  • Place one foot on a footstool to ease tension in your back.
  • Wear flat or low-heeled shoes if you stand for long periods of time.
  • Keep your back straight by tightening your stomach muscles and buttocks and doing a pelvic tilt.

When Lifting and Carrying Objects

  • Bend and lift using your knees and legs instead of your back.
  • Hold the object close to you.
  • Straighten your legs to lift the object.
  • Get help to lift objects that are too heavy.

When Sleeping

  • Sleep on a firm mattress.
  • Place a pillow between your knees while sleeping on your side.
  • Do not sleep on your stomach.
  • If you do not have knee problems, you may try placing a pillow under your knees when lying on your back.

Heat and Cold Therapy

Heat can help relieve back pain by relaxing muscles and soothing painful areas 48 hours after the pain begins. Some safe, effective options include hot showers or baths, warm compresses, hot water bottles, heat wraps, heating pads, warm-water therapy and hydromassage. If you have arthritis, warming your muscles first may make it easier for you to do back exercises. Sometimes, a healthcare professional may recommend applying cold to your back when pain is acute or severe, or after you exercise.

Exercise

There are stretching and flexibility exercises that may help to alleviate pressure on the back and loosen tight muscles. These include yoga and tai chi.  Make sure to talk to your doctor before beginning an exercise program.

Weight Loss

The doctor may recommend weight loss as one way to reduce your back pain and improve your general health. The best way to lose weight is by eating a balanced diet and exercising regularly. Be sure to avoid fad diets or quick weight-loss programs.

Natural and Alternative Therapies

Acupuncture may provide back pain relief. The practice involves inserting very fine metal needles into your skin at specific points, but not necessarily the area that’s bothering you. For example, back pain may be treated by stimulating points in your feet. Make sure you are treated by a certified acupuncturist.

Massage is also a great way to reduce pain. It can be done by massage therapists or some physical therapists.

A licensed chiropractor can provide spinal manipulation that can help with back pain.  But be aware that this procedure should not be done in individuals with inflammatory back pain such as ankylosing spondylitis. Spinal manipulation of the neck is also potentially dangerous in older individuals who have an increased risk of stroke.

Stress Relief

Here are some ways to reduce daily stress that may cause you to tighten shoulder and back muscles and worsen pain.

  • Soak in a warm bath, hot tub or spa.
  • Get involved in a hobby.
  • Do therapeutic exercise such as yoga or tai chi after getting clearance from your doctor.
  • Plan fun and relaxing activities with your family or friends.
  • Learn to accept what you cannot change instead of feeling constantly frustrated.
  • Consider getting professional help for problems that you are unable to handle on your own.

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