LET’S START WITH THE BASICS
What is Back Pain?
You’re Not the Only One With Back Pain
Back pain is an incredibly common condition. Young or old, healthy or ill, active or sedentary — every category is represented with those who report back pain. Estimates predict that 80% of the population will face back pain at least once in their lives.
Back pain is also the third leading cause for visits to the doctor, right behind joint pain and skin problems. Have you ever had to call off work because you couldn’t get out of bed due to debilitating, shooting pain in your lower back? Well, you’re not alone. Back pain is the leading cause of disability in people across the world, severely limiting people’s ability to show up to work, let alone complete normal day-to-day activities.
It can become discouraging to be in pain, especially when it interferes with activities you love. We have created an extensive article for your reference in the hopes that you will gain insight into many of the options available for treatments that can be utilized before resulting to an invasive surgery.
The Anatomy of the Back
Before diving into the symptoms and causes of back pain, it is helpful to understand the anatomy of the back and spinal region. The vertebral column (spine) runs vertically along the back and helps the body stay upright, as well as houses the central nervous system — an essential operating center responsible for movement, touch, pain, organ function, thought, emotion (and so much more).
The spinal column itself consists of stacked vertebrae and intervertebral discs divided into three categories: the cervical spine (or neck), the thoracic spine (or upper/middle back), and the lumbar spine (or lower back).
A complex system of nerves runs through the hollow center of the spine, as well as out to the surrounding body systems. The spine is surrounded by muscles, assisting in stability and movement. If any of these structures experience an injury such as strain, compression, or herniation, the nerves running through the spine may be directly affected, causing back pain.
Symptoms of Back Pain
What are considered common symptoms of back pain? Back pain symptoms range from dull and achy to sharp and sudden, to chronic and radiating. Pain may be localized in one area or referred to another area (for example, from the lower back to the lower extremity) such as with sciatica. Back pain might come on suddenly with no apparent cause, or it may start with a sudden movement your body was not properly equipped to handle, such as lifting a heavy object improperly or a sudden twisting motion of the spine.
Symptoms should be considered more serious if you have a history of cancer, experienced unintentional weight loss, a weakened immune system, a history of trauma, nighttime pain, pain that hasn’t improved even after rest, or pain lasting more than a month.
Acute vs. Chronic Pain
To better understand the type of back pain you’re dealing with, try to categorize the pain: Is it acute or chronic? Acute pain is often related to a specific cause and source of injury (for example, a sudden impact such as a fall). Often the experience goes something like this: the initial encounter of pain (such as touching a hot stove), withdrawal from the pain (removing your hand from the heat), then the settling in of a less intense, persistent ache. To be considered acute, the pain should not last more than 3 to 6 months.
Chronic pain, on the other hand, is a more complicated condition and thus more difficult to explain. It often does not have a distinct cause, or the pain is no longer related to the cause (in the case that the damage or injured tissue has healed). Chronic pain characteristically lasts longer than three to six months. Sometimes thoughts or emotions associated with the pain may contribute to the continuation of symptoms. Treatment for chronic back pain can be more challenging than treatment for acute back pain.
Axial, Referred, and Radicular Pain
Another anatomical system, consisting of three categories, is helpful for tracking causes of back pain. The first category, axial pain (mechanical pain specific to the structure of the spine), is localized to one area of the back. It is often described as sharp, dull, achey, infrequent, or constant. Common causes include disc tears, facet joint degeneration, and muscle strains.
The second category is referred pain, which varies in intensity and is felt in other areas of the body, not just the site of injury. It is often described as dull and achy, and may be caused by bulging or herniated discs pressing on the nerves of the low back, thus referring pain to the legs.
Radicular pain (or radiculopathy) is the last category for back pain. This pain is described as shooting and searing, and follows the spinal nerve paths. The cause is often compression or inflammation at the nerve root caused by compressed discs, spinal stenosis, or spondylolisthesis.
THERE CAN BE MANY DIFFERENT CAUSES OF BACK PAIN
What Causes Back Pain?
The causes of upper, middle, and lower back pain can be numerous and difficult to track, however there are some common patterns. Four common categories of causes are structural compromise (spinal or muscular), injuries, lifestyle, and pathologies.
Back pain stemming from structural compromise is related to either the spine itself or the muscles surrounding the spine. Bulging or herniated discs are common sources for back pain. The discs between each of the vertebrae of the spine are like tough jelly donuts. When compressed too much, they “bulge” out to either side of the spinal column. A herniation would be the more severe form of a bulging disc. Sometimes a bulging disc will press on the nerves surrounding it, thus causing shooting and referred nerve pain.
Degenerative discs are another cause for pain, often occurring in the older population. As the discs age, they begin to wear away, creating more friction between vertebrae. Another possible source for back pain is spinal stenosis. This is a narrowing of the spinal canal, limiting the space in which nerves can travel. This often results in numbness and tingling in the arms and legs.
Scoliosis, which often begins to form just before puberty during a growth spurt, is a deformity in which the spine curves from side to side. This obstructs the alignment of the back, and in extreme cases can cause severe pain.
Muscular problems also contribute to back pain. Because muscles surround and support the spine, a muscle tear, weakness, or excess tension can compromise the alignment of the spinal column and cause residual achiness or pain.
Injuries and Back Pain
The back is susceptible to many forms of injuries. Strains, fractures, and spasms being a few.
A muscle strain is a partial or complete tear in the fibers of a muscle or tendon. Strains may occur due to numerous causes, including overuse, a sudden twisting motion, or powerful force. Strains that occur in the back may be caused by lifting a heavy object with improper form, or overworking a particular muscle during a workout or other repetitive activity.
A small to minor break in bone tissue is described as a fracture. Spinal fractures may occur from an impact injury or from a hard fall. High intensity impact sports or car accidents are examples for leading causes of spinal fractures.
Muscle spasms are another common back condition. Spasms are typically a protective mechanism that activates after a muscle is stretched too much or too quickly. Spasms may be a direct result of either muscle strains or spinal fractures.
How Lifestyle Affects Back Pain
Lifestyle factors contribute greatly to back pain. A sedentary lifestyle, slouching over a computer or phone, wearing high heels to work, being overweight, and frequently lifting heavy objects are just a few examples.
Posture is one of the leading causes for back pain. We are so used to engaging in our habitual patterns — like driving a car, texting, watching TV, or reading a book while slouched in bed and we forget how these seemingly insignificant actions are compromising our back health. Until we are in pain. And at that point if prevention wasn’t on the agenda, treatments to correct posture must be.
When slouched over, for instance at a computer, the spine falls out of alignment, the chest muscles become short and tight, and the upper back muscles become over-stretched and weak (a condition referred to as upper crossed syndrome). Poor posture while standing or lifting also can contribute to muscle fatigue or strain. For a detailed expalanation of this postural syndrome, see our blog post that gets in to all the nitty gritty details.
Obesity may be another cause for back pain. Excess body weight places extra pressure on the sacrum, causing the pelvis to tilt too far forward into anterior rotation. This position disrupts how weight is distributed throughout the body, and functional movement quality may become compromised leading to consistent pain. This situation also put you at risk of soft tissue injury.
Back pain may also be exacerbated by smoking. Some studies suggest that smoking causes damage to the vascular structures of the discs and joints of the back, thus causing back pain.
Pregnancy often causes back pain as the developing fetus grows. During pregnancy, the excess weight of the baby forces the mother’s pelvis into anterior rotation. This causes an excessive lumbar curve in the low back, causing a disruption in proper body mechanics. In this instance, the quadratus lumborum muscle of the back becomes strained and possibly painful.
Lastly, excessive exercising or muscular overuse is an influential factor in causing back pain. Without sufficient recovery, the muscles supporting the spine may become exhausted to the point of strain and fatigue. Lifting heavy objects repeatedly with improper posture is also a common cause for muscle strains and spasms. However, this should not discount the incredible benefits of exercise to heal and prevent back pain when done correctly.
Pathologies That Cause Back Pain
Aside from structural problems, injuries, and lifestyle, certain pathologies may inherently cause back pain.
There are many forms of arthritis that directly affect the spine. In osteoarthritis, the cartilage between vertebrae begins to wear away, affecting the facet joints and causing friction. Reactive arthritis is an inflammatory condition that typically affects the sacrum, due to an infection in the gastrointestinal tract. Ankylosing spondylitis is a form of arthritis specifically related to the spine which may eventually lead to fused vertebrae.
Osteoporosis is another pathology that commonly creates back pain. Osteoporosis is a disease in which bones become brittle and thus more susceptible to injury. Spinal fractures and compressions may be the result.
Kidney problems may manifest as mid-back pain. If you are experiencing fever, chills, difficulty urinating, or nausea in conjunction with back pain, you may be experiencing kidney problems and should contact a doctor immediately.
Another pathology that may cause back pain is fibromyalgia. Although fibromyalgia is a widespread disease causing pain and fatigue throughout the body, it may also be linked to back pain — especially upper back pain.
DON’T WAIT TOO LONG TO SEEK HELP
How to Relieve Back Pain
When to See a Health Care Specialist for Back Pain
There are several symptoms to watch out for when considering whether or not your back pain is serious enough to see a doctor or health care provider.
Fever accompanied with back pain may be a sign that a systemic infection is developing. If this is the case, it is imperative that you visit your doctor as soon as possible for imaging and diagnosis. Loss of bladder control may also be a serious indicator of a rare condition called cauda equina syndrome. Back pain only at night or unexpected weight loss could be a sign of a tumor or cancer. Foot drop, a condition in which one foot drags along the ground or has difficulty lifting, may be signifying a nerve injury.
Some less serious symptoms to consider seeing a health care provider for would be pain lasting more than six weeks, numbness or tingling in extremities, or pain that doesn’t improve with at home remedies.
Types of Medical Interventions for Back Pain
Medical interventions may be necessary to manage back pain, depending on the severity of the condition.
The first point of action should be to have some tests run to determine possible causes for the back pain. A X-Ray will reveal any fractures in vertebrae or a condition like arthritis. It will not indicate nerve related conditions. An MRI or CT scan will give a more detailed image of the spinal cord and related conditions, such as herniated or bulging discs, degenerative discs, and nerve compressions. Bone scans, blood tests, and nerve tests (such as electromyography) may be necessary to further evaluate causes, test for infections, and monitor the responsiveness of particular nerves.
Once the cause of the back pain has been determined, medications, home remedies, physical therapy, or massage therapy may be recommended. For more serious conditions or when symptoms don’t subside over a long period of time, surgery may be indicated.
Home Remedies for Back Pain
Keep moving. The worst thing you can do for the health of your back is spend all day in bed because the pain is too much. Continue to do everyday normal tasks, such as making the bed and walking the dog. Gentle cardio should be relatively safe and will often lessen rather than increase symptoms.
Stretch regularly. Make it a habit to get up every twenty minutes from your desk and do some simple side body and front body opening stretches, as well as stretches that release the low back. A standing toe touch hang, cobra pose, and child’s pose specifically target and help the back release. Don’t forget to stretch the lower body too — hamstring stretches are paramount to relieving lower back pain.
Think ergonomically. Consider investing in a new desk chair or pillow that will adequately support your lower back or allow your spine rest in alignment. Sitting on a stability ball instead of a typical desk chair, for example, will train your back to stay upright and strengthen your core muscles.
Try herbal remedies. Ginger root, chamomile, and St. John’s Wort contain anti-inflammatory properties that are great for treating back pain. Making sure to get magnesium, calcium, and Vitamin D in your diet is also crucial. Try taking an epsom salt bath — the salt is good for detoxing and mineral replenishing and the warm water soothes uptight muscles. CBD oil, used topically or orally, is also proving to be an excellent pain reliever with numerous other health benefits.
Heat and Cold Therapy for Back Pain
If you are experiencing a recent injury, inflammation, and acute pain, cold therapy may be a good way to treat the discomfort. Ice is typically used for acute injuries that have occured in the past 48 hours. Cold may help reduce swelling, minimize inflammation, and reduce spasms. Do not use ice directly on skin, and only use cold for a max of 15-20 minutes per icing. Cryoderm is a great alternative to ice that combines a variety of natural ingredients to work quickly and effectively. Pick up a sample to try next time you visit the clinic!
Heat therapy is best applied to chronic tension or pain. It is most effectively used to soften tight and sore muscles, speed up circulation, and increase flexibility. Moist heat is considered more effective than dry heat. Heating pads, warm damp towels, are easy applications to try at home. Do not use heat on acute or swollen injuries and only use moderate heat. Consider coming in for a dry sauna treatment before your next massage to speed up back pain recovery.
Self Myofascial Release for Back Pain
Self Myofascial Release (SMFR) is a type of therapy that utilizes steady pressure to release tight and dense connective tissues (fascia) throughout the body. SMFR is excellent for trigger points, knots, and scar tissue, or for general back tension. A foam roller is one of the best at home methods for SMFR. It works to relieve habitual sitting or standing postures, and can be used as a warm up or cool down for a workout. Pick up a foam roller from us next time you visit The Anatomy of Wellness!
PREVENTATIVE HEALTH IS THE BEST FORM OF HEALTHCARE
How to Prevent Back Pain
Exercises and Stretches for Back Pain
Facilitating a strong core and back is probably the best thing you can do to prevent back pain. Exercises that specifically target the anterior and posterior core (front and back) are key to maintaining proper posture and preventing injury. Becoming aware of your core muscles and how to engage them is the first step to building strength. A transverse abdominus hold (T.A. hold), dead bug exercise, and bridges are just a few exercises to start practicing if you want to build a healthy core.
Building upper body strength and alignment is very important for preventing upper cross syndrome and maintaining proper alignment. Many upper body workouts unintentionally target only the front of the upper body (the pecs, biceps, and front of the shoulders), while neglecting the muscles of the upper back (the rhomboids and lats). This creates a muscular imbalance. Chest opening exercises and stretches such as snow angels, reverse flys, scapular retraction, and rows should be incorporated into your fitness routine in order to prevent these common problems. A resistance band would be a great addition to increase the intensity and effectiveness of upper back exercises.
Proper Lifting Technique
Lifting heavy objects with proper form is critical, whether at the gym, at work, or in day to day life. Learn to keep your back straight and your core engaged while performing heavy lifts. Never lift only from your back, always engage your legs when lifting a large object, bending your knees if necessary.
Decreasing Repetitive Activities
Some activities are engaged in every single day, sometimes for hours, without thinking about–like picking up your child, texting, sitting up late in bed watching TV, or typing at your computer. Some of these activities may be unavoidable, but some may also be greatly reduced or the technique itself improved.
Start to become aware of these daily repetitions and consider how you can reduce the negative impact they may be having on your back health. If your work requires repetitive activities, consider how to perform these actions with better posture, or learn stretches and exercises to help your body recover at the end of the day.
THE HUMAN BODY NEEDS TO BE TREATED NOT AS ONE SYSTEM BUT AS A SYSTEM OF SYSTEMS
Treat Back Pain Holistically
Massage Therapy for Back Pain
There are numerous benefits of massage therapy, including back pain relief. Massage increases circulation to stiff and sore muscles, promotes relaxation, and encourages endorphins for that “feel good” pain relief effect. Aside from these common benefits, clinical massage therapy targets a specific injury or condition of the back. Appropriate techniques and protocols are combined by the therapist to best initiate the healing of strains and sprains, reorganize scar tissue, reduce muscle spasms, release trigger points, stretch tight muscles, and encourage proper alignment.PRO TIP: With massage therapy for pain management, do your research on the massage therapist you choose. Look for someone who has training beyond the standard curriculum offered in massage therapy schools in clinical assessment and treatment techniques.
Corrective Exercise/Postural Correction for Back Pain
Corrective exercise and postural correction are aimed at repairing faulty movement patterns throughout the body that may be contributing to various dysfunctions or conditions, including back pain. Typically the client is prescribed various exercises to perform at home in order to build proper alignment, stability, and mobility. These exercises work to reduce compensating patterns, thus improving back pain and discomfort.
Yoga for Back Pain
Yoga is an effective way to start building core strength and muscle stability, while at the same time increasing balance and flexibility. Traditional yoga focuses on the mind-body connection, which is an excellent way to decrease stress and gain a sense of being grounded and in control.
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Acupuncture for Back Pain
Research indicates that acupuncture is an effective way to treat back pain. Acupuncture, stemming from traditional Chinese medicine, utilizes tiny needs to stimulate the central nervous system and repair flows of energy throughout the body. Although there are differing theories as to how acupuncture actually affects the body, it is known to have positive outcomes.
Chiropractic for Back Pain
Chiropractic care utilized the manual manipulation of spinal joints to restore functionality and balance to the vertebral column. It is often used to correct distortions in the spine (such as upper cross syndrome or scoliosis) or injuries causing scar tissue buildup and immobility around vertebral joints. It can be a great alternative to medication or other forms of traditional medical treatment.
Manual Lymphatic Drainage for Back Pain
If the cause of back pain is a pathology or injury that requires surgical intervention to correct, many patients discover that receiving Manual Lymphatic Drainage (MLD) is effective in reducing edema (swelling) and aiding in a speedy recovery time. MLD uses a gentle massage technique to aid in directing the flow of lymphatic fluid toward lymph nodes for processing.
Cupping Therapy for Back Pain
The cupping method was founded in Eastern Medicine, and has been used for centuries to treat back pain. Although the oldest method of cupping was done with hollow animal horns, modern cupping typically utilizes either glass, plastic, or rubber cups. The suction the cups produce when placed on the body creates a “lifting” effect, allowing the muscle tissue beneath the skin to relax and expand, encouraging fresh circulation to get to the area. The result is a release of toxins, trigger points, lactic acid, and stagnant lymph fluid. Cupping is an excellent way to recover from a tough upper or lower back workout, or to treat tired or tight muscles.
Stretch Therapy for Back Pain
Stretch therapy is like yoga, only without any of the work. PNF stretching (proprioceptive neuromuscular stretching) is a very effective way to surpass the body’s automatic muscle contraction response and allow muscles to relax fully into a stretch. This method of stretching uses a contract-relax method to encourage the full lengthening of muscles. Often back pain is aggravated by either tight hamstrings, quads, hip flexors, or QLs. Specifically target these muscles in stretch therapy to feel immediate results.
Nutrition for Back Pain
Sometimes the cause of back pain is due to something deeper going on inside the body–such as inflammation caused by diet. Imbalances in nutrients and minerals may manifest in various pains, aches, and reactions throughout your body. If you are experiencing chronic back pain without a cause, it may be a good idea to consult a dietician or a naturopath who specializes in gut health or hormonal imbalances.
Treat Back Pain Holistically
Our programs include targeted stretching for specific muscles. We also offer Assisted Stretching sessions.
Underactive muscles need to be strengthened to reduce the occurrence of muscles imbalances.
Managing stress is important to keep pain and inflammation levels down.
Nutrition can affect inflammation levels in the body that may lead to conditions such as arthritis.
Posture & Body Mechanics
Back pain can potentially be relieved and prevented with careful attention to posture and body mechanics on a daily basis.
Regular bodywork such as massage therapy is essential in reducing and preventing back pain.
The Anatomy of Wellness Approach
At The Anatomy of Wellness, we design Home Exercise Programs (HEP) aimed at treating the root cause of repeat soft tissue pain and injury and postural and movement dysfunctions. This requires that the HEP focus on stretching over active muscles while also strengthening the muscles that are under active in conjunction with targeted bodywork. New research underscores the importance of the the combination of these therapies for the body to retain results.
Stretch overactive and tight muscles! We will educate you on proper form.
Corrective strengthening exercises are not the same as weightlifting to build muscle mass.
Targeted massage applied to tight and overactive muscles
aid in corrective pain and tension.
The Anatomy of Wellness Can Help
How The Anatomy of Wellness Can Help
Have you been suffering from back pain that nothing seems to help? Here at The Anatomy of Wellness we are dedicated to achieving results for our clients. We have a staff of highly trained clinical massage therapists and corrective exercise specialists that design a treatment plan from your personal assessment results.
Clinical Assessment in Treating Back Pain
At The Anatomy of Wellness, we believe in doing our best to treat the root cause of the problem rather than only managing symptoms. Part of this process is using assessment tools to gain insight into what is causing the dysfunction, compensation, or pain in the body. Our staff use a variety of assessment techniques to create a comprehensive treatment approach.
Clinical Massage for Back Pain
Our clinical massage therapy sessions include assessments deemed necessary by the therapist including postural assessment, range of motion assessment, and orthopedic tests.
Clinical massage sessions follow the outline of the treatment plan developed from the assessment process. Our clinical therapists are specially trained to utilize a variety of techniques to target your pain or injury and help you see results quickly. This targeted approach focuses on the specific injury or area of pain, as well as the patterns throughout the body that could be contributing to symptoms and prolonging the condition. A clinical massage could include cupping, stretch therapy, taping, or cryotherapy, according to the therapist’s discretion and client’s request.
We offer a Clinical Massage Package at a discount to further treat your condition, get ahead of symptoms and see results fast.
“Our clinical massage therapy sessions include assessments deemed necessary by the therapist including postural assessment, range of motion assessment, and orthopedic tests.”
Corrective Exercise Prescription
We have corrective exercise specialists on staff who will design a program around each individual’s needs and goals. Your HEP (home exercise program) is adjusted as needed on a weekly basis. The purpose of the HEP is to assist the body in making a lasting change in the tension and function of the soft tissues. Occasional body work is great, but consistent clinical massage therapy coupled with corrective work will provide long-term results.
Functional Movement Screening (FMS)
We incorporate the use of Functional Movement Screening into our assessment tool bag, which is the current gold standard in movement screening used by physical therapists, manual therapists, and trainers. A FMS screen entails rating the quality of 7 basic functional movements to establish a baseline for your movement quality. We look at the quality and efficiency of the movement, take into account any pain or tension, and rate each movement on a pre-established 0-3 score.
From there we prescribe corrective exercises to improve upon the three pillars of functional movement: mobility, stability and motor control with the goal of preventing injury and falls and correcting movement and postural dysfunctions that contribute to pain and repeated muscle injury.
We include the FMS screen in our signature CoreEx™ package.
Topical Analgesics Pain Relief for Back Pain
There are many products on the market for topical use to manage pain. One of the most popular over-the-counter products is IcyHot. Our clinic carries a product called Cryoderm which is a clinical grade, fast-acting, deep penetrating topical cold treatment. It is excellent for pain relief and may be used for soft tissue injuries such as muscle strains, neurological symptoms, arthritis, and plantar fasciitis. We love Cryoderm because of its immediate pain relieving effect and its natural ingredients, which include eucalyptus and peppermint oil, arnica, and boswellia. It works so incredibly well, our clients and staff swear by it.
Foam Rolling for Back Pain
One of the best ways to perform self-myofascial release is with a foam roller. We offer the perfect density foam roller to effectively assist to warm up your muscles before a workout, help flush out lactic acid after working out, or roll out painful trigger points and tightness. We carry a foam roller available for purchase at our clinic that is the recommended length and density for the corrective exercises we prescribe to our clients.
TheraBand for Corrective Exercise
Don’t have access to expensive gym equipment at home? No problem! Therabands are a great tool to provide resistance at home! Easy to use and efficient, Therabands are an amazing way to build stability, balance, and strength throughout the body. They are versatile enough to target multiple muscle groups in a variety of exercises. TheraBands are recommended frequently to have on hand for Home Exercise Programs prescribed by our therapists.
Trigger Point Ball
Trigger Point Balls offer an excellent method for targeting stubborn and hard to reach muscle knots. These dense rubber balls can be placed against a wall, on the floor, or rolled with your hands along tight and sore muscles. Ask a therapist to demonstrate their favorite technique for attacking trigger points!
PRO TIP: Take 1-2 trigger point balls with you the next time you travel. They are light weight, easy to pack and extremely effective in reducing muscle tension once you get to your destination.