The majority of lower back pain is directly associated with lower back or lumbar strain which is an injury to the muscles or ligaments in the lower back region.
When the muscles of the lower lumbar region are strained the area surrounding the muscle becomes inflamed. This inflammation leads to the onset of muscle spasms which results in severe pain and difficulty moving.
From an anatomical standpoint the muscles and ligaments in the back hold the bones in the spinal column in place. Stretching these lumbar muscles too far causes tiny tears within thus weakening the muscle structure attached to the spine. The spine becomes unstable thus resulting in pain and difficulty changing positions.
Because this is an area where nerve roots originate from the spinal cord lumbar strain can result in radiating pain to other areas of the body.
In this article we will discuss causes of low back pain, symptoms, physical therapy/chiropractic care and prevention.
Lower back pain caused by any type of movement that puts tremendous stress on the area is likely to cause lumbar strain. This is usually caused by lifting a heavy object especially with poor body mechanics, lifting and twisting or a sudden fall. Lower back strain is often seen in sports where twisting is seen like golf and baseball. In any type of impact sports such as football there is a high incidence of lower back strain.
Symptoms of lumbar strain can be mild to severe and include some common signs such as (1) pain is usually localized on one side and sensitive to palpation (2) the onset of pain is sudden (3) evidence of muscle spasms or involuntary contraction of the para lumbar musculature (4) the lower back pain subsides with rest but standing or walking is difficult (5) listing of the trunk to the side and in severe cases (6) radiating pain or numbness down the lower extremity.
Usually low back strain symptoms decrease in a few days and can see complete healing in 2-4 weeks. The muscles of the lumbar region are thick and large with a good blood supply enabling the necessary nutrients and proteins to accelerate healing.
Initial treatment is to start reducing the acute pain and inflammation by taking pain and anti-inflammatory medication. The doctor may also prescribe muscle relaxants to reduce the spasms and pain. From a chiropractic stand gentle manual manipulation is utilized to loosen tense muscles and massage to promote increased blood flow into the region.
Physical therapy will consist of the use of modalities like ultra sound, electrical stimulation, cold laser and intermittent pelvic traction. For review purposes ultrasound is a form of deep heat that soothes muscle spasms and enhances healing; electrical stimulation reduces muscle tension by impulses; cold laser deceases inflammation and accelerates healing by light and intermittent pelvic traction increases lumbar mobility by a mechanical stretch apparatus.
Once the acute low back pain subsides the physical therapist will begin mild stretching progressing to strengthening exercises. William’s Flexion Exercises are simply low back stretches and Mckenzie Exercises are mild strengthening. The physical therapist should stretch the hamstrings, hip adductors and calf musculature to create core flexibility and less tension on the lower lumbar region.
Low impact exercises on a bike or treadmill is often seen in a lower back strain regimen. Strengthening of the back extensors, gluteal, abdomen, iliopsoas and oblique musculature must not be overlooked.
A patient in physical therapy must perform a low back exercises at home on a daily basis. Keeping away from low back pain is really a full time commitment. An important fact to consider is resting too much has been proven not to aid in recovery of low back pain because muscles that weaken from inactivity lose functioning capability.
Here are some points to avoid low back strain (1) stop any activity that causes low back strain (2) get back in shape by exercising and stretching on a routine basis (3) do not sleep on your stomach; best is sleeping on side with a pillow between knees or on your back with a pillow under knees (4) absolutely bend at the knees not at the waist when lifting something heavy (5) lose weight if you are overweight and (6) good posture should always be on your mind especially when sitting. It is extremely important to keep the back straight so it is supported by the back of the chair.
One word of caution if you push yourself before your low back pain is healed then you could end up with chronic low back pain thus permanent injury.