FAQ Category: Lumbar Spine

You may feel some improvement within a few months, though actual muscular change happens more slowly. A recent study looked at patients who did one of three exercise therapies (physical therapy, training with special devices, or aerobics) twice a week. After two months, these patients did better on tests of physical strength and endurance. However, the improvements didn’t necessarily show up at the muscular level. The size and type of muscle cells inside the muscle hardly changed at all in three months’ time. The improvements most likely had to do with better muscle action and coordination.

Researchers believe that it may take more than a few months for muscles to change, especially if you haven’t been active for a while. But in the meantime, you’ll get the benefits of better strength and endurance. Plus, you’ll be on your way to a more successful and complete recovery.

A physical therapy program aimed at improving the strength of your back can do just that. A recent article reported on treatment similar to what you describe. Patients who had low back pain for an average of 11 years started doing physical therapy twice a week. After three months of treatment, patients had much better trunk strength moving their trunk in every direction. They were better able to use their back muscles and showed improved muscular endurance on certain tests. 

When you have low back pain, it’s natural to stop using your back muscles to some degree. Physical therapy can help get those muscles back in good condition, so you can do your daily activities with less pain and less chance of re-injury. Talk with your physical therapist about what kinds of changes you can expect from your program.

Research suggests that the form of exercise you choose is not as vital as simply being active. In a recent study, patients with low back pain did one of three types of exercise therapy. The first group had one-on-one physical therapy. The second group had treatment in pairs using special strengthening devices. The third group went to aerobics and stretching classes with an emphasis on trunk and leg muscles.

All of these treatment programs resulted in better physical performance. After three months of treatment, patients showed improved test results for back strength and endurance. Patients who did exercises using special devices tended to have more strength than the other groups, possibly because the testing equipment was similar to what they had used during treatment.

You’ll probably get the most benefit from an exercise program you enjoy. Ask your doctor for suggestions.

Doctors don’t usually suggest surgery right away in cases of simple back pain. Surgery is sometimes needed after a serious injury, or if nerve problems cause muscle weakness or affect the bowels and bladder. Some people need back surgery for significant back pain that isn’t helped by nonsurgical treatments such as medication and exercise.

Pain that starts after you’ve been on your feet for a while may be related to the surface you stand on, your back posture, or how much you move around on the job. If you have to stand for a long time on hard surfaces such as concrete, a good pair of shoes or a special shoe insert can help absorb some of the shock and strain. If you have poor posture, you may be causing extra pressure on the joints and soft tissues of the spine. If you can’t move around during your work shift, your body may become fatigued. Tired muscles often feel sore and painful. Doing gentle stretches a few times during the work shift may keep your back muscles relaxed and prevent the burning sensation. If not, be sure to discuss this with your doctor or physical therapist.

After a first encounter with low back pain, it’s important to make sure the muscles that protect your spine are in good condition. Otherwise, you may leave yourself vulnerable to more low back pain.  

Researchers recently tested a program to strengthen patients’ back muscles after low back pain. The specific muscles targeted were the multifidus muscles. These muscles lie on the back surface of the spinal column and help steady the vertebrae during movement.

Patients in the study did exercises for these muscles twice a week for a month. One year later, only 30 percent of these patients had more low back pain, versus 84 percent of patients who hadn’t done the exercises. Three years later, patients who did the exercises were still a lot less likely to have low back pain.

A little work now could go a long way in protecting your low back. A doctor or physical therapist can suggest ways to train these important muscles to help prevent future problems.

Scientists are in general agreement that nine of 10 people who have low back pain once will have it again. Doctors call this “recurrent low back pain.” However, a recent study found this wasn’t the case when checking factory workers over a two-year period. This new research found that factory workers who did heavy lifting weren’t more prone to low back pain just because they had had it in the past. In fact, poor physical fitness and lack of social support (not having a confidante) were much stronger predictors of low back pain. Whatever your susceptibility to low back pain, you may beat the odds if you stay physically and emotionally fit.

The multifidus is a muscle in the deepest layer of the back. It runs on either side along the back of the vertebrae. This muscle helps control and protect the spine. When you lift something or rotate your trunk, the multifidus holds the spine steady. If the multifidus weakens, the spine moves too much, which can lead to injury.

In a recent study, patients who did exercises to strengthen the muscles that support the spine had excellent long-term results. After doing exercises for just one month, these patients were much less prone to low back pain. Three years after treatment, only 35 percent of them had another episode of low back pain, versus 75 percent of patients who hadn’t done the exercises. This research suggests that training specific muscles of the low back and abdomen may cut your chances of future low back pain in half.

Stress can certainly take a toll on the body, and the low back is no exception. Research has shown that a host of psychological and social factors can lead to low back pain. A recent study showed that factory workers who didn’t have a confidante were more likely to develop low back pain than those who had someone close to talk to. So as you’re going through your divorce, find a friend or counselor you can confide in. Your back may thank you for it.

A lot of people with low back pain share your concerns. Often, once people see that they can safely do activities without hurting themselves, they feel more comfortable doing the things they used to do.

This effect was observed in a recent study. Patients who did exercise therapy (physical therapy, muscle training, or low-impact aerobics) found that they were better able to go back to their regular activities. They felt more in control of their pain and less worried that work and physical activity would cause more pain.

You may want to work with a doctor or physical therapist to figure out a program that will help you be active in a safe, supported way. A program that involves some kind of physical activity will speed your recovery by getting you moving.

It likely doesn’t matter which type of therapy you choose. A recent study found that patients with low back pain benefited from several kinds of exercise therapy. Some of the patients who participated in the study had physical therapy. Some had muscle training with special devices. And some took an aerobics and stretching class. After three months of therapy, patients in all groups were better able to do their regular activities, no matter which kind of exercise therapy they had.

Ask your doctor what type of exercise therapy he or she would recommend. And make sure to choose a kind of therapy you enjoy. The more you like your program, the more likely you are to stick with it and reap the benefits.

A variety of factors affect whether people can do their regular activities when they have low back pain. According to a recent study, the most important of these is the amount of pain. The greater the pain, the harder it is to do daily tasks.

Depression and the belief that low back pain is “the end of the world” also make it hard to do activities. So does believing that back pain is inevitable and will worsen with work or physical activities. Finally, not being able to use certain back muscles and having poor range of movement seem to prevent patients from going about their days as usual.

So what needs to happen for patients to return to their regular activities? First, steps need to be taken to help relieve pain. These can include the use of medication and physical therapy treatments. But patients may need to work on some of their feelings and ideas as well. Researchers have found that getting past depression helps patients get over disability. Also, getting rid of the belief that work and other activities will worsen low back pain often allows patients to return quickly to their normal ways of living.

A treatment is effective if it makes patients feel and function better than they would had they not been treated at all. 

With injection therapy, patients get anesthetics, steroids, or both. To decide whether this is effective, researchers compare patients who get these substances to patients who have placebo–or “empty”–injections. If patients who have injection therapy have less pain than those who get placebos, the treatment is “effective.”

When weighing a treatment’s helpfulness, it’s important to ask “for how long?” A recent article said that researchers have mostly looked at the short-term results of injection therapy. In other words, they mostly ask how patients feel within a few weeks or months of treatment. The long-term success of injection therapy has yet to be shown.

Many patients get good results with injections for low back pain. In general, though, the results are mixed. A recent article suggested that injection therapy can relieve pain with few side effects. But sometimes it doesn’t do much more for patients than placebo injections, which are basically like getting no treatment at all.

Researchers are trying to figure out whether injection therapy helps patients in the long run. So far, the long-term results aren’t all that promising. Talk with your doctor about how this treatment may help you, given your condition.

Surgery can be done to remove the disc that’s causing your problems. In a recent study, patients who had this kind of surgery wound up with less pain and better backs than patients who didn’t have surgery. However, surgery didn’t necessarily affect whether patients went back to work.

Among patients who were getting Workers’ Compensation before surgery, twenty percent were still getting some kind of disability compensation five years after surgery. The results were the same for patients who didn’t have surgery. Patients who had surgery were a little more likely to be working five years after treatment, but this difference was very slight.

Surgery may not be the magic wand that gets you back on the job. Still, it may make you feel better faster than other kinds of treatment. Your doctor can tell you more about how surgery may help you, based on your condition. 

In the right circumstances, the benefits of surgery outweigh the risks. For many patients, surgery to correct sciatica, the pain you describe, may be one of those occasions.

A recent study showed that patients with sciatica improved more if they had surgery than if they didn’t. Seventy percent of patients who had surgery had less pain after five-years, as opposed to 56 percent of those who didn’t have surgery. Patients who had surgery were also more satisfied with their treatment five years down the road. These differences didn’t translate to the work setting, however. Patients were equally likely to be back on the job five years later whether or not they had surgery.

Researchers believe that surgery is especially helpful for patients who have moderate to severe sciatic pain. These patients seem to get better, faster relief from surgery than from other kinds of nonsurgical treatment, like medication, rest, and physical therapies. Patients who start out having less pain from sciatica seem to recover whether they have surgery or not. Your doctor can tell you more about how surgery may help you, given your condition and history.

Research has shown that the surgery you describe–discectomy–can relieve sciatic pain and help patients toward better back functioning. 

A recent study looked at 220 patients who had this type of surgery. The benefits were the most pronounced within two years of surgery. However, these benefits were still clear at a five-year follow-up. Seventy percent of patients who had surgery had less pain five years later, and 63 percent of them were satisfied with their results. In fact, eighty-two percent said if they had to go back, they would choose surgery again.

Surgery for your condition may be a fast fix, but it isn’t an immediate fix. The benefits can take three to 12 months to appear. In rare cases, there may be a need to repeat the surgery to get the full effect. In general, though, the evidence suggests that surgery is the fastest and the most complete fix for patients with moderate to severe sciatica.

Research suggests that low back pain can result from incidents of bending or lifting, either at home or at work. For the most part, these injuries are preventable. Most people aren’t trained to use their bodies in the right way. They end up putting too much strain on their spines, which can lead to low back pain.

The solution? Education and practice. It’s never too early to start. Researchers recently reported on an educational program to promote better back health for third graders. Students learned about the spine and good posture in a series of classes. They also practiced exercises to strengthen and protect their low backs. Four years later, the majority of these students were still using good back technique in their daily activities. Compared to other students who didn’t go through the training, they were less likely to need treatment for low back pain.   

As we get older, it’s harder to change our habits. Talk to a pediatrician or physical therapist about ways to help your children start developing good back habits.

Low back pain is more common among children and teenagers than most people realize. In fact, kids who are 13 and older are just as prone to low back pain as adults.

Talk to a doctor or physical therapist about your son’s condition. He or she can recommend special exercises to strengthen your son’s low back and to help him keep good posture while bending or lifting. A little bit of education and training may go a long way in keeping back pain out of your son’s future.

There are several places that anesthetics, steroids, or both can be injected to relieve low back pain. Facet-joint injections are given into the small joints linking the vertebrae together on the back of the spinal column. Epidural injections go into the membrane that surrounds the spinal cord. Local injections can be applied to other sites, including ligaments and trigger points.

The location of the injection depends on the kind of pain being treated. Facet-joint injections are often used when pain is coming from an arthritic or sprained facet joint. Epidural injections may help patients with pain that spreads from the back into the legs, primarily due to a herniated disc. Local injections help reduce muscle spasm and pain from a sore ligament. Your doctor can tell you which kind of injection may help you, based on the source of your pain.