Gulf Coast Pain Management
Benign Pain

BACK PAIN

Your back covers the area from below the neck to the tailbone. It includes the bones of the spine (vertebrae), the joints that guide the direction of the movement of the spine, the discs that separate the bones of the spine and absorb shock as you move, and the muscles and ligaments that hold them all together. One or more of these structures can be injured.

Back injuries are a common cause of back pain, such as:

Strain or sprain of the ligaments or muscles from sudden or improper movement or by overuse. Symptoms can include pain, muscle spasms, and stiffness. This type of injury accounts for 80% of back pain. The majority of pain often goes away within 4 weeks without any treatment. Home treatment can help speed healing, relieve pain, and prevent re-injury. Some factors may increase your risk for back pain and injury. Damage to discs so that they tear, stretch, or rupture. If the tear is large enough, the jelly-like material inside the disc may leak out and press against a nerve. Shooting pain, tingling, or numbness may be felt in the low back, in the buttock, or down one leg (sciatica). The muscles controlled by the compressed nerve may become weak. Fracture of the spine may occur from an injury, such as a car accident, a fall from a high place, a direct blow to the back, a blow to the top of the head, or a fall onto the buttock.

Injury is not the only cause of back pain. Back pain can be a symptom of other
health problems, such as:

Diseases that affect the spine. The spine can be worn or weakened by diseases such as arthritis, osteoporosis, or Paget's disease. These diseases are more common in older adults. In rare cases, tumors or infections in or around the spine can cause pain. Medical conditions can cause pain to spread to the back from other parts of the body. Many health problems that can cause back pain have nothing to do with the bones, joints, muscles, or ligaments of the back.

Home Treatment

Immediately after an injury and for the next few days, try home treatment to relieve your symptoms.

For a Tailbone Injury:

Apply ice or a cold pack to the tailbone area for 15 to 20 minutes, 3 to 4 times a day, for the first 24 to 48 hours. Cold decreases inflammation, swelling, and pain. A warm sitz bath for 20 minutes, 3 to 4 times per day, after the first 24 to 48 hours, can be soothing to the tailbone area. Sitting in a hot tub or warm bath may also feel good, as long as you are not sitting directly on the tailbone. Avoid slumping posture or sitting on hard surfaces. Consider using a doughnut-shaped pillow to take pressure off the tailbone area. Avoid constipation, as straining to have a bowel movement increases tailbone pain.

For a Back Injury:

Get in a comfortable position and apply ice or a cold pack to the injured area. Apply cold packs or ice for 15 to 20 minutes, 3 to 4 times a day, or up to once an hour for at least the first 3 days. Cold decreases inflammation, swelling, and pain. Sit or lie in positions that are most comfortable and reduce your pain, especially any leg pain. Do not sit up in bed and avoid soft couches and twisted positions. Avoid positions that make your symptoms worse, such as sitting for long periods of time.

Bed rest can help relieve back pain but may not speed healing. Unless you have severe leg pain, it is probably best to try to continue with your usual daily activities. If any activity makes your pain worse, modify it or avoid it altogether. If you have difficulty sleeping at night, try one of the following positions:

Lie on your back with your knees bent and supported by large pillows, or lie on the floor with your legs on the seat of a sofa or chair. Lie on your side with your knees and hips bent and a pillow between your legs. Lie on your stomach if it does not increase your pain. Take aspirin, ibuprofen (such as Advil), or naproxen sodium (such as Aleve) regularly as directed. Check with Dr. Columbus if you've been told to avoid anti-inflammatory medications. Acetaminophen may also be used. Take these medications sensibly and follow the directions on the bottle. The maximum recommended dose will reduce the pain. Masking the pain completely might allow movement that could lead to reinjury. Do not give aspirin to anyone under the age of 20. Take short walks (3 to 5 minutes every 3 hours) on level surfaces (no inclines) as soon as you can to help keep your muscles strong. Walk only distances that you can manage without pain, especially leg pain. Relax your muscles. Gentle massage can relax and soothe painful muscles.

After 2 to 3 days of Home Treatment:

Continue daily walks (increase to 5 to 10 minutes 3 to 4 times a day) and the exercises above. Try swimming, which is good for your back. It may be painful immediately after a back injury, but lap swimming or kicking with swim fins is often helpful to prevent back pain from recurring. Begin easy exercises that do not increase your pain as soon as your pain has improved. One or two of the exercises in the Prevention section may be helpful. Start with 5 repetitions twice a day and increase to 10 repetitions as you are able.

Symptoms to Watch for During Home Treatment

If one or more of the following symptoms occur during home treatment, contact Dr. Columbus immediately:

• Weakness or numbness in the legs
• Loss of bowel or bladder control
• Back pain worsening or not better after 1 to 2 weeks

Prevention of Future Back Pain

The frequency of back pain has increased dramatically in all developed countries. The more time we spend sitting at desks, in cars, or in front of the TV, the more we must do to prevent back pain. Good posture and body mechanics will reduce the stress on your back. Exercise (stretching, strengthening, and aerobic exercise) will help maintain your flexibility, strengthen the muscles that support your spine, and maintain your overall fitness. Maintaining an ideal body weight also reduces the load on your lower back.

Exercises to prevent back pain

The exercises below and general aerobic exercise (such as walking, swimming, cycling) are important to prevent back injury and pain. They will also speed your recovery from injuries and decrease chronic pain.

Exercises to Absolutely Avoid

Many common exercises actually increase the risk of low back pain.
Avoid the following:

• Straight leg sit-ups
• Bent leg sit-ups during acute back pain (may be safe if back is kept in neutral position)
• Leg lifts (lifting both legs while lying on your back)
• Lifting heavy weights above the waist (military press or biceps curls while standing)
• Any stretching done while sitting with the legs in a "V"
• Toe touches while standing

AQUATIC EXERCISES

1. Walk in Water:
Stand in chest-deep water at one end of the pool and walk, heel first, across the pool. Walking heel to toe strengthens muscles in your lower legs. Initially, take small steps. Let your arms swing naturally, just they would on land.

Cup your hands to add more resistance to the water as you walk. If that creates too much resistance, slice the water by spreading your fingers.
 
2. Make Circles:
Raise both arms forward until they're just a few inches below water level. Keep elbows straight. Make small circles with your arms. Gradually increase the circles' size, then decrease them. Make forward, then outward, circles.
 
If the bigger circles cause pain, go back to making smaller circles. Don't cross your arms or raise them out of the water.
 
3. Side Leg Lift:
Stand with your left side to the pool wall. Keep your knees relaxed. For balance, hold the wall with your left hand. Lift your right leg to the side, no higher than your hip joint. Swing the leg out in front of you and in forward the wall, crossing in front of your left leg. Stand with your right side to the pool wall. Repeat with your leg.
 
4. Spread Eagle:
Sit on the edge of the pool stairs. Straighten one knee and slowly move it out to the side. Hold it out for 3 seconds. Bring it back to the center. Lower your foot. Relax. Repeat with your other leg.
 
5. Sideways arm reach:
Slowly raise both arms out to the side, keeping your palms down. Raise only to shoulder (water) level, then lower your arms to your sides. Don't shrug your shoulders or twist your trunk while reaching.
 
6. Finger Curl:
Curl your fingers into your palm to make a loose fist. Straighten them out and relax. Repeat with your other hand.
 
7. Stacy Justine also recommends "Using your noodle."
Get into deeper water where you're not touching bottom. Place a foam noodle under your arms to help you hang vertically in the water. Slowly move one knee in cycling motion. Slightly bend your knee up and down, leading with your hell, keeping your toes up. Bend your knee only as far as you comfortably can. Rest. Switch to the other knee. Repeat.
 

If you have any questions whatsoever regarding this information,
please do not hesitate to ask Dr. Columbus

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