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EXERCISES FOR BACK RELIEF

Many people believe that rest is best for a painful back, but actually, what your back really needs when it’s hurt is exercise. Regular exercise relieves back pain by strengthening and stretching the muscles that support the spine and helps to prevent future injury. This is a use it or lose it situation: the more you rest, the weaker your back gets, even if it is hurt. Studies have actually shown that you can heal your back pain faster and get back to your regular activities with just two days of rest. So let’s look at some of the best exercises for relieving back pain.

Yoga
A good, regular yoga practice will go far in relieving the stress and tension that sometimes cause mild back pain, and in fact, studies have shown that yoga is the number one most effective exercise for relieving back pain. However, not all yoga poses relieve back pain, and some can in fact aggravate existing pain, so it is important to know which poses will be most helpful in relieving back pain. It is best to do these exercises under the supervision of a certified yoga instructor, and if you encounter any problems with these poses, you should consult an expert. Even just one or two sessions with a yoga instructor can help, as an instructor will help you with your form and posture during poses. Here are some of the best yoga poses for relieving back pain. Each pose should be held from five to ten seconds, depending upon your level of comfort, and should be done on a mat or other soft, supportive surface.
CORPSE: Lie flat on your back in a relaxed position, arms resting at your sides, palms down, and legs lying naturally, with knees turned out slightly. If it hurts your back to have your knees turned outward, do this pose with knees bent, feet flat on the floor. Breathe in and out for a few seconds while allowing any tension to leave the body.
CAT STRETCH: Start out on your hands and knees with a flat back. Your hands should be directly under your shoulders with fingers spread. Knees should be directly under the hips. Head is held loosely so that you are looking at the floor between your hands. Inhale, and as you exhale, arch your back toward the ceiling, tuck your chin in to your chest so that you are looking at your navel, and tuck your tailbone underneath. Hold, then release back into your original position.
WIND-RELEASING POSE: Lie flat on your back as in Corpse pose. As you inhale, bend your knee, place your hands right below the knee, and draw your leg towards your chest. Your left leg should remain flat on the floor. Exhale and bring your forehead up to touch your knee. Inhale, and then as you exhale, return to your original position. Repeat with the other leg.
SAGE TWIST: Warning for this pose—it involves twisting your back, so you should take particular care not to twist too far or you risk aggravating any existing back pain. This should be a gentle stretch; twist just as far as is comfortable. Sit on the floor with both legs out in front of you. Bend your right knee, lift your right leg over your left, and place your right foot on the floor next to your left knee. Sitting with spine straight, place your left elbow on the right side of your right knee. Bend your left arm so that your left fingertips are touching your right hip, while at the same time, twisting to look over your right shoulder. This is where you need to be careful not to twist too far. Hold for a few seconds, release, and repeat on the opposite side.
PALM TREE: Stand with feet facing forward, arms at your sides, weight distributed evenly on both feet. Raise both arms over your head, interlock your fingers, and turn your hands so that your palms are facing upward. Next, place your palms on your head and turn your head so that you are looking slightly upward. Stretch your arms upwards, and at the same time, come up onto your toes if you can do so without pain. Stretch your entire body upward and hold, if you can. Some people have difficulty balancing during this pose, so just do the stretching parts if you need to.
FISH POSE: Lie on your back with knees bent and arms at your side. Arch your back as far as you comfortably can and raise it off the ground by pushing the floor with your elbows. If you can, tilt your head backwards and rest the crown of your head on the floor. Breathe deeply from the diaphragm and hold pose for one minute if you can.
LOCUST: Lie face down with arms at the side, palms down, and elbows slightly bent with fingers pointing towards the feet. Raise your legs and thighs as high off the ground as possible without causing your back any pain. Hold for one second and repeat up to twelve times. This can be a vigorous exercise so you must take care to strain already injured muscles.
BENDING FORWARD POSTURE: Stand up straight with feet together and arms hanging loosely along your sides. Breathe in deeply and raise your arms straight above your head. While breathing out, bend forward and touch your toes if you can. If you can’t reach your toes, grab hold of your ankles or calves. To complete the pose, you should touch your head to your knees, but this may be too difficult for many who suffer from lower back pain. Your movements during this pose should be smooth, not jerky.

Exercise Balls

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BACK ARCH: Sit on the ball as if it is a chair. Walk your feet forward so that the ball rolls under your back until your rear end is on the ground. Place your hands behind your head and slowly push yourself back up so that you roll backwards over the ball.

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Diagnostic Testing
For back pain relief, any of several tests can be performed; x-rays or radiographs, isotope bone scan (referred to as technetium and SPECT), magnetic resonance imaging (MRI), computerized axial tomography (CAT) scan, myelogram, blood and nerve tests and injections.
Where To Go For Pain Relief
Where to go for a diagnosis about back pain can include your family doctor, the emergency room, an orthopedic surgeon, a naturopathic specialist, a rheumatologist , an occupational therapist, a physiotherapist, a chiropractor, an acupuncturist, a massage therapist, an osteopath and a chronic pain heath care provider. And here is a brief overview of each.

FAMILY DOCTOR – This is a popular beginning point for many seeking back pain relief. Although family doctors generally do not have extensive orthopedic backgrounds nor sufficient time to schedule complete histories and examinations during regular hectic weekdays, they are often able to do preliminary testing and assessment. Their blood tests and general knowledge of your health and basic back care can help them point you to further resources and places for following up, especially if they deem the case an emergency. And hopefully your family doctor will be at the center or helm of your pain relief management so that all testing, treatments, office visits, etc. are coordinated and not left to chance, and also so that patient care is optimized.

EMERGENCY ROOM – When a family or general doctor is not available, some symptoms may warrant an emergency room visit. The following list of symptoms, though not limited, is what most often sends people to the emergency room for back pain relief; a major injury or trauma, history of osteoporosis, steroid medications or cancer, severe pain, fever, aggressive or quick weight loss for no known reason. The degree of suggested seriousness in the symptoms may determine how quickly a person is seen in the emergency room, with the more serious cases seen quicker.
Emergency room procedures can involve history and examination assessments and a series of blood, urine and other tests. Additionally the emergency room physician may recommend a consult with a specialist while you are there. Or they may recommend you to your family doctor or other treatment facility for follow up, depending upon their results.

ORTHOPEDIC SURGEON – Orthopedic medicine in a nutshell deals with the prevention or correction of injuries or disorders of the skeletal system and associated muscles, joints, tendons and ligaments. Surgeons in this field offer treatment for fractures, strains, arthritis, dislocations and other related problems throughout the entire body. And their treatments vary with surgery and non-surgical health care; structure repair, joint replacement, arthroscopy or the examination and possible treatment of the interior of a joint, like the knee, using a type of endoscope inserted into the joint through a small incision. Likewise, they coordinate healing activities during healing and pain relief stages. Note that some orthopedic surgeons specialize: in the area of back pain relief, a specialist based in spinal practice may be advisable.

NATUROPATHIC SPECIALIST – Naturopathic medicine refers to natural substances or remedies massage as treatments. Doctors in this field are educated in nutrition and herbal, botanical, homeopathic and Chinese medicines (and acupuncture). They may also treat with hands-on procedures and lifestyle consultations where preventative measures are a focus. These specialists may refer you to your family doctor and may also coordinate healthcare activities before, during and after your back pain episode for overall improved wellness. Often for back pain relief, they may advise natural supplements like herbal medicines or minerals along with dietary modifications. And physical therapy; acupuncture or message, combined with stress management and relaxation therapy may be added in for good measure.

RHEUMATOLOGIST – A rheumatologist deals with an array of pathological conditions like arthritis related to the tendons, muscles, joints, nerves or bones, when seeking aid for discomfort and disability. Although some may perform arthroscopy, most do not do surgery. For back pain relief, they may suggest medications, occupational or injection therapy and other medical treatment to determine cause and pain relief.

OCCUPATIONAL THERAPIST – An occupational therapist emphasizes correct ergonomics or design factors, posture and safety practices both at the workplace and in the home environment. These therapists educate patients about daily life activities and can help with adjusting to health devices for mobility and operation. Adjusting to using crutches, a back brace, a cane and other lifestyle changes are benefits of occupational therapy.

PHYSIOTHERAPIST – Registered therapists practice physiotherapy and focus on educating and instructing patients about their pain- both in book learning and physical understanding, like with posture and movement modifications. Their shared knowledge helps patients overcome fear and anxiety and better manage their treatment programs. Doctors often refer patients to physiotherapists for extended learning, particularly if there is difficulty in diagnosing the cause and / or treatment for pain. Additionally, physiotherapists help with the development and managing of their healthcare programs, activities and preventive care instruction. For example, they may teach about using heat or ice along with a varied range of motion for pain relief.

CHIROPRACTOR – In a nutshell, chiropractors diagnose spine, joint and muscle problems with their hands. And their treatment is hands-on as well. For back pain relief, they use mobilizations and manipulations in manual spinal movements, some known as “cracking” the back into place. Although there is no scientific evidence to support or negate chiropractors treatment, most generally work with the relief of acute low back pain. Besides in-office treatment, many provide exercise and preventative strategies for follow up.

ACUPUNCTURIST – Acupuncture, relating to Chinese medical practice, is the piercing of specific areas of the body with fine needles. The reasons for acupuncture are threefold; for therapeutic purposes, to relieve pain or for regional anesthesia. It is mainly used for musculoskeletal pain and low back pain and other related relief.

MASSAGE THERAPIST – Massage therapy incorporates hands-on handling or manipulation of body tissues, especially helpful for low back pain relief. The reasons for massage vary; for relief from pain and muscle spasms associated with it, for relaxation, for stretching, improved circulation and metabolism.

OSTEOPATH – Osteopaths use Osteopathic Manual Medicine (OMM) to practice medicine based on the theory that conditions in the musculoskeletal system affect other bodily parts. These conditions cause disorders that they believe can hopefully be corrected by manipulative techniques combined with traditional medical, pharmacological, surgical and other therapeutic strategies. Generally within 10 to 14 days, osteopathy relieves low back pain. But there is no evidence to suggest osteopathy as preventative treatment long-term.

CHRONIC PAIN SPECIALIST – A chronic pain specialist is for rare cases and works in teams. He or she generally manages pain relief treatment with psychiatrists, social workers and other medical and counseling healthcare providers

COPING WITH CHRONIC PAIN

There is not a single definition of pain that is appropriate for everybody because it is a highly subjective experience. What, to another person, is excruciating may be nothing more that a slight discomfort for you. Not only do views of pain vary among individuals, your own perception of it can change over time. Even when you do have a clear perception of what pain means to you, there is not an objective way to measure it you can use to convey your impressions to somebody else. It is not unusual for patients in a doctor’s office, who have come in because pain is severely impairing their day-to-day lives, to have great difficulty describing it clearly.

One thing we do know, however, is the difference between when we are hurting and when we are not. In the case of acute pain, you may cry out from it and experience terrible suffering for a time, but it ends eventually, and usually the sufferer returns to their normal activities and way of life. Chronic pain is different. A sufferer of chronic pain not only hurts, but they keep on hurting. Indeed, the psychological impact of chronic pain can be worse than the physical sensation itself, especially when the daily grind of it wears you down and turns the world grim. Acute pain usually does not change one’s personality. Chronic pain, if not addressed properly, can alter it drastically.
Chronic pain may have a physical basis, a psychological basis, or some mix of the two. Maybe it comes from an injury. Maybe it comes from stress. Maybe the two factors are interconnected. People who cannot pinpoint a clear physical connection often say, or are told, that it is “all in their heads.” But that is not how it feels. Chronic back pain caused by stress can hurt just as badly as chronic pain that resulted from falling off of a roof.
It has been estimated that over 34 million Americans suffer from chronic pain, be it from arthritis, migraine headaches or their backs (with lower back pain being the most common). 15 million people experience chronic pain at work on a daily basis. So if you are a sufferer of chronic pain you are not alone – though it can certainly feel that way.

What Can You Do About It?

To begin with, you must make sure clear lines of communication have been established with you physician(s) and any other health care providers being seen for chronic back pain. Do not just assume it is your cross to bear and suffer in silence. Though it is true that the majority of back pain in general is not symptomatic of serious illness, do not assume you are therefore free from all risk. There have been cases of people whose backs’ hurt persistently and they just mistook it for a fact of life and went on the best they could, only to discover that “bad back” was really a sign of something much worse, like cancer or otherwise damaged internal organs.
In order to facilitate communication to a health care professional it is a good idea to spell out some specific things to yourself first as a means of organizing your thoughts and presentation. For example, asking yourself and answering the following questions can go a long way toward clarifying what you are experiencing:

1 How bad, on a scale of 1 – 10 is my pain?
2 How long have I had this pain?
3 What words can be used to describe it (tearing, burning, throbbing, etc.)?
4 What could have caused my pain? Is there an injury, psychologically stressful event, or activity I can link to its onset?
5 Are there any other health problems I am having?
6 In addition to pain medication, what other medicines am I taking?
7 What kinds of things have I done to try alleviating the pain? Have any helped, even some?
8 Both emotionally and physically, how has pain affected my daily life, be it at work or at home?
The questions do not have to end with the examples above, of course, and asking a few may help you zero in on more specific inquiries – just as the information provided will help your physician to get a clearer picture of what is happening with you. Once the chronic pain is described, a variety of approaches, alone or in combination, are available to treat it.

CONTROLLED BREATHING
Control your breathing slow and steady for a few minutes. Focus on rhythmic, controlled breathing, holding inhaled breaths in for about three seconds, then exhale and repeat to help redirect focus from back pain and allow the body to naturally respond on its own. Repeat as needed throughout the say to help the body relax.
Some helpful suggestions are:
Choose a comfortable position that takes the strain off your back and is least painful for you. Some suggestions are:
A. On your back with your knees up, rest your lower legs over the coach or a chair.
B. Lie in a fetal position on your side and place a pillow between your knees.

REST
When possible for back relief, rest for a couple of days. Find a couple of your most comfortable breathing positions above and alternatively use them throughout the day. From time to time, every hour to couple hours or so, include these into your routine:
A. Get up and move around a little, walking and arching your back a little.
B. Add some light stretching activities like gently pulling knees, one at a time, to your chest.
C. Light water / pool activity or aquatherapy
D. Light stationary bike riding or sitting in a comfortable chair for brief periods.

OTC HELP
Check with your local drug store pharmacist to see which pain medications are available over-the-counter (OTC). Popular to use are aspirin for overall pain relief, ibuprofin for a combination anti-inflammatory and pain relief response like in the Advil, and acetaminophen products like Tylenol. When selecting the type of medication, keep in mind that liquid gel types absorb fasted into your system. However, regardless of your choice, do follow the directions on the labels, unless otherwise directed by your physician, and follow the recommended dosage guidelines.
Check with your local pharmacist and health store to see which liniments and ointments are available. Some popular items on the market are BENGAY, Tiger Balm and Sportscreme; generally products with a form of rubbing alcohol listed in the ingredients.
Ask about the availability of other back pain remedies including herbal treatments. Some health food stores stock packaged herbal tablets, teas and other products. Be aware, though, that most often these alternative products are not thoroughly tested as OTC products are, nor can the contents be assured for safety, quality and potency.

MISC TIPS
Here are some other back pain relief strategies for you.
1. Place an ice pack on the pain area up to three times a day for about 12 minutes per session during the first two days of the onset of your pain.
2. Moist heat applied to the pain after one day can help sooth your body. A warm washcloth or a heating pad for about 30 minutes should do the trick.
3. After the first day or two, interchange your ice and heat solutions. Heat is for mornings and before physical activity. Ice is for after activities, and in the evening.
4. As your back pain decreases, gradually increase your activity.

Cautionary Measures
An encouraging thing about back pain is that so much of it can be avoided by simple cautionary measures, usually, in fact, by making slight modifications to things we do every day.

Standing
When standing upright, your chest should be forward, your head up, shoulders straight, and your weight even distributed between your feet with your hips tucked in. If you have to remain standing for long periods, avoid remaining in the same position for the entire time. Be sure to move around and change positions regularly. Another good idea is to rest one foot on a stool, curb, etc. then switch to the other foot after a few minutes.
If your work requires you to perform tasks on a platform or desk make sure to adjust it to a height that is comfortable for you. Spending day after day hunched over while on your feet is almost a sure recipe for back problems.

Sitting

In today’s work world many of us have jobs that involve spending most of our time in a seated position. The rule of thumb here is to sit for as little as possible, and even then for only short periods of time. Since this is not always possible, be sure to get up and walk around frequently. Even a short stroll across a room will help.
When in a seated position for long periods, sit with a support positioned in the curve of your back. Nothing fancy, even a firm pillow or a rolled up towel will do the trick. At the same time, keep your hips and knees at right angles. If your chair is too high for this, either replace the chair or get a stool to rest your feet on. Otherwise keep both feet on the floor and do not cross your legs.
The chair you use should be firm and have a high back and arm rests. The problems with soft chairs or couches in that the curve in your back is not supported and it can come to be in a rounded position, which causes the kind of muscle and joint stress that leads to problems.
When seated in a chair in front of a desk, make sure the different pieces of furniture complement each other so that you can sit up straight as you work, with your elbows and arms on your chair or desk and your shoulders relaxed. Hunching or leaning over should be avoided.
Finally, when getting out of a chair after sitting for a period of time, be sure to stand up by straightening your legs, not bending at the waist. Once in a standing position stretch your back by doing a series of simple back bends.
Much of the same applies when driving in a seated position. Support the curve of your back and be sure your seat is positioned close enough to the wheel so that your knees can bend and your feet reach the pedals without having to stretch for them.

Lifting
The simplest thing to do is avoid lifting heavy objects, or those whose size or shape make them awkward to move. Since lifting cannot always be avoided, be sure not to lift with your back. When grasping a object to be lifted have it close to your body with your feet spread shoulder width apart and planted firmly on the ground. Use your leg muscles to do the actual lifting, with the simplest means of doing this being to start with your legs bent so that you merely need to straighten your knees.
Once you have lifted the object, keep it in front of you and move with small, slow steps. Instead of twisting, change direction with your entire body coordinated together for the move. When the object is set down, once again keep it close to your body and let your legs do the work. Remember, the muscles in your legs are a lot bigger and stronger than those in the lower back.

Exercise
Many a back injury can be prevented by following an exercise program that keeps the muscles strong and flexible. When designing your own, do so with the aid of your physician, physical therapist, or a qualified trainer.

Sleeping
Invest in a firm mattress and box spring that supports your body without sagging. It is best to sleep in a position where the curve in your back can be supported. Lying on one’s stomach on a soft mattress is exactly the wrong thing to do for your back.
The sleeping method recommended by many experts in on your back with three sources of support for your body: one below your lower back that is fitted to the curve there, one below your knees that supports them enough to take strain off the lower back, and a pillow below your neck that, like the lower back support, conforms to the natural curve found there and provides support.

METHODS OF BACK PAIN DIAGNOSIS

In order to diagnose back pain for relief treatments, generally health care professional begin by ordering a medical history and physical examination. A look at each of these in depth can shed some light into what to look for and how to find relief from pain. Then we’ll look at specific diagnostic tests. And then where to go for the diagnosis and testing follows.
No matter whether the patient has acute back pain, which is what most have and recover from with around a 4-week period, or chronic, recurring pain episodes, a medical history helps patient an doctor become familiar with one another in confidence to begin or continue a treatment program together. The medical history delves into these areas of the person seeking pain relief: family medical history and personal and work history with regards to back pain episodes and related symptoms and issues, psychological and psychosocial factors, referral source(s) for evaluation and treatment, education on the subject and treatment options, assessment throughout their working together on pain relief treatment and treatment outcomes. For example, if physical therapy needs to be added to the regimen or enhanced, it would be discussed in the medical history and updated as needed.
The medical history incorporates past and present factors of fatigue, fever and weight loss. And it notes any use of drugs or herbs, minerals and supplements. A history of past and present infections, cancer or other conditions is also noted.
The history also includes details about the back pain, focusing on the many facets of the pain: information about any initial injury or trauma, if available, onset, intensity, duration, location, associated symptoms, etc.
The physical examination includes evaluating the person generally inn the “hospital gown” with the body and especially the back in a variety of postures and movement ranges to determine pain symptoms, tenderness and range of motion. So the patient may need to sit, stand, touch toes, move arms, etc. and share any pain symptoms or other information notated with each change along the way.
Neurological testing can also be a part of the routine. A neurologic screening may consist of tests for reflexes, strength of muscles, cramping and a detailed look at sensory issues via various range of motion and movement exercises. Included in this can be an assessment of the legs, upper leg, hip and groin area and pulses for neurological and vascular conditions.
Results may point to a secondary problem like kidney stones or a slight bone fracture, for instance, in which cases, further assessment and treatment options would be considered and discussed in both the medical history and physical examination.
Noteworthy is that patients seeking relief after an extended period can tend to exaggerate or magnify their symptoms out of a variety of reasons; possibly psychological factors associated with fear of the unknown, change, coping alternatives, insurance coverage and treatment costs, previous visits with health care providers, etc. So education and patience is advised to that all bases can be covered, i.e. so that effective pain relief remedies can be determined.

HERNIATED DISK
Also known as a ruptured or protruding disk, a herniated disk extends beyond its own area into a surrounding region. Compression of the nerve root can cause pain. And pressure on the fibers in surrounding ligaments can cause pain. Although an accident involving lifting could be the cause of a herniated disk, it’s not necessarily so. For many, the cause is unknown; pain can occur suddenly or gradually over time. Relief for the pain can come from walking instead of sitting or standing, and surgery is rarely required right away, if at all in the event relief from pain happens within a limited amount of time. During this time (up to several weeks) any of the following might be effective to use, depending upon your healthcare provider: medication, physical therapy or non-frequently, steroid spinal injections.

SPONDYLOLISTHESIS or the forward displacement or slippage of one of the lower lumbar vertebrae (generally the fourth or fifth) over the vertebra below it or on the sacrum. This state of health is diagnosed by x-ray. Pain is believed to occur where the displacement is, at or below the displacement, or from spinal stenosis, discussed next. Depending upon the patient, strengthening exercises or a back support may be all that’s required. In others, surgery may be an option.

SPINAL STENOSIS – is the constriction or narrowing of the vertebral canal. Mainly due to aging, as the gradual lessening of disk space and changes in ligaments advance upon the nerve roots below the lumbar vertebra or L2, pain can result. It’s often accompanied by numbness in the legs and is not aided any by walking. Different vertebra and varied physical activities can affect the pain’s location, intensity, recurring and duration. To help diagnose this condition, healthcare providers can use myelography, or an x-ray of the spinal cord after injection of air or a radiopaque substance into the subarachnoid space, with a post-CAT scan. And depending upon the patient, treatments can vary and be minor with medication if the pain gradually disappears, to epidural corticosteroid injections in the epidural, to blocks or surgery.

SPONDYLOARTHROPATHY - This term refers to a variety of diseases affecting spinal joints; arthritis variations- psoriatic arthritis and ankylosing spondylitis, the more common of the two and in males more often than women; and sacroiliitis, accompanies inflammatory bowels. Diagnosis consists of a physical exam, history and testing including x-rays, CAT or MRI, as the disease progresses slowly long-term fusing sacroiliac joints together and joints between vertebrae together. To relieve pain, there is treatment with exercises and physical therapy to promote better enhanced posture and mobility and some arthritic medications.