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Low Back Pain

Spinal Anatomy Overview

• The spine consists of four main areas

– Cervical– Thoracic– Lumbar– Sacrum/coccyx

Spinal Anatomy

• The spine is a remarkable combination of strong bones, flexible ligaments and tendons, large muscles and highly sensitive nerves. It is designed to be incredibly strong, protecting the highly sensitive nerve roots yet being highly flexible providing for mobility on many different planes.

If This Is You, You Are Not Alone

Quick Back Facts

• 80% of Americans will experience back pain in their lives

• Second most common reason for doctors visit

• Total cost exceeds $100 billion per year• 90% of people will recover within 6

weeks with conservative care• Second only to the common cold for

work sick days

Symptoms

• Depending on the cause, symptoms can vary– Dull, sharp or burning– Felt at a single point or over a broad area– Occurs suddenly or comes on gradually– Occurs with spasms or stiffness– Associated leg symptoms such as pain,

numbness or tingling

Red Flag Symptoms

• History of cancer• Progressive motor

or sensory deficit• Prolonged steroid

use, IV drug use• Major trauma• Numbness in

groin/saddle

• Bilateral leg weakness

• Fever and chills• Unrelenting severe

pain with rest• Loss of bowel or

bladder function

Cauda Equina• A serious problem that can occur if the nerves

at the end of the spinal cord are squeezed• Seek emergency treatment if you experience

any red flag Symptoms

Causes of Back Injuries

• Most back injuries can be attributed to one of these five causes– Poor posture– Improper body mechanics/work habits– Stressful living– Loss of flexibility– Poor conditioning/overweight

“Your back went out because your front went out.”

Obesity• World Health Organization (WHO)

– Overweight: BMI 25-29 – Obese: BMI 30 and above

• By 2015: 700 million will be obese• Overweight and obesity lead to serious health

consequence– Cardiovascular disease– Diabetes– Musculoskeletal disorders– Some cancers

Body Types

Diagnostic Testing

• Physicians will not generally order diagnostic tests in the first six weeks of low back pain

• Most of the time, the causes for back pain cannot be found by x-ray, CT scan or MRI

“I’m the one with the medical degree, I’ll determine if your back

is bothering you or not.”

An Independent Licensee of the Blue Cross and Blue Shield Association

The intensity of the pain does not equal the severity of the injury

Intervertebral Disks• Acts like a cushion

between the bony vertebrae that make up the spine

• 90% water• Wears with age

Potential Disk Problems• Degenerated disks• Thinning disks• Bulging disks• Herniated disks• Osteophyte (bone

spur) formation

Why does back pain seem to always come back?

• The disks between our vertebrae act like shock absorbers

• When disks are injured from either wear and tear or a sudden force, they are unable to repair themselves very well because they lack the rich blood supply needed for healing

Sciatica

• Set of symptoms - not a disease in itself • When the sciatic nerve is irritated or

compressed• Causes shock like or burning low back

pain that can extend down to the foot• Extreme cases can cause loss of motor

control

Sciatica

Sciatica Treatment

• Self care under a doctor’s care• Chiropractic• Prescription medications• Epidural steroid injections• Physical therapy program

Piriformis Syndrome

• Muscle that runs above the sciatic nerve.

• When the muscle becomes tight, causes sciatica like pain down the leg

• Prolonged sitting, car accidents, falls

Piriformis Syndrome Treatment

• Stretching- #1 treatment• Physical therapy• Massage therapy• Anti-inflammatory medications• Temperature treatments

Spinal Stenosis• Congenital or age related narrowing of

the spinal canal

Spinal Stenosis

• Risk of developing increases after 50 years of age, severity can increase with age

• Treatments include – Pilates or yoga to stretch and strengthen

the spine. – Physical therapy– Epidural steroid Injections

Spondylosis

• Spinal arthritis• Can allow for a

forward slippage of the vertebrae onto the vertebrae below it

Helping prevent spinal osteoarthritis

• Stay ahead of the game!

• Get up and go!• Cut the fat!• Sit smart• Stand smart too!

• Save those joints• Only eat the good

stuff• Kick the habit, don’t

smoke!• No pain, all gain!• Be good to yourself

Muscle Strains

• The majority of back pain is caused by muscle strains

• Usually heals with conservative treatments and time

• Muscles in the lower back have an excellent blood supply bringing it the necessary nutrients for healing to occur

Exercise and Low Back Pain• The natural stimulus for healing process

is active exercise• The majority of people do not get

enough exercise from daily activities to support their lower back muscles.

• While some of these muscles are used in everyday life, a complete exercise program for optimal lower back health is needed

Treatment Options

• Exercise• Temperature treatments• Physical therapy• Chiropractic• Acupuncture• Massage therapy• Water therapy

Medications

• Over the counter- Acetaminophen, ibuprofen, aspirin

• Narcotic pain relievers- Not recommended for long term use

• Muscle relaxants- Treats muscle spasms

An Independent Licensee of the Blue Cross and Blue Shield Association

Did you notice surgery was not included?

Healthy Living

• Exercise regularly• Maintain or achieve a healthy weight• Regular core strengthening exercises• Eat healthy, drink plenty of water• Practice good body mechanics• Good quality sleep

Sleeping Easier with Back Pain

• No perfect position for everyone – Listen to your body

• Pillow between your legs• Firmer mattress• Egg crate or pillow top if it helps• Good sleep routine

Four things to take away

• Chances are you will experience back pain at some point in your life

• Expensive diagnostic tests cannot always identify the cause of your pain

• There is no quick fix• Establish a healthy lifestyle

Resources

• www.bcidaho.com• www.spine-health.com• www.spineuniverse.com

www.bcidaho.com