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Entries in Low Back Pain (3)

Monday
Jan302012

Common Causes of Low Back Pain

Keith Brofsky/Photodisc/Thinkstock(NEW YORK) -- Low back pain is one of the most disabling conditions in the U.S., and experts say that 80 percent of Americans will suffer from it at some point in their lives.  It's estimated that back pain costs more than $90 billion a year in lost productivity and work days.

While back pain can be debilitating for many who live with it, in most cases it can be treated non-surgically, according to the National Institute of Neurological Disorders and Stroke.  Exercise and staying fit are among the best treatments, back specialists say.  Lifting objects using the legs while holding objects away from the body is one of the best ways to prevent it.

There are numerous causes for low back pain, ranging from muscle strains to ordinary daily activities that people don't realize can lead to back problems.  ABC News talked to several experts about some of these lesser-known causes of lower back pain.

Obesity

Overweight and obese adults are more likely to have disc degeneration in their lower back than normal-weight adults, according to a new study published in the journal Arthritis & Rheumatism.

Disc degeneration occurs when the discs of the spine start to break down, and it sometimes causes low back pain.  While disc degeneration is part of the normal aging process, researchers in China found that among 2,599 Chinese men and women, body mass index (BMI) was significantly higher in people with disc degeneration.

They also found that underweight participants were significantly less likely to have degenerative disc disease.

"When you look at their underweight group compared to other groups, it's a very compelling observation that there's a clear association between weight and disc degeneration," said Dr. Scott Boden, professor of orthopedic surgery and director of the Emory Orthopaedics & Spine Center in Atlanta.

Exactly what that association is, however, is harder to establish.  The authors believe weight gain may cause physical stress on the disc and, in addition, chronic inflammation brought on by the fat cells can lead to disc degeneration.

Sitting


"Sitting is worse than standing.  Sitting for long periods of time puts pressure on your back, especially if you're not using core muscles to support your back," said Dr. Nick Shamie, associate professor of spine surgery at Santa Monica-UCLA Medical Center in Santa Monica, Calif.

What's even worse is sitting and leaning forward to pick up something from the floor, which places the maximum amount of force on the lower back, he added.  Instead of leaning and reaching, Shamie explained the best way to pick something up is to get on the knees, pick it up and keep the object close to the body.

The National Institute of Neurological Disorders and Stroke recommends sitting in a chair with good lower back support.  If sitting for a long time, people should rest their feet on a low stool or stack of books.  But if possible, switch sitting positions and get up and walk around a bit throughout the day.

Mattress Type


Whether a soft mattress or a firm mattress is better for the back is up for debate.  There hasn't been a lot of research on it, but a 2003 study found that people who slept on medium-firm mattresses reported less back pain.

"If a bed is either too stiff or too soft, it's likely to cause back problems, but there is a lot of individual variation on that," said Dr. Richard Deyo, professor of family medicine at Oregon Health and Sciences University in Portland.  "You need enough support so the spine is not sagging, but you don't want it so rigid that the spine is forced into an unnatural position."

High Heels

There's nothing to definitively link wearing high heels to the increased likelihood of developing back pain, but experts say it does make sense.

"Having the heel elevated changes the posture and probably forces the lower back into more of an extended position, and that can be painful over time," said Deyo.

But Shamie said wearing high heels is more likely to affect other parts of the body more than the back.

"High heels can put a lot of stress on your feet, but not as much on your lower back," he said.

Purses and Backpacks

"It makes perfect sense that if you have a heavy backpack, there's definitely a potential risk for injuring your lower back and other joints," said Shamie.

In general, he said, maximum weight should be no more than 10 to 15 percent of body weight.

Deyo, however, said the backpack issue has been controversial, and study findings have been conflicting.  Nonetheless, it's probably wise to get an extremely heavy load off the back if possible.

Copyright 2012 ABC News Radio

Thursday
Jul282011

Brain Scans May Help Verify the Hurt of Chronic Lower Back Pain 

Getty(BOSTON) -- Millions of Americans live with chronic pain, particularly an aching lower back, but doctors have so far not been able to measure just how much their patients hurt.

Researchers have now edged closer to having a tool that can help quantify the intensity of chronic pain and track it through the course of treatment -- rather than relying on the crude scale that asks patients to rate their pain from 1 to 10. The problem has always been that one patient's 10 may be another patient's 1.

Lower back pain is the second-most common neurological ailment after headaches in the United States. The depression, impaired memory and attention and diminished quality of life associated with chronic lower back pain exact a huge psychological and economic toll, making it an important target for study.

A technique called arterial spin labeling, performed during MRI scans, allowed scientists at Brigham and Women's Hospital in Boston to observe changes in blood flow to specific regions of the brain as chronic back pain patients held uncomfortable positions inside the scanner. As the patients' brains were registering the distressing sensation, the investigators watched blood flow activate or "light up" different regions. They could then measure that blood flow during those painful episodes.

"Normally, when you do studies with older techniques, you're not able to track the changes in people's chronic pain over time," said Dr. Ajay D. Wasan, an assistant professor of anesthesiology and psychiatry at the Brigham and Women's Hospital and Harvard Medical School, who led the study with his postdoctoral fellow Marco Loggia. "This provides a way to look at the physiology of the brain when someone has more or less chronic pain."

Ultimately, he said, "as we understand the network involved in processing pain, we hope we can use that to lead to more targeted treatment that will change the functioning of specific areas of the brain."

Brain scans might determine who is likely to respond to particular treatments and also be used to monitor treatment effectiveness, he said.

Copyright 2001 ABC News Radio

Tuesday
Jul052011

Can You Beat Low Back Pain with Massage?

Creatas/Thinkstock(SEATTLE) -- Massage therapy may provide more relief for patients with chronic low back pain than [previously thought -- at least in the short term -- according to a new study in the Annals of Internal Medicine.

Researchers affiliated with the Seattle-based Group Health Research Institute divided a total of 401 chronic low back pain patients into three groups. One of the groups served as a control group, with no changes in care, while those in the other two groups received either relaxation massage or structural massage.

After 10 weeks of therapy, one in three patients receiving either type of massage said their back pain was reduced, while only one in 25 of those on standard care reported the same relief.  Massage patients also reported improved physical function, fewer days in bed, more activity and decreased use of anti-inflammatory medications.

"This seems to offer clinicians another option for managing a challenging group of patients," said study co-author Dr. Richard Deyo, professor of evidence-based family medicine at Oregon Health and Science University in Portland.  "Some patients are eager to avoid medications, injections, or surgery, and this may offer some relief."

Whether the reported benefits actually point to a therapeutic benefit to massage -- or are simply an example of the placebo effect -- has yet to be determined.  And while the benefits of massage therapy appeared to last up to six months after the beginning of treatment, they tended to dissipate after a year.

Doctors pointed to this latter finding as evidence that the benefits of massage for low back pain were, at best, transitory.

"The data does not fit with most of what is known about low back pain," said Dr. Donlin Long, professor of neurosurgery at The Johns Hopkins Hospital in Baltimore, Maryland.  "We have data from nearly 2,000 patients collected in a nationwide study which showed no lasting benefit with any [physical therapy], manipulation, and massage... I've used massage for years and what is does is relieve muscle pain while the patient improves spontaneously, but only in a well-chosen few."

Part of the problem may be that while massage addresses muscular issues, many cases of chronic low back pain involve skeletal and nerve problems as well.

Still, for those affected by low back pain -- the second most common neurological ailment in the United States and the most common cause of job-related disability, according to the National Institutes of Health -- even the temporary benefits of massage may be time and money well spent.

Copyright 2011 ABC News Radio







ABC News Radio