LOW BACK PAIN/SCIATICA
Low Back Pain is one of the leading causes of physician office visits and missed work days in the United States. It is estimated that 80% of adults will, at some time, experience low back pain, and that between 1-5% will also experience associated leg pain, known as sciatica. The problem may be caused by sprain or strain of the supporting structures (muscles, tendons, ligaments) of the lumbar spine, poor lifting techniques, obesity, or degenerative changes in the spine (arthritis). Chronic emotional stress usually plays a role in the onset and severity of symptoms. Symptoms include low back pain, stiffness, tightness in the hamstrings (thigh muscles), and may include pain that radiates down the leg. If your pain extends beyond the knee, is associated with numbness/tingling in the calf or foot, or with new bowel or bladder problems, notify your physician immediately.
Initial evaluation will include examination and plain x-rays. Further evaluation with MRI, CT myelography, or nerve conduction studies may be indicated depending on responses to therapy.
Treatment may include anti-inflammatory medication, muscle relaxers, heat/ice therapy, and range of motion and strengthening exercises. Weight loss is indicated in those who are overweight. Exercise is the single most critical part of recovery. Patients who do not respond to these measures may be candidates for injection therapy, traction or Physical Therapy. These symptoms may take days or weeks to resolve depending on the severity of any injury and your individual response to therapy. During treatment, avoid activities that aggravate pain such as prolonged sitting, standing, heavy lifting, or high impact/contact sports.
If you have been prescribed anti-inflammatory medications, please take the medication daily for maximum benefit. Continue the medication until you are able to do all of your regular activities without pain. Muscle relaxers and pain medications need only be taken as long as symptoms are moderate to severe and cause limitations in regular activities. You should not drive a motorized vehicle or operate heavy equipment while taking these medications.
You will be given a handout of low back exercises. Since exercise is so important to recovery, you should do these every day. Your Physician or Physician Assistant will guide you in how to progress through the exercise plan. It is generally recommended that you begin with the range of motion exercises for several days before beginning any strengthening exercises.
We recommend as a general guide to returning to your regular activities that include heavy lifting or high impact/contact sports, that you be able bend forward and backward fully and without pain. You should be able to run, jump and twist without pain, and prolonged standing or sitting should not produce pain.
APPROACH TO EXERCISE
- Apply heat to the neck by using a heating pad, taking a hot shower or bath, or soaking in a hot tub for 10-15 minutes prior to beginning the range of motion stretching exercise. Stretches should be to the point of feeling the muscle pull, not to the point of pain. Hold stretches for 5-8 counts and then relax, repeating 3 times.
- After adding any strengthening program, make sure to end the session with additional stretches. Pay close attention to form during your exercise program.
If you have difficulty with the Home Exercise Program, formal Physical Therapy may be indicated. Feel free to ask your Physician or Physician Assistant for a referral.
Request an appointment with our spine specialist Dr. Cubbage.
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