Lower backpain

Expert Advice

October 11, 2007|By Holly Selby

Ouch, your achin' back. Perhaps you spent last weekend planting bulbs, mulching your garden, cleaning the gutters ... and now you're paying for your efforts with a stiff, sore lower back.

You're likely not alone. One in eight people will suffer some sort of back injury during their lifetimes, according to the National Institutes of Health.

And autumn (think raking leaves) presents myriad opportunities for back injuries, says Stephen Moxey, physical therapist and board-certified orthopedic specialist at Greater Baltimore Medical Center.

What types of activities typically cause stiffness and soreness in the lower back?

There are five vertebrae in your lower back, and between each vertebra is a disk and a nerve. When you bend or twist, the disk can get pinched, causing inflammation and pain. So any activities that include bending forward have high risk for back injuries. These might include bending forward to lift the laundry, vacuuming, raking leaves, even bending over and reaching to get something out of the refrigerator.

When do you typically see the most patients with sore backs?

We see a lot of people in the late winter/early spring, because often after several cold months [during which many of us are less active], people go out and take on a lot of physical activity.

And in the fall we see a lot of people. That's when the weather is cool again so people try to do the things they've put off all summer. And they try to do yard work like raking leaves - and those repetitive tasks lead to the injury.

What symptoms do your patients typically describe when they come to you?

Often they describe a general pain or ache in the lower back. If it is severe, it comes with shooting pains down the buttocks and the back of the legs. There is occasional numbness in the legs and feet.

As a physical therapist, most of my patients have seen their doctors by the time they come to me. By Maryland law, you can go to the therapist directly without visiting a doctor, but most insurance won't cover it without a referral.

When should someone with back pain consult a doctor?

They should consult a doctor if the pain is radiating or shooting down the back of their legs or if the pain is keeping them awake at night. They also should go to a doctor if the pain is associated with a fever or night sweats or any flulike symptoms so the doctor can rule out other serious illnesses.

What should you do if you rake leaves today and wake up tomorrow with an aching back?

Get a big ice pack, lie on your side, put ice on your back and rest. A lot of people confuse ice with heat. Ice is for the more acute injury - early on in the treatment. Heat is for a more chronic injury that is less painful and more stiff.

So if the initial injury is healing and your back doesn't hurt anymore, but you are still feeling stiff, use heat.

After that, exercise like walking and gentle hip stretches will help. Treatment in therapy would include all these steps as well as more specific manual therapy that addresses which joint is tight.

But if the injury occurs every time you rake, that may be a red flag, and you probably should go see the doctor.

How can you prevent such back injuries?

There are two important steps you can take. The first is maintaining a relatively good physical condition, which includes staying at a healthy weight and having good abdominal strength and good flexibility.

The second step is using good body mechanics. In other words, try to stand up straight and when lifting things, don't bend at the waist, learn to bend at the hips and legs.

What are a few other steps that people might take in their daily lives to avoid back injuries?

Exercise regularly, whether by walking or following another exercise regime.

Avoid prolonged sitting. Studies show that sitting at a desk puts a lot of pressure on your disks. After spending hours sitting, bending and twisting when doing tasks at home or at work raises the risk for lower back injury. So if you sit at a desk, get up and stretch your legs frequently.

And when sleeping, lying on your side with a pillow between your legs and your head supported well provides the most relief for your back.

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