My lower back has been sore most of the summer. I try to stay active, but the pain is now making that difficult. This morning I even needed help getting dressed. What are my treatment options?
Susan, age 48
Back and neck pain affect people of all ages, with studies showing that these are more common between the ages of 30 and 40, and tend to decrease after age 65.
In my clinic, Susan described the onset of her back pain as somewhat mysterious. I hear this often. There was no slip, trip or fall, no sprain or strain to explain her condition. For a couple of years, her back felt tired or stiff at the end of a busy day, but this was different. This time the pain was sharp, deep and coupled with a restricted range of motion. One day her back felt as it usually does, the next she could not bend down to put on her socks.
Back pain that strikes without an obvious, direct cause can be scary. The change in one's physical capabilities can appear to be sudden and dramatic. The pain severe. For otherwise healthy individuals in the prime of their life, it may be the first time their health has been significantly challenged. It raises questions about lifestyle, aging, treatment options and work-life balance.
Susan's family doctor reassured her that her condition was biomechanical and nothing more ominous was at play. She was encouraged to lose some weight, see a chiropractor and begin a regular exercise program. One day, unable to sit through her son's little league baseball game without pain, she finally went to see a chiropractor.
Clinical guidelines for routine back pain are well established. They recommend conservative management, including the use of non-steroidal anti-inflammatory drugs (NSAIDs) or acetaminophen, a course of manual therapy including spinal manipulation, acupuncture and regular exercise. Routine back pain usually improves with such conservative treatments within three months.
To keep the spine healthy there are also simple exercises you can do at home. The Canadian Chiropractic Association recently released a free app to bring awareness to the importance of good posture for optimal spinal health. Straighten Up Canada includes 12 exercise videos for youth and adults that can be practised almost anywhere as a great warm up, cool down, stand-alone routine or ergonomic break. (The app is available at the Apple Store, Google Play and on straightenupcanada.ca.)
Here are two of my favourite exercises featured in the app:
- Reach for the Sky focuses on upper back and shoulder posture. Standing with your back against a wall and your arms raised overhead, elbows bent, slowly lower your arms down the wall as you squeeze your shoulder blades together. Repeat three times.
- Tightrope Lunge focuses on your hip flexors and lower back. Step forward with your right foot, longer than a normal stride, lowering your body straight down until your left knee almost touches the floor. The right knee should not bend past 90 degrees and should be kept in line with your right ankle. Keep your back straight throughout the movement. Repeat on the left.
Susan's back problems stem from a sedentary lifestyle and poor core stability. Her treatment program includes a multidisciplinary approach consisting of spinal manipulation and soft-tissue therapy to correct the alignment and biomechanical function of her spine; active rehab to improve her core strength; and a daily postural exercise program at home.
She is expected to have a full recovery.
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