Lumbar Spinal Stenosis

Archive for January, 2010

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Lower back pain is a common affliction, with millions each year visiting physicians for relief. Not only will they seek relief, they will want a diagnosis.

It is not always easy to diagnose lower back pain. Many body structures can cause it. There are muscles, ligaments, and tendons; spinal column bones; joints, discs and nerves. In addition to these structures, there may be underlying medical conditions your physician needs to evaluate.

Whether you initially diagnose lower back pain yourself, or leave that to your physician, the diagnosis will need to consider both the location and symptoms of your pain.

Step 1 – Location

The first step is to decide the location. “Where does it hurt?”

1. Axial lower back pain: This lower back pain hurts only in the low back. Pain does not travel into any other area.

2. Radicular lower back pain: This lower back pain hurts in the low back, and also radiates down the backs of the thighs into one or both legs.

3. Lower back pain with referred pain: Diagnose lower back pain with referred pain if it hurts in the low back area, and tends to radiate into the groin, buttocks, and upper thighs. The pain will rarely radiate below the knee, but may seem to move around.

Step 2 – Symptoms

Once you diagnose lower back pain as to location, you will consider symptoms. “How does it feel?”

1. Worsens with certain activities: If you play football, for example, the pain is worse.

2. Worsens in certain positions: Perhaps it gets worse if you stand for too long. Or it is more painful after you sit in a car.

3. Feels better after rest: Resting from the activity or position usually reduces the lower back pain.

4. Deep and steady: Not a sharp muscle catch, this pain is constant and deep within the affected areas.

5. Severe: The pain is excruciating, possibly more so in the calf than the lower back.

6. Numbness and tingling: There may be “pins and needles” within the area.

7. Fleeting pain: Pain may seem to come and go, leaving you unsure at times just how it feels.

8. Achy and dull: Like the flu, this pain is sore and dull, though sometimes intensifying.

9. Migratory: It hurts in one spot, then another.

Diagnosis

AXIAL: If location is best described by number 1 above, and symptoms are a combination of 1, 2, and 3, you can probably diagnose lower back pain as being axial – the most common type. This is also called “mechanical” lower back pain. A variety of back structures can cause axial lower back pain, and it is difficult to identify which is the cause. Axial pain gets better on its own, and about 90% of patients recover within six weeks.

RADICULAR: If location is best described by number 2 above, and symptoms are a combination of 4, 5, and 6, you can probably diagnose lower back pain as being radicular – commonly called sciatica. This lower back pain is caused by compression of a lower spinal nerve, usually the sciatica nerve that runs from the spinal column, down the back of the thighs to the feet. Doctors usually recommend conservative treatment such as physical therapy exercises, medications, and possibly spinal injections, for six to eight weeks.

REFERRED: If location is best described by number 3 above, and symptoms are a combination of 7, 8, and 9, you can probably diagnose your pain as being lower back pain with referred pain – the least common type. This lower back pain is treated the same as axial back pain and frequently goes away as the problem resolves on its own.

How do you diagnose lower back pain?

Diagnose lower back pain with care. You need an accurate diagnosis, which your physician can best make, to be sure no underlying causes need attention. It is not enough to know you have sciatica. You need to know the underlying cause of the sciatica to determine treatment options.

If you do diagnose lower back pain, check the diagnosis with your physician.

Anna Hart
http://www.articlesbase.com/medicine-articles/how-to-diagnose-lower-back-pain-115645.html

The reasons for back pain during pregnancy are understandable. Many revolutionary changes, mind level and physical, happen with the woman, during this period. Therefore, pain in the back during this time is a common compliant. More than 50% of the pregnant women suffer from it.

The main reason being, the extra weight of the baby which changes the center of gravity of the mother’s body causing back ache. Hormonal changes during the early part of the pregnancy other contributory factors for the back pain. The other characteristics of pregnancy such as loosening ligaments between the pelvic bones and joints in preparation for the birth of the baby and urinary infection also contribute to back pain.

You need to distinguish between back pain and severe back pain in a pregnant woman. If it is severe back pain, it may be a pointer to some other serious types of problems. This requires thorough investigation and treatment.

The cure for back pain during pregnancy lies not in medications but in exercising. Try to keep the right posture, avoid artificial strain, walk properly, maintain good body mechanics, avoid slouching, use a lumbar cushion or a pillow and do appropriate muscular exercises in consultation with your physician or physiotherapist. Most of the back pain problems are resolved thus.

Know and practice certain practical hints. Frequently change the sitting position and do avoid standing for long periods. You need to take proper rest and sleep adequately. Never wear high-heeled shoes. Use flat shoes only. High-heeled shoes create back pain, even in the normal course without pregnancy. To walk on those shoes in pregnancy is both dangerous and harmful.

Yoga is helpful and good at all times, for men and women of all ages. But during pregnancy its practice cannot be overemphasized. No doubt the regular practice of yoga will make the body of the pregnant woman healthy and strong. Still, the woman should consult a professional yoga teacher to know the safe and helpful asanas for her during the pregnancy. Many special maternity classes are conducted by the yoga professionals to teach yoga postures which are beneficial and easy to practice during pregnancy. Reportedly such exercises help in the process of normal delivery of the baby.

So, if you have back pain during pregnancy, do not consider it as a disease. Do consider it as a natural development, and try to meet it as a development in the natural course. Do not be stressed. Delivery is normal process of the creative force of the nature. So, there is nothing to worry as such about the back pain during pregnancy.

Ashish Jain
http://www.articlesbase.com/women’s-issues-articles/coping-with-pregnancy-back-pain-85420.html

The health of your back depends to a great extent on your posture and body movements, your ability to cope with stress, and your exercise regime.

Many types of back pain can be blamed on weak abdominal and back muscles. That’s why most doctors oppose prolonged bed rest for back pain and instead recommend light physical activity along with pain relief medication and other proactive treatments.

Physical activity may not only provide pain relief, but it can also prevent future back pain. Along with pain relief medication, many doctors and physio-therapists tailor individualized exercise routines to treat patients who suffer from various types of back pain.

A typical exercise program for back pain may involve stretching and strengthening exercises, flexing, and endurance training. A variety of exercises and techniques are available for back pain relief; your doctor can help you choose an appropriate routine, taking into account the cause and severity of your back pain.

Advantages of Exercise for Back Pain Patients

Along with a healthy diet, doctors recommend exercise as an important component of a healthy lifestyle for most people, not only those who suffer from back pain.

The potential benefits of an exercise program for back pain may include: * Immediate, short-term pain relief * Stretching of tight, contracted muscles * Strengthening of weak muscles, which can contribute to back pain * Reducing mechanical stress on the back * Stabilizing the back * Increasing the ease and efficiency of body movements * Improving posture, which can guard against future back pain * Minimizing the frequency and magnitude of chronic back pain * Increasing the likelihood of quicker recovery from back pain in the future * Improving fitness to prevent future injuries

A Basic Exercise Program for Back Pain Relief

A basic exercise program for dealing with back pain involves strengthening the back and supporting muscles. If you have injured your back or have other health problems such as osteoporosis, start the exercises only after consulting with a doctor.
You can start on a gentle stretching and strengthening routine if you have no serious spinal problems.

Exercise #1 For Back Pain Relief:
Abdominal contractions gently stretch the back muscles: 1. Lie on your back. Bend your knees and place your hands below the ribs. 2. Tighten your stomach muscles to squeeze the ribs toward the back. Do not hold your breath. 3. Keep your muscles contracted for five seconds and then release. 4. Repeat ten times.
Exercise #2 To Prevent Back Pain:
Even when you no longer have back pain, doctors often recommend that you continue exercising to strengthen the back. Choose exercises that help align your body correctly and improve your posture to prevent back pain from recurring. For example, curling against the wall can help improve your standing posture. 1. Stand with your back against the wall, with your feet approximately six inches away from the wall. 2. Bend your knees and drop your head and shoulders. 3. Pull your stomach in and slowly roll up one vertebra at a time against the wall.
Exercise #3 To Prevent Back Pain
Strong abdominal muscles prevent many types of back pain so exercises that involve those muscles are often part of physical therapy programs designed to avoid back pain. For example, diagonal crunches not only strengthen the stomach muscles, but also keep the tummy from sagging. 1. Lie on your back. Place your hands behind your head. Bring your knees to your chest at right angles to the waist and cross your feet at the ankles. 2. Exhale slowly while raising your trunk, and move your right elbow as much as you can to the left knee. Slowly lower your trunk. 3. Repeat with the left elbow and the right knee. 4. Repeat ten times.
To improve fitness, you may wish to include stamina-building exercises such as aerobics. As these exercises are more rigorous, start them slowly and only after checking with your physician.
Always warm up before the physical activity and cool down afterward. Walking or light jogging, bicycling, and swimming are some exercises that can provide excellent aerobic conditioning.
Alternative Exercise Therapy Options for Back Pain Relief and Recovery A variety of alternative exercise therapies and programs are available to help alleviate, cure and prevent future back pain. Some of the more popular programs are:

* Tai Chi Chuan: This gentle martial art form provides exercise for the body, while helping the mind to concentrate. The movements relax the muscles, free the joints, and ease tension. Some people suffering from back pain use this technique along with pain relief medication.

* Yoga: This ancient Indian tradition involves a wide range of mind-body exercises including postural and breathing exercises, deep relaxation, and meditation. Many yoga postures focus on increasing spinal strength and flexibility, which can provide back pain relief. According to researchers, regular yoga practice may also prevent some types of chronic back pain.

* Chi Kung: Also known as Qigong, this ancient Chinese system of exercise focuses on breathing and posture while teaching the mind to concentrate. Chi Kung therapists claim that this system may be used effectively for back pain relief.

* Feldenkrais Method: This exercise technique aims to increase the ease and efficiency of body movements. Therapists try to increase your awareness of body movements, while teaching you to recognize and correct muscle tension.

* Buteyko Breathing Technique: This Russian therapy involves exercises in slow breathing and holding the breath. Therapists claim that this technique reduces muscle tension and can provide back pain relief.

Note: When you perform any type of exercise, it is imperative to distinguish between pain and the feeling of exertion. Pain is a signal from the nerves that a certain activity is wrong for you. If you experience pain while exercising, including back pain, you should instead start with mild exercises that feel comfortable.

Treating AND Preventing Your Back Pain

Exercise can be an important part of an effective treatment program for back pain. Customizing an exercise program that’s suitable for you can help you safely strengthen your back, improve your stamina and fitness, and prevent future back pain.

For more information on back pain and effective pain relief options, consult the online knowledge base at eDrugstore.md. To order prescription pain relief medications at discount prices, visit eDrugstore.md home page and look for the pain relief section.

Mark Smith
http://www.articlesbase.com/wellness-articles/how-to-exercise-for-back-pain-relief-443992.html

Sciatica exercises are an important part of both short and long-term treatment, but it is critical to choose the right exercises. Even commonly-recommended exercises for sciatica may not be indicated during times of severe acute symptoms, and some exercises may only make things worse.

For example, while commonly recommended to people with sciatica, exercises such as hamstring stretches and the yoga position, “downward facing dog” can be beneficial as part of managing one’s condition once the pain is reduced, these exercises can place tension on the sciatic nerve and aggravate an already inflamed and sensitive condition. In general, any exercise that causes pain to increase in the leg and/or extend further down the leg should be completely avoided during the acute phase of sciatica.

During the acute phase of sciatica pain, McKenzie exercises provide one of the best and safest treatment approaches available – more effective than medication and epidural steroid injections in many people. Though often associated with spinal extension and mistakenly called the “McKenzie Extension Exercises”, McKenzie method may involve any number of spinal positions/movements. The whole point of the McKenzie method is to evaluate different positions/exercises to find what best produces “centralization” of symptoms.

McKenzie practitioners use the word “centralization” when the pain and other symptoms are relieved in the areas the greates distance away from the spine. To give an example, in a person with sciatica all the way down the leg to the foot, centralization might occur in which the pain left the foot and lower leg and then only extended down to the knee. Or, if sciatica symptoms started out going as far as the knee, centralization would be if the symptoms left the thigh and only went as far as the hip area.

A position or exercise that results in symptom centralization is one that will be beneficial, even in situations where symptoms increase for a time in areas closer to the spine. For example, if you had sciatica and low back pain and tried one of of the McKenzie exercises and the sciatica completely went away but the back pain got worse, the exercise would still be considered beneficial and it would be recommended to continue using it. In the long run, a sciatica exercise that produces centralization will usually eventually result in improvement in all symptoms, even if more central (closer to the spine) symptoms get worse at first.

The simplest of the McKenzie exercises for alleviating sciatica is done by simply lying on one’s stomach on the floor or a firm surface and propping one’s chest up on the elbows. This places the lower spine in a gentle extension, which can help relieve sciatica by pushing bulging spinal discs forward, and away from the nerve roots that form the sciatic nerve, reducing pressure and irritation. Although you can maintain this position for relatively long periods of time, I recommend doing it for short periods of one or two minutes with a rest break of at least a few minutes in between. The frequent breaks prevent the low back muscles from tightening up as much, and yet still allows for good overall results. For more complex sciatica exercises, getting detailed instructions either through an illustrated guide or an experienced health care practitioner is advised.

George Best
http://www.articlesbase.com/health-articles/sciatica-exercises-the-good-and-the-bad-365442.html

Obesity has become one of the most prevalent medical conditions affecting the US population. The American Obesity Association reports that over 60% of the adult population can be classified as obese. Besides the risks for medical conditions such as high blood pressure, colon cancer and coronary heart disease, back pain is another area that has greatly impacted those who suffer from obesity. The medical conditions that result in back pain that are the most common risks are degenerative disc disease, disc rupture or herniation, and spondylolisthesis or slippage of the lower back. Other risks for obese back pain sufferers are spinal stenosis, osteoporosis and osteoarthritis.

The spine carries the body’s weight and disperses the weight that we encounter during our daily activities and rest periods. When we carry excess weight due to obesity, the spine absorbs the additional burden. This can lead to damage or structurally compromise the ability of the spine to do its job. Our lower back is the most sensitive to the effects of an overweight condition. The muscles in the lumbar spine region that support the back, thighs and pelvis can become weak and inflexible due to inadequate amounts of exercise and lessened mobility that frequently occur with obesity. With weakened muscles, the possibility of curvature of the spine increases dramatically in the lower back region. The result is poor posture and additional pain, as well as further affecting whatever medical condition the person is experiencing.

A sedentary lifestyle combined with an unbalanced diet can diminish the strength or density of our bones, leading to osteoporosis. The risk of fractures occurs when the actual design of the spinal column has been endangered by the weakened density of the bone structure. Fractures of the vertebrae are not a pleasant experience causing excruciating pain.

Osteoarthritis can be a result of excessive body weight causing a disproportionate amount of pressure and stress on the facet joints in the spine. Unhealthy posture may result in neck and back pain. The spine requires good posture and appropriate physical activity to provide the needed support to keep the spine healthy.

When you are obese, exercising is very difficult. It takes time to get to a level of activity that allows you breath well and not tire as quickly. If you are already experiencing back pain or other pains, exercising is even more difficult because of the very fact that you are exercising. Your body, muscles and joints are not accustomed to the activity and it is readily apparent in the additional pain that you experience. As much as the pain is too much to bear while beginning to exercise, the long term result of not exercising will be more pain that will only become more intense. Start slowly with gentle exercises that stimulate healing by allowing nutrients to flow to the spine. Every little bit of activity that the muscles and joints experience will condition them and strengthen them, so that it becomes easier and less painful over time.

When you add a healthy diet to your exercise program, you are providing additional assistance to your body to help it heal itself. Appropriate vitamins and nutrients are essential to better health. Balance is important, so consult with your doctor or other health care provider to ensure that you get the best results.

Obesity and pain feed off of each other. Once the pain starts, activity decreases so as to not aggravate the pain. The lessened activity results in a more sedentary lifestyle which promotes weight increase. As weight increases, more medical problems occur, bringing with it more pain. Experiencing more pain encourages less activity… It spirals out of control and simply does not stop – unless you take action by exercising and eating healthy.

Pete Wyatt
http://www.articlesbase.com/non-fiction-articles/obesity-and-pain-feed-off-of-each-other-53311.html