Low Back Pain

1. Low Back Pain

2. Spinal Anatomy Overview • The spine consists of four main areas • Cervical • Thoracic • Lumbar • Sacrum/coccyx

3. Spinal Anatomy • The spine is a remarkable combination of strong bones, flexible ligaments and tendons, large muscles and highly sensitive nerves. It is designed to be incredibly strong, protecting the highly sensitive nerve roots yet being highly flexible providing for mobility on many different planes.

4. If This Is You, You Are Not Alone

5. Quick Back Facts • 80% of Americans will experience back pain in their lives • Second most common reason for doctors visit • Total cost exceeds $100 billion per year • 90% of people will recover within 6 weeks with conservative care • Second only to the common cold for work sick days

6. Symptoms • Depending on the cause, symptoms can vary • Dull, sharp or burning • Felt at a single point or over a broad area • Occurs suddenly or comes on gradually • Occurs with spasms or stiffness • Associated leg symptoms such as pain, numbness or tingling

7. Red Flag Symptoms • History of cancer • Progressive motor or sensory deficit • Prolonged steroid use, IV drug use • Major trauma • Numbness in groin/saddle • Bilateral leg weakness • Fever and chills • Unrelenting severe pain with rest • Loss of bowel or bladder function

8. Cauda Equina • A serious problem that can occur if the nerves at the end of the spinal cord are squeezed • Seek emergency treatment if you experience any red flag Symptoms

9. Causes of Back Injuries • Most back injuries can be attributed to one of these five causes • Poor posture • Improper body mechanics/work habits • Stressful living • Loss of flexibility • Poor conditioning/overweight

10. “Your back went out because your front went out.”

11. Obesity • World Health Organization (WHO) • Overweight: BMI 25-29 • Obese: BMI 30 and above • By 2015: 700 million will be obese • Overweight and obesity lead to serious health consequence • Cardiovascular disease • Diabetes • Musculoskeletal disorders • Some cancers

12. Body Types

13. Diagnostic Testing • Physicians will not generally order diagnostic tests in the first six weeks of low back pain • Most of the time, the causes for back pain cannot be found by x-ray, CT scan or MRI

14. “I’m the one with the medical degree, I’ll determine if your back is bothering you or not.”

15. The intensity of the pain does not equal the severity of the injury

16. Intervertebral Disks • Acts like a cushion between the bony vertebrae that make up the spine • 90% water • Wears with age

17. Potential Disk Problems • Degenerated disks • Thinning disks • Bulging disks • Herniated disks • Osteophyte (bone spur) formation

18. Why does back pain seem to always come back? • The disks between our vertebrae act like shock absorbers • When disks are injured from either wear and tear or a sudden force, they are unable to repair themselves very well because they lack the rich blood supply needed for healing

19. Sciatica • Set of symptoms - not a disease in itself • When the sciatic nerve is irritated or compressed • Causes shock like or burning low back pain that can extend down to the foot • Extreme cases can cause loss of motor control

20. Sciatica

21. Sciatica Treatment • Self care under a doctor’s care • Chiropractic • Prescription medications • Epidural steroid injections • Physical therapy program

22. Piriformis Syndrome • Muscle that runs above the sciatic nerve. • When the muscle becomes tight, causes sciatica like pain down the leg • Prolonged sitting, car accidents, falls

23. Piriformis Syndrome Treatment • Stretching- #1 treatment • Physical therapy • Massage therapy • Anti-inflammatory medications • Temperature treatments

24. Spinal Stenosis • Congenital or age related narrowing of the spinal canal

25. Spinal Stenosis • Risk of developing increases after 50 years of age, severity can increase with age • Treatments include • Pilates or yoga to stretch and strengthen the spine. • Physical therapy • Epidural steroid Injections

26. Spondylosis • Spinal arthritis • Can allow for a forward slippage of the vertebrae onto the vertebrae below it

27. Helping prevent spinal osteoarthritis • Stay ahead of the game! • Get up and go! • Cut the fat! • Sit smart • Stand smart too! • Save those joints • Only eat the good stuff • Kick the habit, don’t smoke! • No pain, all gain! • Be good to yourself

28. Muscle Strains • The majority of back pain is caused by muscle strains • Usually heals with conservative treatments and time • Muscles in the lower back have an excellent blood supply bringing it the necessary nutrients for healing to occur

29. Exercise and Low Back Pain • The natural stimulus for healing process is active exercise • The majority of people do not get enough exercise from daily activities to support their lower back muscles. • While some of these muscles are used in everyday life, a complete exercise program for optimal lower back health is needed

31. Treatment Options • Exercise • Temperature treatments • Physical therapy • Chiropractic • Acupuncture • Massage therapy • Water therapy

32. Medications • Over the counter - Acetaminophen, ibuprofen, aspirin • Narcotic pain relievers - Not recommended for long term use • Muscle relaxants - Treats muscle spasms

33. Did you notice surgery was not included?

34. Healthy Living • Exercise regularly • Maintain or achieve a healthy weight • Regular core strengthening exercises • Eat healthy, drink plenty of water • Practice good body mechanics • Good quality sleep

35. Sleeping Easier with Back Pain • No perfect position for everyone – Listen to your body • Pillow between your legs • Firmer mattress • Egg crate or pillow top if it helps • Good sleep routine

36. Four things to take away • Chances are you will experience back pain at some point in your life • Expensive diagnostic tests cannot always identify the cause of your pain • There is no quick fix • Establish a healthy lifestyle

37. Resources • www.bcidaho.com • www.spine-health.com • www.spineuniverse.com

38. www.bcidaho.com