The spine is the main component of the back, it is made up of the vertebrae, the spinal cord, the muscles, the ligaments and the nerves that provide support for the whole body, allow for movement and convey neurological signals. The spectrum of back problems and injuries goes from the minor ones that produce pain and discomfort or limited movement, to the severe ones that disturb the work of the whole system, and it can be hard to cope with either of them. Back disorders are treated according to their severity, and may include physiotherapy, medicines, or surgical treatments aimed at relieving pain and restoring functionality.
The spine can hurt either in a traumatic or in a non-traumatic way. For instance, accidents that lead to the spinal bones getting fractured or dislocated commonly result in traumatic lower back pain. Contrary to the traumatic back pain, non-traumatic back pain is mostly associated with factors that result in structural alterations such as poor posture, which may cause muscle and joint strain, nerve damage and thus pain. Bad posture can be defined as drooping in a chair, exerting pressure on the stomach while lying down, or walking slumped over. Correcting posture while sitting, standing, or walking helps reduce spinal pressure and prevent lower back pain. Furthermore, lifting large goods wrongly or unsafely might contribute to non-traumatic lower back pain.
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Back pain is often caused by a mixture of three basic factors. Back pain in the muscle is a consequence of stress or overwork that are applied to the lower back tissues, giving rise to discomforts and cramps. The sciatic pain is related to intervertebral discs that lie between the spinal bones; a tear in the outer fibers (annulus fibrosus) would cause severe pain and increase the chances of disc protrusion. Facet joint pain, on the contrary, is connected with the spinal facet joint degeneration with age that leads to both back pain and buttock discomfort. Understanding these causes is critical for accurate diagnosis and therapy of back pain.
Backache is a result of a multiple of illnesses each of them having its own set of symptoms and reasons.
For instance, a slipped disc occurs when the gel-like inner portion of the spinal disc is forced through a tear in the tough outer layer in the most severe cases, which may be necessary to stop the disc from pressing on spinal cord nerves.
With spondylosis, we refer to the spinal deterioration that occurs in joints, discs, and bones, such as degenerative disc disease and bone spurs.
Facet joint arthritis occurs due to the deterioration of the cartilage in the facet joints of the spine.
Spinal stenosis happens when the spinal canal becomes too narrow which leads to pain or discomfort.
Spondylolisthesis and spondylolysis are disorders which are defined by the dislocation of the spine with the occurrence of the fracture. These conditions are the main reason for the emergence of nerve-related discomfort.
The spinal infections and tumors, though much rarer, are among the hardest ones to treat, with the symptoms ranging from the persistent pain in the lower back to deformities and neurological issues, which are mostly dependent on the case.
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As a rule, you are likely to experience pain and tension in your lower back after a workout, especially if you’ve been performing exercises like squats, deadlifts, or yoga which works out your back muscles of course. This is a mechanism that our bodies use naturally during exercise. It may occur a few days after the strenuous activity. Consequently, it is recommended that you watch out for these signs. If your backache is severe and lasts for a long time or has some other severe symptoms like numbness, tingling, and weakness, be sure to see a doctor to get a full evaluation and proper treatment.
Back discomfort can present as a variety of symptoms, many of which indicate underlying spinal abnormalities. Buttock discomfort, which is usually accompanied with back pain, can be caused by worn-out facet joints in the spine, indicating transferred pain from shared nerves in the back. Shooting pain down the leg is frequently caused by a constriction of nerve passageways in the spine, which is usually caused by disc degeneration or facet joint osteoarthritis. This ailment, also known as sciatica or radicular pain, causes electrical or lightning-like pain down the back of the leg. Additionally, back-related nerve compression can cause leg or foot numbness and weakness, occasionally to the point of foot drop or extreme numbness. Leg cramps after walking can be the result of significant spinal canal constriction. Other symptoms may include tingling, burning, or insect crawling sensations, indicating nerve pinching (paraesthesia), and in severe cases, loss of bowel and bladder control due to disc prolapse pressing on controlling nerves. If any of these symptoms persist without improvement, it’s crucial to schedule an appointment with an orthopaedic surgeon for a thorough evaluation and appropriate treatment.
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Exercise safety is critical for reaping the full advantages of a fitness plan. You should always see an orthopedic surgeon before starting a new exercise regimen, especially if it is severe, taking into account aspects such as age, health history, and personal fitness levels. Moderation during workout, wearing appropriate gear, being hydrated, and including warm-up and cool-down routines all contribute to a safe transition into and out of physical exercise. Follow these procedures to prevent lower back pain after workouts:
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Treatment options for back pain could differ a lot depending on the lifestyle, your age and presence of any pre-existing diseases. Such therapies could consist of pain-relieving drugs to target the back, buttocks, and legs regions, and a plan to help manage back pain by adjusting lifestyle. A physiotherapy that emphasizes on the core and back muscle strengthening exercises can help improve the function and reduce pain. If there are underlying causes of back pain, pain procedures may be indicated. Surgery may also be considered to relieve pinched nerves and stabilize deteriorating spines. Finally, therapy options will be tailored to your unique circumstances and needs.
Preventive Measures
Preventive measures to reduce the likelihood of lower back pain may include learning proper techniques, initiating a warm-up, using flexibility exercises, improving physical condition, maintaining spinal health, and seeking educational resources—especially before starting a new activity. Low back motion is anticipated to vary due to the specificity within each of these categories. The best way to prevent injury during daily activities is to participate in regular, low-intensity physical activity while monitoring one’s body, diet, and rest.
Common activities associated with lower back injury involve four types: movements involving poor spine biomechanics; immediate overuse; repeated use over time; and the influence of environmental factors. This includes barbell running, standing for an extended period without a break, and deadlifting with poor trunk motor control. Poor spine biomechanics can raise the risk of low back injury. Proper alignment ensures the greatest efficiency and lowest workload required to complete tasks or physical activities, protecting against back injury and potentially preventing damage to other body parts. Training physiological and joint motion is important in carriage running. Additionally, educational tools and safety options are crucial to ensure the proper execution of these techniques. Warming up before physical activity along with stretching is important to help increase joint range of motion. Although the evidence is not clear as to whether or not stretching before exercise really lowers the risk of injury, it is still commonly recommended prior to physical activity. Regardless, engaging in regular, safe, and appropriate physical and physiological activity is the best prevention.
Running
Athletes require a unique set of preventive measures tailored specifically for the demands placed upon the body during their chosen activity. Technological advances have made it easier to identify common pitfalls associated with running. Adequate footwear, for example, is crucial because poor shoe fit, particularly not having enough room in the toe box for the first metatarsal, is a common factor in lower back pain. Simple measures such as proper shoe lacing can ensure the foot stays in place, providing sufficient support. Sufficiently relatable warm-up exercises, progressed to more functional activities, could be implemented as a pre-routine for competitive or recreational runners in an attempt to prevent running-induced low back pain. Runners are encouraged to participate regularly in self-myofascial release, as well as to apply a static back stretch and pelvic tilt exercise in the event lower back pain is experienced after a run. Finally, an increase in miles should not exceed 3 to 5 miles per week to avoid excessive overload on the lower extremity and lower back or a 10 to 20% weekly increase for intensity training.
Biomechanical alignment refers to an optimal static and dynamic posture of all components of the body relative to one another, i.e., proper alignment between the segments such as pelvis, legs, and trunk. Since the relationship between biomechanical alignment and lower back pain is closely interrelated, it is important to recognize what postural anomalies predispose this high-risk population. The gradual wearing down of the cartilage between the vertebrae explains the direct correlation between long-time running and the appearance of osteoarthritis. It is important to acknowledge individual differences such as body type in order to create a customized running program. Usually, 2 to 3 days per week of running training is sufficient to prevent detraining. Ideal running sessions are those that have an average intensity and duration that promote overall body endurance while minimizing overload, prevent running detraining, are enjoyable, and have rest days available for injury prevention. A summary of all running-specific and supporting exercises along with their rationale is presented.
Standing Too Long
Being on our feet for a long time means that there are several mechanisms involved that increase the risk of injury or the onset of pain. The longer you are standing, the more likely your posture and alignment are compromised, with this eventuality impacting the risk of tissue insult and pain. Standing for long periods of time and being still places mechanical strain on tissues. When you stand, the lower back will curve inwards. When you stand for long periods and there are no movements or changes in posture, the muscles of the lower back and hips have to work harder to keep your body in this position. Over several hours, this can lead to fatigue and discomfort. Adopting a different position and some movement can help to change the force loads across the tissues and reduce the effort and stress on the muscles, which reduces fatigue and discomfort.
To work in an ergonomically correct position, health professionals generally recommend sitting down. However, it is important to appreciate that the use of furniture is not the cause of lower back pain and that sitting is not bad for the back per se. Given that each position carries its own risk profile, I believe that the best position for the desk worker is to alternate the work posture and change from sitting to standing during work hours, as this will reduce the sustained stress on the tissues. For those working in an occupation where they are required to be on their feet for long periods of time, they can introduce movements into their day and move around each hour, as well as taking the weight off each leg every 20 minutes. Periods spent on their feet should be less than 30 minutes continuously in one position. Other important points are for you to wear flat, comfortable, low-heeled shoes or use a footrest and sit on a stool that can be moved with the use of a swivel or tilt mechanism so that you sit comfortably with your knees under the desk and lower arms parallel to the desk to provide an open angle in the hip joint. High stools or workbenches are also not recommended. Stand up and move around regularly. The body has lots of discomfort before the onset of pain, so listen to the signals your body is giving you and address these before your back becomes fatigued and painful. Some of these signals could be a tingling foot, an ache in your calf muscle, or a stiff knee. All of the above is important, making sure that your working space is ergonomically designed in that the keyboard is slightly below elbow level, between your keyboard and monitor, to avoid having to lean your neck forward and having the top of the screen at eye level. A document holder in line with the computer screen is also a good idea.
Deadlifting
Perhaps no other short physical activity creates as much curiosity for everyday gym-goers as performing a heavy deadlift. An unskilled observer may wonder why an individual is picking up a large weight from the floor, what muscle group is being worked, or perhaps, “Isn’t he really messing up his lower back?” One could argue that, as in most weight-bearing physical activities, there may be some risk of increasing the prevalence of lower back pain. Unfortunately, back pain while deadlifting is frequently experienced, primarily due to poor form and not having a prior foundation of strength to provide additional support. It is vital to gradually work towards heavier weights with proper form to prevent any type of injury.
The purpose of a deadlift is to engage core and lower extremity muscles in order to overcome gravity and vertically lift a weight (or oneself) from the ground. To begin a deadlift, engage the core muscles by pulling the belly button towards the spine. Then, slightly push the hips backward and allow the knees to bend as the body moves forward. Begin the lifting portion of the exercise by extending the hips and knees to raise the weight. Be sure to keep the spine straight from the beginning to the end of the movement. Stand tall at the top of the lift, and then lower the weight back down in the reverse order to complete one repetition of the deadlift. As crucial as hypertrophy for back muscle development may be, novel studies suggest that isometric and dynamic fatigue may be one of the biggest risk factors for developing a posture that may increase the prevalence of lower back pain. Since this is the case, you have to consider specificity, as well as structured and metric-based weight lifting exercises that are performed with good form and form progression.
Targeted Exercises
For those individuals with lower back pain resulting from physical activity, it is important to complete exercises that are designed for the affected musculature groups. Such exercises can minimize discomfort as well as improve the supporting and surrounding tissues of the back and help in restoring the resiliency in the structures. It must be noted that the purpose of exercises or stretching is not to cure the injury. Rather, the stretching would alleviate the inflammation. Furthermore, it may eventually help prevent further aggravation or injury to musculature.
Several types of exercises are recommended, depending on the patient’s current condition and symptoms. For example, several health care practitioners stress specific strengthening to the core musculature, also known as the group that assists in stabilizing the low back and pelvis. These exercise groups include several of the Pilates movements as well as other exercises completed on a gym ball. Other health care professionals suggest more general stretching of the surrounding musculature groups. These exercises will help in providing relief and healing as well as help in avoiding new low back pain, as prescribed exercises are useful. The choice of exercise can be discussed with variations in other musculature areas if coping with leg pain, to include the surrounding muscle groups. The emphasis is on providing the exercise that fits the musculature problem causing the most discomfort and providing exercises that a patient can complete without further exacerbating the low back pain.
Stretches for Lower Back Pain Relief
The trunk has powerful muscles. This prevents them from collapsing and compressing internal organs. But many times, it could cause stiffness and muscle tension conditions that cause pain. Stretching these front and back muscles will help to reduce muscle tension and restore flexibility in the lumbar region. Here are some stretches; some are static, others are dynamic.
– Child’s Pose (Static Stretching). Kneel on the floor on your hands and knees. Extend your arms in front of you. Lower your chest to the ground and hold the pose. Try to lengthen as you relax. Hold for up to 1 minute. – Seated Forward Bend (Static Stretching). Sit on the floor with your legs extended straight in front of you. Reach for your toes. Use a towel or belt if you can’t reach. Hold or try to touch your toes for up to 1 minute. – Cat-Cow (Dynamic Stretching). Begin on your hands and knees in a tabletop position. Inhale as you arch your back and hold your neck long (cow). Exhale as you round your spine, drop your head, and tuck your chin to your chest (cat). Continue flowing back and forth from cat to cow for 15–30 seconds.
How often should you do back stretches? You can usually do back stretches up to 1–3 times per day, especially at bedtime and again in the morning when you first wake up. The goal is to try to help keep it from getting to the pain again. It’s a good thing to do all your stretches every day. It keeps you from getting sore and helps you show your body and your mind that you are doing good things for yourself. That helps you respond better. There are some things you don’t want to do: you don’t want to stretch too hard or too long because that can make your muscles sore. Any pain is a sign to stop. Stretches can help to relax you, especially if you do some deep breathing exercises when you do them. Deep breathing can help muscles relax and let tension go too.
Personalized Advice
Increasing personal training, individually tailored exercise, and extensive popularization of probably the healthiest physical activity—movement that has been with us for more than a million years—require a broad approach to what “we” can or should do in the unfortunate case of low back pain. It is difficult to consider the individual approach in depth due to the very wide range of factors to be accounted for. This problem is so common that dogmatic recommendations for anamnesis collection, physical examinations, recommendations for imaging or additional tests, treatment or rehabilitation planning, and even prevention are created. In thought, the most important aspect of the classification of loads on the musculoskeletal system is age, or more precisely the period of life and what “we” do, or so-called age-dependent physical development. Simple but different common-sense advice for sport/exercise and, more generally, physical activity is presented here for people in four groups, particularly for the first three groups which are undergoing various life stages in terms of physical development, and people aged between 45 and 50, or in the next stage, when the majority of the evolutionary wisdom does not carry an advantage based on biology. Age dependence is also the main topic of many studies that show a considerable change in the value of the waist–hip ratio or ROM, or the amount of physical activity that may reflect the change in favorite training techniques and advice. Moreover, advice given to recipients of any age should be adapted to their current fitness level, the shape of the whole body, and the given ailment accompanying the musculoskeletal system.
Age-specific Recommendations
Obesity, smoking, and a sedentary lifestyle paired with overuse of screen time influence the condition of one’s back. Up to the age of 20 years, children suffering from lower back pain (LBP) often present with minor functional disorders, raising the need to consult a healthcare provider only when the pain does not abate within approximately a week after physical activity, at which time the differential diagnosis from a sports injury will be mandatory. Activities: any. Management: time-limited sport suspension until full recovery before return-to-play is declared. Adults over 20 years of age with or without risk factors may seek medical consultation for acute-onset back pain following physical activity. Management: a full clinical and orthopedic consult is encouraged for specific treatment and return-to-play recommendations or sick leave instructions.
Between 30 and 59 years old, interest and participation in various types of physical activity typically decrease as a result of caregiving, chronic low back pain (≥3 months), and not initiating acute (non-traumatic) LBP treatment to return to sport. To lower the first medical encounter occurrence and subsequent chronicity, the emphasis of this phase is on prevention (rather than cure). Activities: in general, Nordic walking, Pilates, spinal yoga, essentially dynamic proprioception exercises, and clinical review on muscle strength, lumbar flexibility, standing static balance, or movement for the elderly to monitor the risk of falls. Management: negative pain management and coping strategies before LBP starts. Medication should be used carefully as an acute-phase management. An exercise plan should be in place before an injury occurs. The best advice will be written in layman’s terms on how to adapt skilled movements for tasks of daily living to perform with minimal risk of injury. For example, focusing on teaching adults to bend at the knees and not the back as they push up from a squat position for work or house labor. The patient must follow preventive guidance given or return for an appointment.
Fitness Level Considerations
– An individual’s physical conditioning can increase or decrease the likelihood of an injury and influence recovery processes, including the way pain is produced and modified.
– Advice should be tailored to individual fitness levels and conditioning.
– A range of adaptive strategies can be included in programs to benefit individuals of varying fitness levels.
– The prevention of injury includes performing gradual change progressions leading back to desired activities at an individual’s level.
– Individuals are encouraged to consult with fitness professionals to receive tailored advice, monitor technique and form, and introduce appropriate programs to reduce potential injury risks.
– Regressing to a foundational strength program can be beneficial for reducing injury and promoting recovery in some cases.
Lower back pain after running is often caused by poor posture, inadequate core strength, improper footwear, or overtraining.
There is no best treatment but strengthening core muscles and improving running techniques can help prevent recurrence.
Preventive measures include warming up, maintaining proper posture, strengthening core muscles, and wearing supportive running shoes.
Lower back pain after standing too long is usually due to muscle fatigue, poor posture, or spinal issues such as herniated discs.
Relief methods include taking breaks to sit or stretch, using supportive footwear, and practicing good posture. Regular exercises to strengthen your back muscles are also helpful.
Yes, improper form or lifting too much weight during deadlifts can strain lower back muscles and lead to pain or injury.
Rest, ice application, stretching, and gentle lower back exercises can alleviate pain. Consult a doctor if the pain persists or worsens.
Ensure proper form by keeping a neutral spine, engaging your core, and lifting appropriate weights. Consider seeking guidance from a certified trainer.
Avoid high-impact or strenuous activities until the pain subsides. Focus on low-impact exercises like walking or swimming, and consult a specialist if needed.
Seek medical advice if the pain is severe, persists for more than a few weeks, or is accompanied by numbness, tingling, or weakness.
Yes, poor posture or incorrect technique during physical activity can place unnecessary strain on your lower back, leading to pain or injury.
In some cases, it may indicate an underlying condition like spinal stenosis or a herniated disc. Persistent or severe pain warrants medical evaluation.
Recovery time varies but typically ranges from a few days to weeks, depending on the severity and the effectiveness of the treatment approach.
Dr Yong Ren graduated from the National University of Singapore’s Medical faculty and embarked on his orthopaedic career soon after. Upon completion of his training locally, he served briefly as an orthopaedic trauma surgeon in Khoo Teck Puat hospital before embarking on sub-specialty training in Switzerland at the famed Inselspital in Bern.
He underwent sub-specialty training in pelvic and spinal surgery, and upon his return to Singapore served as head of the orthopaedic trauma team till 2019. He continues to serve as Visiting Consultant to Khoo Teck Puat Hospital.
Well versed in a variety of orthopaedic surgeries, he also served as a member of the country council for the local branch of the Arbeitsgemeinschaft für Osteosynthesefragen (Trauma) in Singapore. He was also involved in the training of many of the young doctors in Singapore and was appointed as an Assistant Professor by the Yong Loo Lin School of Medicine. Prior to his entry into the private sector, he also served as core faculty for orthopaedic resident training by the National Healthcare Group.
Dr Yong Ren brings to the table his years of experience as a teacher and trainer in orthopaedic surgery. With his expertise in minimally invasive fracture surgery, pelvic reconstructive surgery, hip and knee surgery as well as spinal surgery, he is uniquely equipped with the tools and expertise necessary to help you on your road to recovery.
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