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Does back pain ever go away: 7 Ways to Treat Chronic Back Pain Without Surgery

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Does Back Pain Go Away On Its Own?

Eighty
percent of people suffer from back pain at some point in their lives.
Back pain is the second most common reason for visits to the doctor’s
office, outnumbered only by upper-respiratory infections. Most cases of
back pain are mechanical or non-organic, i.e., not caused by serious
conditions, such as inflammatory arthritis, infection, fracture, or
cancer.

What Causes Back Pain?

The back is a complicated structure of bones, joints, ligaments, and
muscles. You can sprain ligaments, strain muscles, rupture disks, and
irritate joints, all of which can lead to back pain. While sports
injuries or accidents can cause back pain, sometimes the simplest of
movements-for example, picking up a pencil from the floor-can have
painful results. In addition, arthritis, poor posture, obesity, and
psychological stress can cause or complicate back pain. Back pain can
also directly result from disease of the internal organs, such as kidney
stones, kidney infections, blood clots, or bone loss.

Back injuries are a part of everyday life, and the spine is quite good
at dealing with these often “pulled” muscles. These very minor injuries
usually heal within 1 or 2 days. Some pain, however, continues. What
makes some pain last longer is not entirely understood, but researchers
suspect that the reasons may include stress, mood changes, and the fear
of further injury that may prevent patients from being active. In
addition, sometimes a painful injury or disease changes the way the pain
signals are sent through the body, and, even after the problem has gone
away or is inactive, the pain signals still reach the brain. It is as
if the pain develops a memory that keeps being replayed.

Will Back Pain Go Away on Its Own?

Until recently, researchers believed that back pain will “heal” on its
own. We have learned, however, that this is not true. A recent study
showed that when back pain is not treated, it may go away temporarily
but will most likely return. The study demonstrated that in more than
33% of the people who experience low-back pain, the pain lasts for more
than 30 days. Only 9% of the people who had low-back pain for more than
30 days were pain free 5 years later.1

Another study looked at all of the available research on the natural
history of low-back pain. The results showed that when it is ignored,
back pain does not go away on its own.2 Those studies demonstrate that
low-back pain continues to affect people for long periods after it first
begins.

What Can I Do to Prevent Long-Term Back Pain?

If your back pain is not resolving quickly, visit your doctor of
chiropractic. Your pain will often result from mechanical problems that
your doctor of chiropractic can address. Many chiropractic patients with
relatively long-lasting or recurring back pain feel improvement shortly
after starting chiropractic treatment.3 The relief they feel after a
month of treatment is often greater than after seeing a family
physician. 4

Chiropractic spinal manipulation is a safe and effective spine pain
treatment. It reduces pain, decreases medication, rapidly advances
physical therapy, and requires very few passive forms of treatment, such
as bed rest.5

How Can I Prevent Back Pain?

5 Things To Do When Back Pain Just Won’t Go Away: David Chang, MD-PhD, DABNS: Complex Spine Neurosurgeon

Back pain rarely goes away for good without the injured party taking at least one step to resolve it, but for some, no matter what they try their back pain simply seems to linger. However, if you buckle down and make a concentrated effort to treat your back pain, we’re confident you’ll be able to achieve some level of pain relief. So today, we’re going to share five ways to improve your spine when your back pain just won’t go away.

Treating Lingering Back Pain

Consider these five tips if your back has been hurting for more than a week.

1. Visit a Doctor/Get a Second Opinion – If your back pain is lingering, consider heading into a spine specialist’s office for a diagnosis. You may think you’re dealing with one problem, but if it turns out something else is causing your pain, your current treatment methods may be exacerbating the problem. If you’ve already gone to your primary care doctor but still feel like your back isn’t getting any better, a spine specialist offers more comprehensive knowledge about all things spine and is a better bet to provide you with the most accurate diagnosis and a comprehensive treatment plan.

2. Rest – Rest is the best option for minor tweaks and strains, but oftentimes people try to power through it, and that can make the problem worse. We understand that you don’t want to miss school or work, but missing one or two days and coming back healthy is better than working a full week in pain and risking a more serious injury. Give your back a solid 48 hours of rest from manual labor.

3. Exercise – It may sound counterintuitive to suggest that you should exercise right after we said you should take it easy and rest, but exercise can do wonders for your aching spine.  Exercise helps to strengthen muscles and other spinal structures, and exercise also leads to the release of endorphins in our brain, which can enhance our mood and take our attention off our injured back. If exercises like running or walking are too stressful on your spine, head over to the pool and do some aqua-therapy, as the water helps to bear your weight and acts as a natural resistant.

4. Physical Therapy – If you want to take exercise one step further, consider going to physical therapy for your spine. Physical therapy works by targeting specific areas in your back that are hurting or that need strengthening. Your spine specialist can recommend a physical therapist in your area, or if you’ve already received a diagnosis, you can look online for physical therapy exercises you can do on your own that help your specific condition.

5. Diet Changes – Finally, take a closer look at your diet. Are you getting a good range of fruits, vegetables, vitamins and minerals, or are you snacking too much on salts and sweets. Junk food can contribute to the buildup of inflammation in our joints, which can compress structures in our spine and lead to pain. Try to ensure that you are eating a range of foods each and every day, and couple that with plenty of water to remain hydrated.

If you have any questions about your spine pain, reach out to Dr. Chang’s office today.

Common misconceptions about chronic back pain

If an exercise hurts it must be causing me harm

Not necessarily.

Some movements that human beings must do every day like standing or walking will stretch a painful, stiff, or shortened gluteal muscle. Physical therapists can teach you to get used to safe exercises for day-to-day movements.

By understanding that “hurt” does not always mean “harm,” you can slowly train your brain to not over-respond to the pain associated with these physical activities. Even though these exercises may cause more pain, this doesn’t represent damage or harm to your spine.

Bulging discs cause a majority of my back pain

Actually, no.

Many have been told their pain is coming from disc bulges or tears that look abnormal on their MRIs. Research shows that chronic back pain frequently does not correlate with the structural abnormalities that may appear on MRIs. Many people with disc degeneration, tears, and bulging discs are able to lead pain-free and active lives. 

Disc degeneration is a normal process. In fact, the blood supply to our discs was the best when we were teenagers. Every year afterward, the blood supply to the disc decreases. By the time we turn 40, many of us without back pain will have radiographic evidence of disc degeneration.

This process is completely normal. Our spines have the ability to adapt to new environments and activities. Studies have shown the disc actually benefits from increased physical loading and gradually adapts as joints, bones, muscles, tendons, and ligaments do.

My chronic back pain must have begun with an injury

Consider this:

Unless you undergo significant trauma to your spine, like being thrown out of a moving vehicle, the human spine is capable of absorbing a lot of energy without being damaged. By the time we develop chronic pain, our bodies have usually had several decades of wear before the first sign of back pain occurs. If one has neglected routine maintenance for many years, (such as maintaining a healthy weight, diet, and exercise habits) it makes the occurrence of problems like chronic back pain more likely. Acute back pain, the kind that accompanies a minor injury, usually heals within six months. 

I need to severely restrict my activity because I have back pain

Let’s rethink that conclusion.

We lose muscle strength and endurance much faster than we can regain it. Being off work or stopping our exercise deprives our bodies of physical activity for all of our muscles. Being able to take it a little easier while your muscle rebuilds itself is advisable, but long leaves from work or exercise deprive these deep muscles of the regular exercise they need in order to repair themselves. This is why keeping our muscles at their best flexibility, strength, and endurance is so critical.  Regular exercise may actually have a preventive effect in terms of frequency of back pain and recurrence.

My back pain means something is significantly damaged or diseased

The chances are low.

In a study of 1,200 patients with acute back pain, less than 1 percent of patients with back pain had a serious condition including a fracture, infection, cancer, or multiple nerve root compressions. Several treatment guidelines can identify certain items in your personal history or examination that may lead us to suspect an underlying serious medical condition.

There has to be some form of sure-fire treatment for chronic back pain

Start by being a conscientious consumer.

Once reassured by your doctors that there is no fracture, infection, tumor, or a sinister medical condition that is responsible for your pain, the next step is to look for whether there are any factors that you can use to improve your pain condition.

Research shows back pain treatment to be one of the most-treated conditions in the United States. Consumers’ expectations are that this pain can be “cured” with a straightforward medication or procedure. 

Think back to the concept that chronic back pain is coming from overactive nerve or pain sensors that are amplified by the spinal cord or brain. Unfortunately, we cannot get into your deep muscles and spinal cord to adjust your microscopic pain filters without harming their various other vital functions. Our approach is to help you address the root causes of your pain by focusing on muscle flexibility, strength, and endurance.

Everything You Need To Know About Lower Back Pain

Almost everyone experiences lower back pain at some point in their lives. For some, it’s just a slight discomfort in the morning, while others may experience a debilitating pain that just won’t go away. Understanding what causes back pain can help you minimize the symptoms or possibly eliminate them altogether. Below is useful information to help educate you on lower back pain. 

  • Causes: Lower back pain can be caused by a number of things. As we get older, our spines go through degenerative changes. Some people begin experiencing these changes as young as 30; however, lower pain back caused by aging is typically not debilitating and does not interfere with day-to-day life. Over-activity is another common cause of lower back pain. This usually happens when the muscles and ligament fibers in the back haven’t been used in some time. This type of lower back pain normally dissipates in a few days. If you experience back pain that does not go away within a few days, you may be experiencing a disk injury, such as a tear or herniation.
  • Symptoms: The severity of lower back pain varies from person to person. Some people may experience a dull, aching pain, while others feel a sharp, stabbing pain. When someone with back pain bends or lifts, the pain is often exacerbated. Typically back pain will come and go, worsening with stress. The pain usually radiates from the back toward the buttock or outer hip area.
  • Diagnosis: It’s important to see a doctor if you start experiencing lower back pain. Your doctor will want to discuss your symptoms and medical history. He or she will also examine your back to determine where the pain is coming from. In order to confirm the cause of your back pain, your doctor will probably order other tests, which may include x-rays, MRIs, CAT scans, bone scans and bone density tests.
  • Treatment: Your doctor will likely recommend either medication, physical medicine or surgery to treat your lower back pain. Medications often prescribed for lower pain back include aspirin, non-steroidal anti-inflammatory medicines, narcotic pain medications and even steroids. Physical medicine may include physical therapy, braces, chiropractic therapy, traction and other exercise-based programs. If nonsurgical treatment options have proved unsuccessful, surgery is often a last resort and should only be considered once your doctor has determined the source of your lower back pain.

While lower back pain is usually a harmless, nagging pain, it can also be debilitating if it gets bad enough. By seeing a doctor soon after your back pain begins, you can work to alleviate the symptoms and begin a treatment plan. You can also help minimize potential pain by exercising regularly and maintaining a healthy lifestyle.

Back Pain | Treatments, Causes

Back pain is a common condition and in the UK, it is the largest cause of work-related absence. Back pain can be very uncomfortable, but it is not usually serious.
Brought to you by NHS Choices

This article has been updated

The evidence in this article is no longer current. Click here to see an updated and expanded article

Overview

Back pain can affect anyone, regardless of age, but it is more common in people who are between 35 and 55 years of age.

In the majority of cases, the cause of back pain can be linked to the way that the bones, muscles and ligaments in the back work together.

Top tips

  • Keep your back mobile. If you’re in so much pain that you have to go to bed, that’s fine – but try and get back on your feet as soon as possible.
  • Do not do any lifting. If you do, you’re likely to strain the back further.
  • Be careful bending your back – this puts a lot of strain on it, which can make your problems much, much worse.
  • Try some ice on the back. Apply an icepack or a bag of frozen peas wrapped in a towel to the base of your spine for five minutes.
  • Follow with 20 minutes of heat – a hotwater bottle wrapped in a towel, placed on the base of the spine. This will help reduce inflammation. You can use it on the spine while you sit down, or when you lie on the bed.
  • Take painkillers and anti-inflammatories, but stick to the recommended dosages and read the packet to ensure they’re suitable for you.

The structure of the back

The back is a complex structure consisting of:

  • 24 small bones (vertebrae), that support the weight of your upper body and form a protective canal for the spinal cord.
  • Shock-absorbing discs (intervertebral discs) that cushion the bones and allow the spine to bend.
  • Ligaments that hold the vertebrae and discs together.
  • Tendons to connect muscles to vertebrae.
  • A spinal cord, which carries nerve signals from the brain to the rest of the body.
  • Nerves.
  • Muscles.

The lower part of your back is known as the lumbar region, which is made up of five vertebrae, known as L1, L2, L3, L4 and L5. The lumbar supports the entire weight of your upper body (plus any extra weight that you are carrying), and it is under constant pressure, particularly when you are bending, twisting and lifting.

Lower back pain

Lower back pain, also known as lumbago, affects seven out of 10 people at some time in their lives. Lower back pain is a pain or ache on your back, in between the bottom of your ribs and the top of your legs.

Lower back pain can come on suddenly or gradually, and is sometimes the direct result of a fall or injury. The complex structure of your lower back means that even small amounts of damage to any part of the lumbar region can cause a lot of pain and discomfort.

Pain in your lower back is usually a symptom of stress or damage to your ligaments, muscles, tendons or discs. In some cases, if a nerve in your back is pinched or irritated, the pain can spread to your buttocks and thighs. This is known as sciatica (go to ‘Useful links’ for more information).

In most cases of back pain your back will heal itself, and staying active and continuing with your usual activities will normally promote healing. Back pain will usually last from a few days to a few weeks. Pain that lasts longer usually clears up after about six weeks.

However, in severe and persistent cases of back pain, it is important to seek medical advice so that a correct diagnosis can be reached and appropriate treatment given. Treatment for back pain will usually depend on the underlying cause of the condition. For example, pain that is caused by some types of arthritis may be treated using specific medicines.

Symptoms

Symptoms of back pain

The symptom of lower back pain is a pain or ache anywhere on your back, in between the bottom of the ribs and the top of the legs. The majority of cases of back pain usually clear up quite quickly.

However, if you experience back pain together with any of the following symptoms, visit your GP as soon as possible:

  • a fever,
  • weight loss,
  • inflammation or swelling on the back,
  • constant back pain that doesn’t ease after lying down or resting,
  • pain that travels to the chest or pain high up in your back,
  • pain down the legs and below the knees,
  • a recent trauma or injury to your back,
  • loss of bladder control,
  • inability to pass urine,
  • loss of bowel control, or
  • numbness around the genitals, buttocks or anus.

You should also seek medical advice if you’re experiencing back pain and:

  • you’re under 20 years old or over 55 years,
  • you have taken steroids for a few months,
  • you are a drug abuser,
  • you have or have had cancer, or
  • you have a low immune system due to chemotherapy or another medical condition (for example, HIV/AIDS).

Ask your GP for advice if your back pain has developed gradually and has got increasingly worse over several days or weeks.

Causes

Causes of back pain

Most cases of lower back pain are known as ‘non-specific’ because they are not caused by serious damage or disease, but by sprains, muscle strains, minor injuries or a pinched or irritated nerve.

Back pain can also be triggered by everyday activities at home or work, and by poor posture. For example, back pain may be triggered by:

  • bending awkwardly,
  • lifting, carrying, pushing or pulling incorrectly,
  • slouching in chairs,
  • standing or bending down for long periods,
  • twisting,
  • coughing,
  • sneezing,
  • muscle tension,
  • over-stretching,
  • driving in hunched positions, or
  • driving for long periods without taking a break.

Sometimes, you may wake up with back pain and have no idea what has caused it.

Common causes

Some common causes of back pain include:

  • pregnancy,
  • gynaecological problems in women, such as pelvic inflammatory disease (PID),
  • different types of arthritis, such as osteoarthritis,
  • stress-related tension,
  • viral infections,
  • bone disorders,
  • bladder and kidney infections,
  • osteoporosis (weak and brittle bones),
  • a trip or fall,
  • a trauma or injury, such as a fracture,
  • lack of exercise,
  • obesity, and
  • sleep disorders.

Serious back pain

The bulging or rupture of one or more of the intervertebral discs can sometimes cause serious back pain. This results in the inner jelly-like material (nucleus pulposus) pressing on the spinal cord or nerve roots, which run next to the disc. This is commonly known as a ‘slipped disc’, but is more accurately described as a ‘prolapsed’ (bulging) or ‘herniated’ (ruptured) disc.

The pain will usually be in your lower back, but you may also experience pain in you buttocks, thigh, calves, feet and toes, due to irritation of the sciatic nerve, which runs down both legs. Occasionally, the pain is also accompanied by pins and needles, numbness and weakness.

Intervertebral discs tend to dry out and weaken with age, or following an injury. This results in the discs becoming less flexible, which means they do not cushion the vertebrae as well as they did before. This is a common cause of stiffness and pain, particularly in the elderly. It also tends to be worse early in the morning.

Persistent lower back pain can also be caused by a number of rare conditions, such as:

  • congenital (inherited) spinal defects,
  • bone diseases,
  • shingles (an infection that affects the nerves),
  • fibromyalgia, or
  • cancer that has spread to the spine.

Diagnosis

Diagnosing back pain

Your GP will be able to diagnose back pain by discussing your symptoms with you and conducting a physical examination.

Usually, there is no need for tests, such as X-rays or scans, when diagnosing back pain. If you have simple back pain, tests are not always helpful because they often do not show anything unusual.

You’ll only usually be sent for tests if your pain lasts for longer than six weeks, if you have had an injury or blow to your back, or if your GP suspects that there may be an underlying cause for your pain.

For suspected disc problems, X-rays or a computerised tomography scan (CT scan) may be required. Your GP may suggest having a magnetic resonance imaging (MRI) scan, that uses a strong magnetic field and radio waves to produce detailed images of the inside of your body, in order to provide more accurate information about the soft tissues in your back.

In some cases, blood tests or a myelogram (a special kind of X-ray using an injected dye) may be needed.

A chiropractor, osteopath or physiotherapist?

Chiropractic and osteopathy are similar disciplines. Both osteopaths and chiropractors can diagnose by visual inspection and feeling by hand (palpation).

Chiropractic treatment tends to involve a more ‘direct’ approach, with an emphasis on adjustments of the spinal joints. Chiropractors also rely on X-rays, blood and urine tests and MRI scans for diagnosis.

The osteopathic approach involves mobilisation (slow, rhythmic stretching), pressure or ‘indirect’ techniques and manipulations on the muscles and joints.

Physiotherapists are trained to diagnose problems in the joints and soft tissues of the body. Physiotherapy for back pain provides a wide range of treatments to relieve pain, promote relaxation and restore movement. They include manipulation, mobilisation and massage. Exercise may also be used to increase general fitness or to strengthen muscles that support the spine.

Treatment

Treating back pain

Advice from Pain Concern

  • Learn to believe that your pain is what you say it is.
  • Pain makes you tired, sad and irritable. Explain this to your family and friends so they realise they are not to blame for you being unhappy.
  • Learn the art of relaxation and work at it daily. Relaxation tapes may help.
  • Get professional advice on appropriate exercise.
  • Set goals for yourself and break them down into workable parts – for example, by increase the distance you walk day by day.
  • Read positive and encouraging literature.
  • Ask your doctor about the availability of local pain-relief services, such as pain clinics.

Generally, back pain is categorised as:

  • Acute – where your back pain occurs suddenly and lasts for less than three months, and
  • Chronic – where your back pain develops gradually, over time, lasts for more than 12 weeks, and causes long-term problems.

However, most people with lower back pain experience mild pain and have occasional bouts of pain that are more severe. This can make it difficult to determine whether their back pain is acute or chronic.

Treating acute back pain

Most cases of acute back pain can be treated using self-help techniques. These are discussed below.

Over-the-counter (OTC) painkillers:
Paracetamol is usually recommended to treat acute lower back pain. If paracetamol proves ineffective, a non-steroidal anti-inflammatory drug (NSAID) such as ibuprofen may be used instead.

Stronger painkillers:
If your back pain symptoms are severe, your GP may prescribe a mild opiate-based painkiller, such as codeine, which can be taken in combination with paracetamol or a NSAID.

Muscle relaxants:
If your back pain symptoms are very severe, your GP may prescribe a muscle relaxant such as diazepam.

Diazepam can make you feel very sleepy, so do not drive if you have been prescribed this medication. After your course of diazepam has ended, you should wait at least 24 hours before driving. Diazepam will also make the effects of alcohol worse, so you should avoid alcohol while you are taking the medication.

Diazepam has the potential to be habit-forming, and can cause a number of unpleasant withdrawal symptoms when coming of the medication. To minimise these effects, your GP will not usually prescribe more than seven days worth of the medicine.

Exercise:
It’s important to remain as physically active as possible. While bed rest may provide some temporary relief from your symptoms, prolonged bed rest will make your symptoms worse.

Recommended exercises for back pain include walking and gentle stretching.

Your back pain may be so severe that you need to have some time off work. However, if this is the case, you should aim to return to work as soon as possible. While you may not feel any immediate benefit, research has shown the people who continue to work during an episode of back pain recover quicker than people who stay at home.

Compression packs:
Many people with back pain find that using either hot or cold compression packs helps reduce pain. You can make you own cold compression pack by wrapping a bag of frozen food in a towel. Hot compression packs are often available from larger pharmacies. You may find it useful to use one type of pack after the other.

Treating chronic back pain

This will usually require a combination of self-help techniques and medical treatment. Treatment options are discussed below.

Painkillers:
As with acute back pain, painkillers are usually the first method of treatment for chronic back pain. Initially, it is likely that paracetamol will be recommended, but if your back pain is severe, codeine may be prescribed.

Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, should only be used for long periods under the advice of your GP. If long-term treatment using NSAIDs is required, your GP may prescribe gastro-protective medicines, such as proton pump inhibitors (PPIs).

Amitriptyline:
If your back pain is severe and does not improve with the use of painkillers, your GP may recommend a one-month trial of a medication called amitriptyline. Amitriptyline is usually used to treat depression, but it has also been found to be useful in treating nerve pain.

If you are prescribed a course of amitriptyline, you may experience some side effects including:

  • drowsiness,
  • dry mouth,
  • blurred vision,
  • constipation, and
  • difficulty urinating.

You should not drive if you are taking amitriptyline and it is making you drowsy.

Amitriptyline should not be taken by people with a history of heart disease.

Exercise:
As with acute back pain, if you have chronic back pain, you should try to remain as physically active as possible because doing so will reduce the severity of your symptoms. It is also recommended that you continue working, or return to work as soon as possible.

Regular exercise will help to strengthen the muscles that support your back. Exercise also promotes the production of endorphins, which are natural painkilling chemicals. Ask your GP for advice about a suitable exercise plan for you.

Bending, twisting, or placing strain on your back can be painful. However, excessively protecting your back can delay return to normal activities. The trick is to be careful when making potentially painful movements, but to pace your return to full normal activity.

Physiotherapy:
If you have chronic back pain, Your GP may refer you to a physiotherapist – a qualified specialist who will be able to help you to improve your range of movement.

A physiotherapist will be able to teach you exercises that strengthen the muscles that support your back, as well as improving the flexibility of your spine. They can also teach you how to improve your posture and reduce any future strain on your back.

Cognitive behavioural therapy (CBT):
Some studies have shown that a type of therapy called cognitive behavioural therapy (CBT) can help in the management of chronic back pain.

CBT is based on the principle that the way you feel is partly dependent on the way that you think about things. Studies have shown that people who train themselves to react differently to pain, by using relaxation techniques and maintaining a positive attitude, report that their levels of pain went down.

They were also more likely to remain active and take exercise, further reducing the severity of their symptoms.

Surgery:
Surgery may be an option to treat cases of chronic back pain when:

  • there is an identifiable cause, such as a ruptured hernia,
  • the symptoms have not responded to other forms of treatment, and
  • the symptoms are getting progressively worse.

The type of surgery that will be recommended will depend on the cause of your back pain. Some surgical options are listed below.

  • Discectomy – where the part of the herniated disc that is pressing on your nerve is removed.
  • Fusion surgery – if a vertebra has slipped out of place, it may be possible to fuse it into place using metal rods.
  • Injections – a variety of injections are available that a surgeon can make into your back in order to help relieve the pain.

As with all surgical procedures, spinal surgery carries some risks. For example, following surgery, there is a 10% chance of infection. If this occurs, further surgery may be required to clean out the infection, although some cases can be treated with antibiotics.

In the case of fusion surgery, there is a 1-2% chance of the vertebrae failing to fuse into place. If this occurs, further surgery will be required.

There is a very low risk that your spinal cord will be damaged during surgery. The chances of this happening are estimated to be six in 1,000 (0.6%). In the rare situation that the spinal cord is damaged during surgery, it could result in problems ranging from some muscle weakness to total paralysis. Your bladder and bowel control may also be affected.

Before having back surgery, your surgeon will be able to fully discuss the risks and benefits of the procedure with you.

Complementary therapies:
Some people with back pain choose to use complementary therapies alongside more conventional treatments, while others choose to use them as stand-alone treatments

Complementary therapies such as chiropractic, osteopathy, shiatsu and acupuncture may help to ease your back pain, and encourage you to feel relaxed.

An osteopath is a health professional who specialises in treating the skeleton and muscles, and chiropractor treats joint, muscle and bone problems, focusing on the spine.

Shiatsu is a traditional Japanese technique that is often described as ‘finger pressure’ therapy. It is a form of massage that works by applying pressure to energy lines in your body. A shiatsu therapist will use their fingers, thumbs and elbows to carry out the treatment.

Acupuncture is a form of traditional Chinese medicine which involves the insertion of very fine needles at key points in the body. This can help encourage the body to release its natural form of painkillers, known as endorphins. It can also help to stimulate nerve and muscle tissue.

For many complementary therapies, clinical studies have not produced conclusive evidence as to their safety and effectiveness. Therefore, if you are considering using a complementary therapy, you should carefully weigh up any benefits and potential risks and discuss it with your GP if you are uncertain.

Transcutaneous electrical nerve stimulation (TENS):
The transcutaneous electrical nerve stimulation (TENS) machine is an increasingly popular treatment method for people with long-term back pain. The machine delivers small electric pulses to your body through electrodes that are placed on your skin.

It is thought that these pulses work in two ways. A low electric pulse can encourage your body to produce more endorphins – the body’s own painkilling chemical. A high electric pulse can also block pain signals going from your back to your brain.

Many medical studies have been carried out on the use of TENS but the results have been conflicting. Some studies suggest that the machines are of little use, while other studies suggest that they may be able to help certain people.

You should only use a TENS machine under the direction of your GP or other healthcare professional.

The following people should avoid using a TENS machine:

  • pregnant women – unless specifically advised to by their doctor,
  • people with epilepsy,
  • people who have a pacemaker fitted, and
  • people with a history of heart disease.

Managing your pain

Pain management programmes can help you to learn how to manage your pain, increase your activities and have a better quality of life. This is done with a combination of group therapy, exercises, relaxation and education about pain and the psychology of pain.

People with persistent pain may be able to attend a specialist pain clinic for assessment and possible pain management. You need to be referred to a pain clinic by your GP or consultant. For more information on pain clinics in your area, contact the British Pain Society.

Prevention

Preventing back pain

To avoid back pain, you must reduce excess stresses and strains on your back and ensure that your back is strong and supple.

If you have persistent, recurring bouts of back pain, the following advice may be useful:

  • Lose any excess weight
  • Practise the Alexander technique.
  • Wear flat shoes with cushioned soles, as these can reduce the stress on your back.
  • Avoid sudden movements or muscle strain.
  • Try and reduce any stress, anxiety and tension.

Posture

How you sit, stand and lie down can have an important effect on your back. The following tips should help you maintain a good posture:

  • Standing – you should stand upright, with your head facing forward and your back straight. Balance your weight evenly on both feet and keep your legs straight.
  • Sitting – you should be able sit upright with support in the small of your back. Your knees and hips should be level and your feet should be flat on the floor (use a footstool if necessary). Some people find it useful to use a small cushion or rolled-up towel to support the small of the back. If you use a keyboard, make sure your forearms are horizontal and your elbows are at right angles.
  • Driving – make sure your lower back is properly supported. Correctly positioning your wing mirrors will prevent you from having to twist around. Foot controls should be squarely in front of your feet. If driving long distances, take regular breaks so you can stretch your legs.
  • Sleeping – your mattress should be firm enough to support your body while supporting the weight of your shoulders and buttocks, keeping your spine straight. If your mattress is too soft, place a firm board – ideally 2cm thick – on top of the base of your bed and under the mattress. Support your head with a pillow, but make sure your neck isn’t forced up at a steep angle.

Exercise

Exercise is both an excellent way of preventing back pain and reducing any back pain you might have. However, if you have chronic back pain (back pain that has lasted more than three months), you should consult your GP before starting any exercise programme.

Exercises like walking or swimming strengthen the muscles that support your back without putting any strain on it, or subjecting it to a sudden jolt.

Activities like yoga or pilates can help improve the flexibility and the strength of your back muscles. It is important that you carry out these activities under the guidance of a properly qualified instructor.

There are also a number of simple exercises you can do in your own home to help prevent or relieve back pain:

  • Wall slides – stand with your back against a wall with your feet shoulder-width apart. Slide down into a crouch so your knees are bent to about 90 degrees. Count to five and then slide back up the wall. Repeat five times.
  • Leg raises – lie flat on your back on the floor. Lift each heel in turn just off the floor while keeping your legs straight. Repeat five times.
  • Bottom lifts – lie flat on your back on the floor. Bend your knees so your feet are flat on the floor. Then lift your bottom in the air by tightening your stomach muscles while keeping your back straight. Repeat five times.

At first you should do these exercises once or twice a day, and then gradually increase to doing them six times a day, as your back allows.

These exercises are also useful for ‘warming up’ your back. Many people injure their back when doing everyday chores at home or work, such as lifting, gardening or using a vacuum cleaner. ‘Warming up’ your back before you start these chores can help prevent injury.

Lifting and handling

One of the biggest causes of back injury, especially at work, is lifting or handling objects incorrectly. Learning and following the correct method for lifting and handling objects can help prevent back pain.

  • Think before you lift – can you manage the lift? Are there any handling aids you can use? Where is the load going?
  • Start in a good position – your feet should be apart with one leg slightly forward to maintain balance. When lifting, let your legs take the strain – bend your back, knees and hips slightly but don’t stoop or squat. Tighten your stomach muscles to pull your pelvis in. Don’t straighten your legs before lifting as you may strain your back on the way up.
  • Keep the load close to your waist – keep the load as close to your body for as long as possible with the heaviest end nearest to you.
  • Avoid twisting your back or leaning sideways – especially when your back is bent. Your shoulders should be level and facing in the same direction as your hips. Turning by moving your feet is better than lifting and twisting at the same time.
  • Keep your head up – once your have the load secure, look ahead, not down at the load.
  • Know your limits – there is a big difference between what you can lift and what you can safely lift. If in doubt, get help.
  • Push, don’t pull – if you have to move a heavy object across the floor, it is better to push it rather than pull it.
  • Distribute the weight evenly – if you are carrying shopping bags or luggage, try to distribute the weight evenly on both sides of your body.

Preventing back pain in children

Back pain in secondary-school-age children has been linked to heavy schoolbags and ill-fitting classroom seating. Nearly half of all teenagers in the UK have experienced occasional backache from poor posture, carrying overloaded bags, and an unhealthy lifestyle.

The best schoolbag for your child is a well designed backpack. This should be worn over both shoulders to balance out the weight. A heavy satchel or shoulder bag can put stress on your child’s spine.

Encourage your child to exercise regularly, or plan joint activities, such as a walk in the countryside or a trip to a swimming pool.

References

CKS Guidelines (2008). Lower back pain and /or sciatica

Waddell, G. (2004) The back pain revolution. 2nd edn. London: Churchill

Expert View

Back pain expert Philip Sell on the questions to ask

We asked Philip Sell, consultant orthopaedic and spinal surgeon, what he would want to know if he was suffering from back pain.

What is the cause of my back pain?
In 85% of cases, we’re unable to be precise about why people have back pain. This can be frustrating. It may be more helpful to think about what you can do to make your back better quicker. Research has shown that occupational factors or physical factors only play a small part in back pain. Your genes are probably the most significant factor in back pain.

When should I visit my GP with back pain?
See your GP as soon as possible if the back pain is combined with difficulty in passing urine or numbness between the legs or around the bottom. For people over the age of 55 with new back pain, a previous history of cancer surgery or loss of weight should also be medically checked as soon as possible.

Should I be resting?
You may feel it’s the wrong thing to do, but keep mobile and active. Resting, bed rest in particular, can prolong the duration of an episode of back pain. Most acute episodes of back pain will settle on their own, often within days rather than weeks. Taking pain relief and keeping active will stop stiffness setting in and keep muscles in good condition.

Are there any drugs to help me cope with the pain?
Constant pain can grind you down and make it more difficult to cope. Take a combination of painkillers and anti-inflammatories, such as paracetamol (1g) every six hours and ibuprofen (400mg) every eight hours. Short courses of this type of tablet are very safe, which is why they’re available over the counter. Ask your pharmacist if it’s OK for you to take ibuprofen.

Should I be worried that my back pain will get worse as I get older?
No. Even the most serious cases of back pain usually improve with time. As people age, the discs in the back lose some of their water content and become stiffer and less likely to prolapse or have sciatica.

My friends and family have been giving me advice about how to handle my back pain. I’m confused. What should I do?
Back pain and sciatica are common conditions and everyone seems to have a story. Mixed messages about what to do or what not to do can be confusing and a bit worrying. Use reliable information sources and make sure you’re treated early.

Real Stories

Anne’s story

‘I’ve picked up my life again’

Back pain was agony for Anne Parker, 68, from Berkshire, but thanks to the right diagnosis she’s now walking tall

“My bad back started 12 years ago, with pains in my right buttock. When I saw my GP, he said the problem was actually my back and gave me painkillers. I do orienteering so I tried to move and stretch more, but the pain just got worse. Then I saw an osteopath, who said I should rest.

“One morning, when I was getting up, I rubbed the bad spot on my spine. It triggered a sciatic spasm that left me immobile and screaming in pain. My GP gave me stronger painkillers and anti-inflammatories, which improved things when I was lying down or standing up, but sitting was agony. I still went walking, though. Now it’s recognised that exercise is one of the best things for certain kinds of back pain.

“A year later, I had an X-ray and an MRI scan and discovered I had a lateral stenosis, a build-up of tissue that blocks the spinal canal. The treatment was an injection of steroids into my spine. It took away the constant, gnawing pain. Three months later I was able to go orienteering again.”

Kiran’s story

‘I can continue going about my daily life’

Kiran Mohan, a 42-year old teacher, has suffered from lower back pain for the past seven years

“My back problems started in 1999 when I developed a severe pain in the heel of one of my feet, which gradually progressed to the other foot. It was incredibly painful and badly affected my walking. It was eventually diagnosed as plantar fasciitis, a condition where the heels and surrounding joints become inflamed. This condition means that I walk with a limp, which in turn kicked off my lower back pain.

“Because I’m a teacher, I’m unable to remain seated for most of the day to take the weight off my feet, which can make the problem much worse. My doctor recommended a lower back exercise class, which was a six-week course of relevant exercises. It did help and I found that the exercises gave me some relief. But over the years, I’ve also privately seen an osteopath, had acupuncture and tried Pilates. In addition, because of limping, I’ve had a couple of falls, which have caused whiplash and made my lower back pain much worse.

“In 2002, after trying just about everything, I started to see a chiropractor and since doing so I have seen a significant improvement. Unfortunately, due to my day-to-day life I’m not able to rest as much as I would like and no doubt this affects the rate of my recovery. Chiropractic treatment has certainly improved my quality of life and, with a few treatments along the way, I can continue going about my daily life.

Useful links

NHS Choices links

External links

This article was originally published by NHS choices

Here’s something completely different for low back pain

It’s a question that has challenged generations of patients and their doctors. The answer has changed over the years. When I was in medical school in the early 1980s, bedrest for a week or more was often recommended for severe back pain. This sometimes included hospital admission. Then, research demonstrated that prolonged bedrest was actually a bad idea. It was no better (and often worse) than taking it easy for a day or two followed by slowly increasing activity, including stretching and strengthening the back.

Medications, including pain relievers, non-steroidal anti-inflammatory drugs (NSAIDs), and muscle relaxants were a standard part of the initial treatment of back pain. But, recommendations released in February 2017 urge doctors to change their approach to back pain once again.

Didn’t I hear that NSAIDs don’t work well for back pain?

You did. A 2017 study found that NSAIDs did not work well for back pain. But, recommendations released that same year take that conclusion even further: it may be best to avoid medications altogether — at least at the start.

The American College of Physicians’ 2017  guidelines for the treatment of low back pain based on a review of more than 150 studies. The big news? Medications tend to have only temporary and modest benefits, so it makes sense to try something other than a pill. The specifics depend on the type and duration of back pain.

For new low back pain (lasting less than 12 weeks), try:

  • heat
  • massage
  • acupuncture
  • spinal manipulation, as with chiropractic care.

If these don’t work, NSAIDs or a muscle relaxant are reasonable options. But given their potential to cause side effects and their modest benefit, they aren’t the first choice.

For chronic low back pain (lasting 12 weeks or more), try:

  • exercise (including stretching, improving balance, and strengthening core muscles)
  • physical therapy
  • acupuncture
  • mindfulness-based programs intended to cope with or reduce stress.

Other approaches, such as tai chi, yoga, or progressive relaxation techniques may also be helpful.

If these don’t work, treatment with NSAIDs, tramadol, or duloxetine is worth consideration. However, opioids should be avoided for chronic low back pain in most cases. 

It’s important to emphasize these suggestions are for low back pain that might begin after an unusually strenuous workout or shoveling snow. It’s not for serious causes of back pain such as a major injury, cancer, infection, or fractures (see “red flag” symptoms below).

What if the pain continues?

If pain persists despite these non-medication and medication-based treatments, your doctor may want to consider additional tests (such as MRI) or treatments. Remember, each person’s situation is a little different, and even medications that don’t work well on average, may work well for you.

You could see this coming?

It’s been known for years that the vast majority of low back pain goes away on its own, regardless of treatment. So, the challenge has been to find something that safely eases symptoms while waiting for improvement.

How do I know it’s nothing serious?

You don’t. But, you should be reassured that the numbers are with you. Ninety-nine percent or more of people with low back pain do not have a serious cause. But to help make sure your back isn’t in that small sliver of dangerous causes, doctors use the “red flag” questions:

  • Have you ever been diagnosed with cancer?
  • Have you experienced unexplained or unintentional weight loss?
  • Do you have an abnormal immune system (due to disease or medications)?
  • Do you use intravenous drugs?
  • Have you had a fever recently?
  • Have you had significant injury to your back recently?
  • Have you had bladder or bowel incontinence?

These questions and a physical examination are intended to identify factors that would increase the chances that your back pain is due to infection, tumor, or other serious cause.

So, what?

These guidelines endorse an approach to treating a common ailment that only a few years ago would have seemed outrageous. The remedies recommended are not brand new; but discouraging medication use as an initial step is a big departure from prior recommendations. An email alert I received just after these guidelines were published included the headline: “Take two yoga classes and call me next month?” It may not be such a bad idea!

Medical practice rarely changes right away, and these guidelines may have relatively little impact in the short run. But I would not be surprised if non-pharmacological treatment of back pain becomes the norm over time. Many of my patients already seek out these treatments regardless of whether I recommend them. After all, the “usual” medications for low back pain are not all that effective and often cause trouble. It’s time we recognize that there are other, better ways to help.

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Back pain – Diagnosis and treatment

Diagnosis

Your doctor will examine your back and assess your ability to sit, stand, walk and lift your legs. Your doctor might also ask you to rate your pain on a scale of zero to 10 and talk to you about how well you’re functioning with your pain.

These assessments help determine where the pain comes from, how much you can move before pain forces you to stop and whether you have muscle spasms. They can also help rule out more-serious causes of back pain.

If there is reason to suspect that a specific condition is causing your back pain, your doctor might order one or more tests:

  • X-ray. These images show the alignment of your bones and whether you have arthritis or broken bones. These images alone won’t show problems with your spinal cord, muscles, nerves or disks.
  • MRI or CT scans. These scans generate images that can reveal herniated disks or problems with bones, muscles, tissue, tendons, nerves, ligaments and blood vessels.
  • Blood tests. These can help determine whether you have an infection or other condition that might be causing your pain.
  • Bone scan. In rare cases, your doctor might use a bone scan to look for bone tumors or compression fractures caused by osteoporosis.
  • Nerve studies. Electromyography (EMG) measures the electrical impulses produced by the nerves and the responses of your muscles. This test can confirm nerve compression caused by herniated disks or narrowing of your spinal canal (spinal stenosis).

More Information

Show more related information

Treatment

Most back pain gets better within a month of home treatment. However, everyone is different, and back pain is a complex condition. For many, the pain doesn’t go away for a few months, but only a few have persistent, severe pain.

Over-the-counter pain relievers and the use of heat might be all you need. Bed rest isn’t recommended.

Continue your activities as much as you can tolerate. Try light activity, such as walking and activities of daily living. Stop activity that increases pain, but don’t avoid activity out of fear of pain. If home treatments aren’t working after several weeks, your doctor might suggest stronger medications or other therapies.

Medications

Depending on the type of back pain you have, your doctor might recommend the following:

  • Over-the-counter (OTC) pain relievers. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve), may help relieve back pain. Take these medications only as directed by your doctor. Overuse can cause serious side effects. If OTC pain relievers don’t relieve your pain, your doctor might suggest prescription NSAIDs.
  • Muscle relaxants. If mild to moderate back pain doesn’t improve with OTC pain relievers, your doctor might also prescribe a muscle relaxant. Muscle relaxants can make you dizzy and sleepy.
  • Topical pain relievers. These products deliver pain relieving substances through your skin via creams, salves, ointments or patches.
  • Narcotics. Drugs containing opioids, such as oxycodone or hydrocodone, may be used for a short time with close supervision by your doctor. Opioids don’t work well for chronic pain, so your prescription will usually provide less than a week’s worth of pills.
  • Antidepressants. Some types of antidepressants — particularly duloxetine (Cymbalta) and tricyclic antidepressants, such as amitriptyline — have been shown to relieve chronic back pain independent of their effect on depression.

Physical therapy

A physical therapist can teach you exercises to increase your flexibility, strengthen your back and abdominal muscles, and improve your posture. Regular use of these techniques can help keep pain from returning. Physical therapists will also provide education about how to modify your movements during an episode of back pain to avoid flaring pain symptoms while continuing to be active.

Surgical and other procedures

Procedures used to treat back pain may include:

  • Cortisone injections. If other measures don’t relieve your pain, and if your pain radiates down your leg, your doctor may inject cortisone — a strong anti-inflammatory drug — plus a numbing medication into the space around your spinal cord (epidural space). A cortisone injection helps decrease inflammation around the nerve roots, but the pain relief usually lasts only a month or two.
  • Radiofrequency neurotomy. In this procedure, a fine needle is inserted through your skin so the tip is near the area causing your pain. Radio waves are passed through the needle to damage the nearby nerves, which interferes with the delivery of pain signals to the brain.
  • Implanted nerve stimulators. Devices implanted under your skin can deliver electrical impulses to certain nerves to block pain signals.
  • Surgery. If you have unrelenting pain associated with radiating leg pain or progressive muscle weakness caused by nerve compression, you might benefit from surgery. These procedures are usually reserved for pain related to structural problems, such as narrowing of the spine (spinal stenosis) or a herniated disk, that hasn’t responded to other therapy.

More Information

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Clinical trials


Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.

Alternative medicine

A number of alternative treatments might ease symptoms of back pain. Always discuss the benefits and risks with your doctor before starting a new alternative therapy.

  • Chiropractic care. A chiropractor manipulates your spine to ease your pain.
  • Acupuncture. A practitioner of acupuncture inserts thin sterilized needles into the skin at specific points on the body. A growing body of scientific evidence indicates acupuncture can be helpful in treating back pain.
  • Transcutaneous electrical nerve stimulation (TENS). A battery-powered device placed on the skin delivers electrical impulses to the painful area. Studies have shown mixed results as to TENS’ effectiveness.
  • Massage. If your back pain is caused by tense or overworked muscles, massage might help.
  • Yoga. There are several types of yoga, a broad discipline that involves practicing specific postures or poses, breathing exercises, and relaxation techniques. Yoga can stretch and strengthen muscles and improve posture, although you might need to modify some poses if they aggravate your symptoms.

Preparing for your appointment

If your back pain persists despite home treatment, see your doctor. Here’s some information to help you get ready for your appointment.

What you can do

Make a list of:

  • Key personal information, including mental or emotional stressors in your life
  • Your symptoms, and when they began
  • All medications, vitamins and other supplements you take, including doses
  • Questions to ask your doctor

Take a family member or friend along, if possible, to help you remember the information you receive.

For back pain, questions to ask your doctor include:

  • What is the most likely cause of my back pain?
  • Do I need diagnostic tests?
  • What treatment approach do you recommend?
  • If you’re recommending medications, what are the possible side effects?
  • I have other medical conditions. How can I best manage them together?
  • How long will I need treatment?
  • What self-care measures should I try?
  • What can I do to prevent a recurrence of back pain?

What to expect from your doctor

Your doctor is likely to ask you questions, including:

  • When did your back pain begin?
  • Have you ever injured your back?
  • Is the pain constant?
  • Does the pain affect your ability to function? If so, how much?
  • Do you have other signs or symptoms besides back pain?
  • Do you do heavy physical work?
  • Do you exercise regularly? What types of activities do you do?
  • How often do you feel depressed or anxious?
  • Do you sleep well?
  • What treatments or self-care measures have you tried so far? Has anything helped?


Aug. 21, 2020

90,000 Back pain treatment in the neurological clinic St. Petersburg

Back pain treatment

Back pain is one of the most frequent problems with which a doctor is consulted.

Back pain can be associated with changes in the vertebrae, joints and discs, hardening of muscles, nerve roots, decreased bone density.

Disc protrusion is a violation of the intervertebral disc, in which the disc protrudes into the spinal canal. Many experts consider this condition as a pre-hernial condition.With the progression of disorders – a herniated disc is formed – a “large protrusion” of the disc into the spinal canal.

The formation of protrusion and hernia, back pain is promoted by:

  • work associated with frequent changes in body position (flexion, extension, jerking movements)
  • lifting heavy loads
  • Incorrect posture when standing, sitting or carrying weights
  • prolonged stay in the same position of the body (sitting near the monitor)
  • unfavorable weather conditions (hypothermia)
  • physical education with excessive physical activity
  • overweight

Sometimes back pain can be caused by a number of other reasons for which it is necessary to undergo research and clarify the diagnosis.

If one of the listed signs is present, you need to consult a doctor to clarify the diagnosis:

  • pain worse when lying down
  • increased pain at night
  • increase in pain intensity over time
  • pain occurred due to fever or weight loss
  • with pain there was numbness of the arms, legs, difficulty urinating
  • There is prolonged stiffness in the morning
  • detected changes in blood tests
  • Recent back injuries and previous tumors
  • very severe and prolonged pain

In case of acute back pain, rules of conduct:

  • Create maximum rest, eliminate stress on the spine
  • lie not on a soft or very hard surface, the surface must be semi-rigid
  • pain relievers can be taken with severe pain
  • in case of need for movement (walking, driving) wear a lumbar corset – it stabilizes the spine and reduces pain
  • you can gently do relaxation exercises (twisting, rolling on the back, etc.)etc.)
  • if pain persists for a long time or the symptoms described above appear, be sure to consult a doctor
  • Get out of bed from a prone position

In order for back pain not to bother it is important to move correctly, stand, sit, lift weights.

How to stand and bend correctly:

  • Stand as straight as possible, keep your posture, your head must not hang
  • Limit flexion without support
  • long-term vertical load (standing) requires unavoidable unloading (lying down)
  • strive to perform any industrial and household work with the maximum straightened back, in an upright position
  • Limit the time spent in a forced flexion or extension position

How to sit correctly:

  • Always sit with your back as straight as possible
  • Eliminate the time spent in the forced flexion position while sitting
  • after sitting, change your position every 10-15 minutes
  • get up and walk every hour of sitting, do warm-up

How to properly lift the load:

  • Do not lift large loads (more than 5 kg), especially with jerky movements
  • Do not carry a load in one hand, the weight distribution must be even
  • when lifting, be sure to bend your legs, not your back
  • when lifting, keep the load as close to the body as possible
  • Avoid lifting loads in combination with a sharp turn of the body
  • do not hesitate to ask for help – it is better to help carry the load than to help you walk later

Influence of diseases of the spine on the nervous system – methods of treatment

Rational view of the problem

Unfortunately, at the moment there are no magic drugs that would permanently get rid of problems with the spine.There are also no magic “disc repositions” that “align the back” forever. In the same way, there is no special oil that can be poured into a car engine so that after that the parts of its chassis are updated.

If you are faced with this problem, then you need to understand that your disease is not the result of some one-time negative impact, but arose due to long-term systematic age processes and your internal predisposition.The age of onset of the disease can be very different and sometimes you can face a problem even before thirty years

Fortunately, you can get rid of the problem and keep it under control, and with the right approach, the percentage of positive results is much higher than with most other diseases.

The main principle of treatment is a systematic effect on the back, designed to maximize blood flow along the spine, normalize muscle tone, optimize the supply of nutrients to the muscles of the intervertebral discs and nerve structures.

According to the recommendations of the following organizations: American Academy of Family Physicians, American Academy of Neurology and European Academy of Neurology, the first methods for both acute pain and prevention should be non-drug methods of exposure, which include stretching manipulations on the spine, reflexology, acupuncture, warming and blood flow intensifying procedures, independent exercises for stretching the muscles of the spine [3]. In some cases, chondroprotective therapy is recommended – the introduction into the body of substances necessary to maintain the normal state of the intervertebral disc [4].

Important! Back Self-Exercises should be carefully and individually selected under the guidance of a suitably qualified person. Inappropriate selection of exercises can lead to an aggravation of the problem.

Methods for the treatment of diseases caused by the condition of the spine.

The recommended technique includes a set of five reflexotherapy procedures aimed at improving blood supply along the spine, improving the condition of the intervertebral discs, deep back muscles and nerves.

1.Manual myofascial therapy.

The procedure involves stretching and relaxing problem areas of the back using post-isometric relaxation and reflexotherapy massage techniques, taking into account clinical research and the recommendations of the German Disease Management Guideline [5].

2. Individual acupuncture session.

The scheme of the procedure depends on the location and severity of the problem.Disposable sterile needles made of hypoallergenic steel with a thickness of 0.3 mm are used. The procedure is usually painless and may be accompanied by a feeling of local swelling. The feeling of fullness is caused by the expansion of small vessels and increased blood flow in the affected area, which helps to eliminate trigger points. It is carried out taking into account clinical research and recommendations of the University Postgraduate Education of Principles and Practice of Traditional Chinese Medicine, Medical University of Vienna, Austria.[6]

3. A session of reflexology vacuum massage.

The procedure is performed using sterilized vacuum jars. The procedure is not invasive and does not involve contact with the patient’s blood. Vacuum massage is one of the widely researched and promising methods of pain therapy, it is effectively used even for pain caused by cancer. The principle of the method is to increase the outflow of venous blood, which stimulates the normalization of blood circulation in general, is carried out taking into account clinical studies and recommendations of the Universidade Federal de Minas Gerais, Escola de Enfermagem, Belo Horizonte, MG, Brazil [7].

4. Pharmacopuncture session.

The procedure involves the introduction into the body of drugs that increase blood flow and nutrition of the intervertebral discs and nerves. The drugs are injected using an insulin syringe (the length of the needle is up to a centimeter) into the subcutaneous fatty tissue, where they accumulate and, within a few days, penetrate to the destination (intervertebral disc, nerve). The procedure is usually painless and has no complications. It is carried out according to the standard protocol for carrying out pharmacopuncture methods.

5. At the end of the session, the patient is given recommendations for the independent use of exercises at home, taking into account the characteristics of his body. It is carried out taking into account clinical research and recommendations of the American College of Physicians [3].
Duration of a full session 40-60 min. The recommended course is 3-5-7 procedures, depending on the problem. Frequency of carrying out from one to 3 times a week. Subjective improvement is noticeable after the first procedure.

References
1.Allegri M, Montella S, Salici F, et al. Mechanisms of low back pain: a guide for diagnosis and therapy. F1000Res. 2016; 5: F1000 Faculty Rev-1530. Published 2016 Oct 11. doi: 10.12688 / f1000research.8105.2

2. Petrenko M. & Svyrydova N (2016). Suchasnі aspects of pathogenesis, diagnostics and treatment of back pain. EAST EUROPEAN JOURNAL OF NEUROLOGY. 2016 No. 4 (10) – C. 23-29.

3. Qaseem A, Wilt TJ, McLean RM, Forciea MA; for the Clinical Guidelines Committee of the American College of Physicians.Noninvasive treatments for acute, subacute, and chronic low back pain: a clinical practice guidlines from the American College of Physicians [published online February 14, 2017]. Ann Intern Med. doi: 10.7326 / M16-2367

4. B. Danilov, A & V. Grigorenko, N. (2015). An antinociceptive effect of chondroprotectors: A myth or a reality. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 115.84.10.17116 / jnevro20151159184-89.

5. Chenot JF, Greitemann B, Kladny B, Petzke F, Pfingsten M, Schorr SG.Non-Specific Low Back Pain. Dtsch Arztebl Int. 2017; 114 (51-52): 883-890. doi: 10.3238 / arztebl.2017.0883

6. Lim TK, Ma Y, Berger F, Litscher G. Acupuncture and Neural Mechanism in the Management of Low Back Pain-An Update. Medicines (Basel). 2018; 5 (3): 63. Published 2018 Jun 25. doi: 10.3390 / medicines5030063

7. Moura CC, Chaves ÉCL, Cardoso ACLR, Nogueira DA, Corrêa HP, Chianca TCM. Cupping therapy and chronic back pain: systematic review and meta-analysis. Rev Lat Am Enfermagem.2018; 26: e3094. Published 2018 Nov 14. doi: 10.1590 / 1518-8345.2888.3094

90,000 Spinal pain treatment – prices for back pain treatment in Moscow

Back pain is different. Effective treatment of back pain in Moscow is always a comprehensive work on the causes of pain, taking into account the individual characteristics of the patient. We are focused on accurately identifying the cause of pain, quickly relieving pain syndrome and starting recovery processes.

CAUSES OF BACK PAIN

BIOMECHANICAL CAUSES OF BACK PAIN

Sprains and subluxations of soft tissues surrounding the bone structure, i.e.That is, the vertebra itself is the most numerous group of causes that cause back pain. Lifting weights, unsuccessful turns, aggressive sports, monotonous movements in some professions can provoke such damage. Such damage can cause the development of myofascial syndrome, when the pain becomes chronic. A distinctive feature of myofascial syndrome is the presence of the so-called. trigger points. Myofascial syndrome can be easily confused with fibromyalgia, but if fibromyalgia is characterized by muscle pain throughout the body, then myofascial syndrome has a fairly well-defined localization, and pain is provoked by pressing trigger points.

Degenerative changes in the intervertebral discs – the second largest group of reasons, forcing to look for a center for back treatment in Moscow. If the intervertebral disc loses its elasticity and ceases to function as a “shock absorber” between the articular surfaces of adjacent vertebrae, then conditions are created for traumatizing both the vertebrae themselves and the surrounding tissues.

Herniated disc – an extreme degree of degeneration of the intervertebral disc, when it loses its shape so much that it goes beyond its anatomical zone, displacing and compressing the surrounding structures.The pains arising in this case are distinguished by their special intensity and nature of distribution.

Radicular syndrome – pain syndrome resulting from compression of the nerve root as a result of displacement of the vertebral body or compression of a herniated disc. The most common examples here are the well-known “backache”, when there is a sharp pain in the back – you have to make an appointment with a doctor urgently.

Spondylolisthesis is a painful condition caused by a displacement of the anatomical ratio of the vertebrae relative to each other.Spondylolisthesis can be described differently as “slipping” of the vertebra from its bed, which is accompanied by severe pain and loss of functionality.

Spinal Stenosis is another cause of back pain. The essence of the problem lies in the narrowing of the spinal canal, through which the main nerve fibers and cerebrospinal fluid pass – a special cerebrospinal fluid that we need for life.

Cauda Equina, or translated “horse tail” . It is a formidable cause of back pain and is a medical emergency requiring immediate surgery.The fact is that in some cases a herniated disc, or other reasons, lead to the fact that the disc blocks the entire spinal canal, “blocks” the passage of nerve impulses and causes persistent, sometimes irreversible consequences. This is a reason to urgently go to a clinic in Moscow with back pain.

OTHER CAUSES OF BACK PAIN

In addition to biomechanical causes of back pain, there are others that are much less common. Nevertheless, it is very important not to overlook these reasons, since back treatment in Moscow is necessarily accompanied by work with the underlying disease.

Tumors . As a rule, independent tumors of the vertebrae are quite rare. More often, metastases occur in the vertebral bodies, as the spread of a tumor with primary localization in other organs of the body.

Infections . The cause of the disease is an infection, a microorganism that destroys the bone structure of the vertebra and requires specific treatment. In our century, infections such as osteomyelitis of the spine or tuberculosis of the spine are very rare.

Abdominal aortic aneurysm . A vascular disease that does not affect the vertebra in any way, nevertheless, manifests itself in severe back pain. In terms of its formidable complications, aneurysm is rightfully one of the most dangerous diseases requiring urgent medical intervention. Better – in a good clinic for the treatment of the back.

DIAGNOSTICS OF THE CAUSES OF BACK PAIN

All of the listed causes of back pain are successfully diagnosed by various methods. The idea of ​​the functional relationship of the vertebral bodies, the integrity of their bone structure, homogeneity gives X-ray of the spine.

Its more advanced “version” – CT of the spine. The step of the computed tomograph is so small that it allows you to get slices of the bone structure “layer by layer”.

Soft tissue is best seen on MRI . This study is invaluable in diagnosing a herniated disc.

In some cases, they resort to the introduction of additional contrast into the spinal canal for a clearer separation of the “diseased” tissue from the “healthy”. The study is called myelography .

Ultrasound of the spine is less widespread due to the complexity of imaging, nevertheless, leading experts speak of a great future for this method, the main advantage of which is the absence of radiation exposure.

The nature of the passage of a nerve impulse is studied electromyelography , during which an electrical impulse is supplied and the nature of the response to stimulation is recorded.

In addition to imaging techniques, blood test is highly effective.In addition to the usual tests for inflammation, autoimmune processes and tumor markers, tests for the carriage of genetic markers of certain back diseases have appeared relatively recently.

POSSIBLE COMPLICATIONS

  • Transition of the disease to the chronic stage, pathology
  • Disability
  • Spinal surgery

What to do if your back hurts and nothing helps? – (Clinics Di Center)

The back is a sedentary part of the body.Every day we, without noticing it, reset our back. Heavy bags, improper lifting of large objects, a sedentary lifestyle, uncomfortable mattresses. For the back, gymnastics, rest, leisurely walks, or just lying down and relaxing on a hard surface are useful. It is worth taking care of the back so that it does not work out, as in the well-known joke: a cold, even if it is not treated, goes away in two weeks (with a cold, you also need to be careful and you should go to a therapist to prevent all possible complications).The back can take years to heal and the pain can get worse. Complaints of back pain are treated almost as often as in the case of ARVI. What to do if your back hurts? The main thing is to contact a specialist and undergo an examination. You cannot make a diagnosis on your own or with the help of the Internet. For an accurate diagnosis of what causes pain and in which particular part of the spine, all the achievements of modern medicine are now used, an ultrasound examination using an expert class apparatus (ultrasound) is proposed.A correct diagnosis is the foundation for successful treatment. If you start the disease and do not diagnose it in a timely manner, the consequences can be very serious – surgery and even disability. Despite this, the majority of patients, instead of going to a specialist, look for an answer on the Internet or ask “some kind of ointment” at the pharmacy. What if you already know your diagnosis, take a long time to heal, and the pain persists? Medicine has advanced far ahead, and today medicine can offer modern methods of dealing with pain syndromes caused by diseases of the spine – INTERVENTIONAL TREATMENT OF PAIN SYNDROME.The essence of the method is quite simple, but effective. It consists in selectively affecting the sensory nerves responsible for the onset of pain.
In a specially equipped operating room, under X-ray control, sensory nerves are detected and turned off using various methods. Not the entire nerves are turned off, but only some of their parts, which are responsible for the transmission of pain. The procedure is performed ONCE, the analgesic effect lasts for several years (3 or more).
This direction originated in the last decade of the 20th century thanks to the achievements of space technology, information and nanotechnology.The method is based on a targeted effect on nerve conductors using a series of modulated radio wave impulses that cause a prolonged cessation of pain.
It should be noted that this treatment is not just pain relief. In medicine, there is such a thing as a “vicious circle”. This means that the pain causes a prolonged, persistent spasm of the muscles located near the source of the pain. Muscle spasm increases pressure on the intervertebral discs and joints, impairs blood circulation and tissue nutrition, and this, in turn, accelerates the development of degenerative-dystrophic changes and increases pain.By eliminating pain, we can break this “vicious circle” and create conditions for a speedy recovery.
To resolve the issue of the use of radio wave neurotomy, a preliminary examination is necessary: ​​a complete blood count, ECG, MRI of the affected spine.
You can find out detailed information and sign up for a consultation with the specialists of the Di Medical Center by calling the numbers indicated on our website. 90,000 Japanese professor told how to quickly get rid of lower back pain

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Japanese professor told how to quickly get rid of lower back pain

Japanese professor told how to quickly get rid of lower back pain – RIA Novosti, 04/05/2020

Japanese professor told how to quickly get rid of back pain back pain

Professor of the clinic at the Medical Faculty of the University of Tokyo, Ko Matsudaira, in an interview with Nihon Keizai, called for “elementary gymnastics” for RIA Novosti, 05.04.2020

2020-04-05T09: 35

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MOSCOW, April 5 – RIA Novosti. Ko Matsudaira, a professor at the Tokyo University School of Medicine, in an interview with Nihon Keizai, called for “elementary gymnastics” to reduce back pain. He explained that the lumbar region is usually the most stressed. If you slouch, then a load of 200 kilograms affects the intervertebral disc between the fourth and fifth lumbar regions.If it is incorrect to lift weights or to hunch over while sneezing, then the load on the lower back increases. At this point, the nucleus pulposus is displaced and can damage the annulus fibrosus. It is from them that the intervertebral disc consists, which plays the role of a shock absorber. Matsudaira explained that he calls the load on the intervertebral disc between the fourth and fifth sections “back pain debt.” This can lead to displacement or herniation of the intervertebral disc. To prevent such problems, you need to do “elementary gymnastics”.To do this, you need to stand up and put your feet parallel to each other a little wider than your shoulders and relax. Then you need to put your hands slightly above the buttocks and bend back as you exhale. This position should be fixed for three seconds, and then return to the starting position. The professor noted that for prevention, such an exercise should be done once or twice a day, and for treatment – at least ten. He also explained that when the lower back flexes, discomfort or pain may appear. If it passes within ten seconds after returning to its original position, then you should not worry.If it does not pass, then this means that you have bent too much, therefore it is necessary to reduce the angle of deflection. for women who wear high-heeled shoes, the lower back sags in the other direction – this can also lead to “accumulation” of debt. In this case, Matsudaira advises to sit on a chair and do the exercises, bending forward.Read the full text of the article on the Inosmi website & gt; & gt;

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in the world, Japan, Tokyo University, health – society, pain

MOSCOW, April 5 – RIA Novosti. Ko Matsudaira, professor at the clinic at the University of Tokyo Medical Faculty, in an interview with Nihon Keizai, called for “elementary gymnastics” to reduce back pain.

He explained that the lumbar region is usually the most stressed. If you slouch, then a load of 200 kilograms affects the intervertebral disc between the fourth and fifth lumbar regions.

If it is incorrect to lift weights or to hunch over while sneezing, the load on the lower back increases.At this point, the nucleus pulposus is displaced and can damage the annulus fibrosus. It is of them that the intervertebral disc consists, which plays the role of a shock absorber.

Matsudaira explained that he calls the stress on the intervertebral disc between the fourth and fifth divisions “back pain debt.” This can lead to displacement or herniation of the intervertebral disc. To prevent such problems, you need to do “elementary gymnastics”.

October 5, 2019, 10:16 am

The doctor told how to reduce pressure without medication

To do this, you need to stand up and put your feet parallel to each other a little wider than your shoulders and relax.Then you need to put your hands slightly above the buttocks and bend back as you exhale. This position should be fixed for three seconds, and then return to the starting position. The professor noted that for prevention, such an exercise should be done once or twice a day, and for treatment – at least ten.

He also explained that when the lower back flexes, discomfort or pain may appear. If it passes within ten seconds after returning to its original position, then you should not worry.

If it does not pass, then it means that you have bent too much, therefore it is necessary to reduce the deflection angle.

March 24, 2020, 08:00 AM What will happen to your back and waist if you regularly do the bar

If during the exercise numbness appears in the hips and calves, then you need to finish the exercise and consult an orthopedist.

In standing workers, as well as pregnant women and women who wear high-heeled shoes, the lower back flexes to the other side – this can also lead to “accumulation” of debt.In this case, Matsudaira advises to sit on a chair and do the exercises, bending forward.

Read the full text of the article on the InoSMI website >>

February 29, 2020, 02:35

The somnologist told how to get rid of insomnia without pills 90,000 Back pain after sleep and how to get rid of them.

For 80% of the world’s population, morning begins not with coffee, but with an aching lower back and a “stone” neck. The good news is that in most cases it is not dangerous, the body copes well with such “problems”.Of course, if the pains have become chronic, accompanied by unpleasant symptoms and interfere with life, then it’s time to visit a doctor. We decided to investigate the non-medical causes of back pain after sleep and figure out how to get rid of them.

Pictured is a multi-zone mattress
Blue Sleep Concept from a combination of foams with anatomical back support

Sleeping position. We have already written about the best and worst body positions during sleep, we repeat: do not sleep on your stomach.But even those people who lie on their backs at night sometimes experience body aches in the morning. If this happens, try placing a pillow under your knees while you sleep. This will keep your body in the most natural position possible. The pillow will also help if you are unable to give up sleeping on your stomach: either place it under the pelvis or remove it from under your head. The result of this action is the same – the maximum physiological curvature of the spine is preserved. And those who prefer to lie down on the barrel will also need an extra pillow – place it between your knees.

Old mattress. And we have already spoken on this topic more than once, but it will not hurt to consolidate the knowledge: the mattress should not be older than 9-10 years. Even if the bed is relatively “new”, carry out regular revisions, check if the bed has sagged, there are no dents and lumps on the surface. A mattress that shows your body print needs to be replaced, regardless of its lifespan!

Incorrect position of the neck during sleep. Whatever position you sleep in, your neck should not “wring”.Make sure that it maintains the correct physiological bend. Lie on your back – place not only your head but also your shoulders on the pillow, so your neck will not “sag”. When lying on your side, try not to throw your head back and not bury your chin in your chest. Sleep on my stomach, we think, is not worth mentioning. A position that is not comfortable for the neck can cause swelling, headaches and migraines. Be careful!

Slouching habit. The connection between long vigils in front of a computer screen and a “broken” back in the morning is not always obvious, but remember in what position you usually sit in front of the screen (and take your hand away from your face).Surely, most of you periodically slouch and lean closer to the display. According to research by American scientists, such a “twisted” position increases the pressure on the spine three to four times compared to the usual, straight body position. Plus, 30% less oxygen enters the bloodstream. In the evening, you may feel tired in the back, and in the morning it is already full-fledged pain. The way out is physical activity. Doctors advise not to wait until the pain is completely gone, but to start moving as early as possible.Of course, you need to choose exercises that will be within your power and will not harm you. It is better to select them together with a doctor or professional trainer.

Diseases of the spine: types | symptoms

07/29/2021

Diseases of the spine

According to statistics, about 80% of people experience back pain at least once in their life. Most of them are not associated with diseases of the spine, but are the result of muscle spasms and overexertion.In this case, no treatment is required, and the pain subsides on its own.
But this happens in 8-9 patients out of 10. And what if the spine hurts, the rest? And how do you know if the problem is really serious and your body needs help? To answer these questions, you need to know the main symptoms of spinal diseases.

Loins – zone of special risk

A healthy spine has a curved shape: it does not have to be absolutely straight, as many are sure. The physiological bends in the neck and lower back are especially noticeable – it is these areas that are especially vulnerable due to their mobility.The thoracic region is firmly fixed by the ribs, therefore it is much less likely to undergo dystrophic changes.
Osteochondrosis, hernias and other pathologies most often develop in the lower back, since this section is the most loaded – it accounts for the mass of the entire upper body. The risk of various injuries increases with congenital and acquired deformities, injuries, and excess weight.

Bechterew’s disease (ankylosing spondylitis)

This is a systemic inflammatory disease that affects all spinal structures.The inflammation begins in the sacroiliac joints, then spreads higher, developing in an ascending line.
Over time, calcium deposits appear in the ligaments, which entails a decrease in mobility and flexibility. Without treatment, ankylosing spondylitis progresses, and gradually the vertebrae grow together: ankylosis occurs.
The first symptoms are dull pain and stiffness in the lower back, which intensifies in the morning and decreases after physical activity, a hot shower.During the day, the pain syndrome is stronger at rest, when a person moves, he subsides. In the later stages, posture deteriorates markedly.

Loins – zone of special risk

This is the initial stage of intervertebral hernia, which does not always manifest itself clinically. The protrusion itself is not dangerous and is often found on MRI or CT examination.
In older people, disc protrusion may be a normal option, since degenerative processes in the spinal column are inevitable with age.Symptoms directly depend on the location of the damaged disc.

Facet joint syndrome

These are the joints that hold the vertebrae together and provide stability and mobility of the spine. The cause of pathological changes in them may be insufficient physical activity, trauma and surgery.
The main symptom is pain, especially when standing and walking for a long time. There is a pronounced stiffness of movements in the affected section, it is difficult for a person to throw the body back or turn sideways.Sometimes the bending of the body forward also causes difficulties.

Stenosis

Stenosis is a narrowing of the spinal canal, diagnosed by doctors mainly in the last stages of osteochondrosis. This condition is also congenital, often develops after back injuries, with ankylosing spondylitis.

Symptoms:

  • Pain in the back and limbs;
  • weakness in one or both legs;
  • lameness.

Herniated disc

Hernial protrusion is caused by the destruction of the fibrous ring of the disc, which, under the weight of the overlying vertebrae, flattens and goes beyond its anatomical boundaries.Hernias are detected during examination for osteochondrosis and are its complication.
Hernias, like protrusions, often develop asymptomatically and may not appear in any way. Otherwise, patients complain of blunt soreness at the site of the hernia. It grows when walking and standing, and disappears after resting in a prone position.
If the nerve root is clamped next to the disc, the pain is difficult to endure, since it resembles an electric shock and is sharply shooting, piercing in nature.In the area of ​​innervation of the pinched nerve, numbness and muscle weakness are possible.

Radiculopathy (radicular syndrome)

The compression of the nerve root described above can be provoked not only by a hernia. Pinching is the immediate cause of back pain caused by:

  • spondylosis;
  • ankylosing spondylitis;
  • trauma;
  • neoplasm;
  • syphilis, tuberculosis, meningitis, osteomyelitis (inflammatory nerve damage).

Nerve injury causes burning, stabbing pain. In the affected area, it bakes strongly and shoots, as if it had been struck by lightning.

Cauda equina syndrome

The cauda equina is a massive bundle of nerves at the bottom of the spinal cord. Its origin is located near the 1st lumbar vertebra. The nerves in this plexus innervate the pelvis and legs.
The clinic of the syndrome is very severe and includes numbness of the legs up to complete paralysis, loss of control over stool.Therefore, it is urgent to provide assistance to the patient. In most cases, surgery is the only treatment.

Scoliosis

A slight curvature of the spine occurs without pronounced symptoms and is detected on a routine examination. Stage 3-4 scoliosis is manifested not only by visible asymmetry, but also by pulling constant back pain, lameness. Due to a decrease in the volume of the chest, the lungs work worse, the respiratory process is disrupted.

Hyperkyphosis

The mid-back curve is a natural curve called kyphosis.It can increase under the influence of external and internal factors, and then they talk about hyperkyphosis – a pathological state of the body.
Hyperkyphosis is manifested by soreness, which takes on a particularly intense character with a curvature of more than 50 °. Symptoms may include numbness of the limbs, dysfunction of internal organs due to skeletal deformation.

When to see a doctor

  • if, after a fall or injury, the pain returns all the time;
  • painful sensations become obsessive and persist even when lying down;
  • back hurts for a long period – more than a month;
  • relief does not come after taking medications, there is no effect from cold compresses and other home remedies;
  • Feel weakness, tingling, decreased or loss of sensation in the hands or feet.

Tips for maintaining spine health

To avoid problems with the “axis of life”, therapists and neurologists advise you to strengthen it with the help of:

  • regular and dosed physical activity. A strong muscular corset reduces the load on the spine – you can get the right “dose” even with daily walking;
  • correct organization of the workplace. When sedentary work, get up and do a warm-up every half hour or hour;
  • weight control, which increases pressure on the vertebrae and discs, and they wear out faster.

Did your back hurt? Take care of yourself and exclude heavy loads, rest more.
For back pain, you can contact our specialists. They know very well what diseases of the spine are, and are familiar with the latest medical techniques.
Here you can improve your health under the guidance of an experienced doctor who will make all the necessary appointments. At the end of therapy, he will recommend how to eat and what kind of exercise will be beneficial for you.