Low-Back Strains Are Common
But Can Be Prevented, Treated

by Darline Turner Lee, Physician Assistant, ACSM Exercise Specialist

Article Last Reviewed: Sept. 9, 2006

It was 4:45 on Friday afternoon. I had one last patient to see and then I was free for the weekend. Approaching the exam room, I thought, “I’ll see this person, do a quick assessment and plan, and be gone.” That was until I read the chief complaint on the chart-low back pain. My heart sank. I thought, “Why the heck would anyone wait until 4:45 on a Friday afternoon to come in with back pain?” Although I hoped to finish quickly, experience told me that I was headed into overtime.

The patient was a young guy who had hurt his back while helping some friends move-the previous weekend. “I just can’t take it anymore.” he said. “I have to have relief. I can’t imagine going through the weekend like this.”

This was his first experience with back pain. He had tried a heating pad and Advil without relief. He denied having any shooting pains into his legs or numbness or tingling in his legs or feet. He could walk, albeit gingerly, but sitting for any length of time and most movements caused him pain.

His back appeared normal, but he was exquisitely tender over his lower back. His lower back muscles were locked in spasm and warm to the touch. He could move his arms and lower legs freely, but even a miniscule movement of his lower back, hips or thighs made him wince.

This gentleman had classic lower back strain. While helping his friends move, he had lifted a heavy box and hoisted it onto the moving truck by himself. The combination of the weight of the box, its awkward size, and the twisting motion of tossing the box onto the truck had exceeded the abilities of his lower back muscles and they were protesting--in the form of pain.

I prescribed a muscle relaxant and anti-inflammatory medications for the pain. I also instructed him to put ice packs, not heat, on his back every two hours for fifteen to twenty minutes each time over the next couple of days. I gave him an instruction sheet with stretching exercises to do two to three times daily to begin gently stretching his back muscles and improving his range of motion, and an information sheet on proper lifting techniques. I saw him the following week and he was much improved. By the final visit four weeks later, he was pain-free and almost back to his full activity level.

Low back pain is one of the most common complaints for which adults visit a physician and accounts for five percent of all visits to primary care providers. Statistics show that eighty percent of adults will experience at least one episode of low back pain in their lifetime and many will have recurrent episodes throughout their lives. In the absence of any major trauma, injury or illness, low back pain is usually the result of muscle strain caused by over exertion or poor body mechanics while moving or lifting.

There are many ways to get relief and even prevent low back strain. As a clinician, I prescribed medications. But other treatments offer nearly instant relief and, done regularly, can help prevent low back pain. Below is a summary of the treatments.

Massage - Massage therapists stroke and rub muscles and soft tissues releasing the “grip” of muscle and connective tissue spasms that cause pain. As a result, the volume of oxygen and blood flowing through the area is increased, taking away injured cells while bringing in substances needed to repair the damage.

Acupuncture – This restores balance between the yin and yang (positive and negative) chi (energy) of the body. The acupuncture needles are placed at acupoints on the body that correspond to areas of disease and illness along the twelve different energy pathways (meridians). The needles release the blocked pathways that cause illness or disease and thus restore energy flow and health.

Chiropractic Manipulations -When the vertebrae of the spine are not in alignment, they compress nerves causing pain and muscle contractions (spasms). Chiropractors manipulate the spine and realigned the vertebrae. That relieves nerve compression and stops the erratic nerve firings that caused the muscles to contract. Regular chiropractic manipulations help prevent injury from occurring by keeping the vertebrae aligned so everything moves freely.

Physical Therapy – This helps regain movement in areas that are “locked up”. During trauma or injury, in an attempt to protect the body and hold it together, muscles contract and go into spasm. After the initial assault, if muscles don’t relax, the continued contraction causes pain and the inability to move that area of the body. Physical therapy uses treatments such as ultrasound, whirlpools, and light massage to relax the muscles and soft tissues. The patient is also guided through exercises designed to increase movement, build strength in the injured area and restore function.

Regular Exercise - A toned body functions more efficiently and can do more with less effort. A person who exercises regularly has increased endurance, muscle strength, balance, flexibility and quicker responses to changes in the environment. They’re less likely to be overweight and are better able to handle stress. Exercises that promote strong, healthy backs are yoga, weight training, core training and Pilates.