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Premkumar et al present evidence that the traditional “red flags” for ominous causes of back pain can be quite misleading. The correlation between red flags and ominous diagnoses is poor, and prone to producing false negatives: that is, no red flags even when there is something more serious than unexplained pain going on. In a survey of almost 10,000 patients “the absence of red flag responses did not meaningfully decrease the likelihood of a red flag diagnosis.“ This is not even remotely a surprise to anyone who paid attention in back pain school, but it’s good to have some harder data on it.
Even though it seems like your legs are moving forward and backward when you’re running, in reality, the femur (your thigh bone) both rotates and tilts in the hip socket, Kalika explains. It’s the hip adductors—most notably the gluteus medius—that keeps the femur sitting in the socket as designed. (The hip adductors are the muscles that move your legs inward.) Any weaknesses make the joint unstable, and can contribute to poor running mechanics, hip drop (when the pelvis drops to one side), too-narrow stances, and aggravated tissues throughout the entire body, Sauer says.
With lumbar stenosis nerves in the spinal cord and lower back become compressed. This type of injury can cause many of the symptoms of sciatica—including numbness and tingling in the legs and pain in the buttocks. Possible treatments include a sciatic nerve block, steroid injections, opioid pain medications, physical therapy, and rest. However, the use of epidural steroid injections is not supported by limited amount of available evidence.
Back pain can suck the joy out of your days for week, months, even years. It can definitely be “serious” even when it’s not dangerous. I have worked with many truly miserable chronic low back pain patients, and of course the huge economic costs of back pain are cited practically anywhere the subject comes up. But your typical case of chronic low back pain, as nasty as it can be, has never killed anyone.
Arthritis is a common cause of radiating lower back pain. Symptoms include back pain that fluctuates, coming and going throughout the day and night and numbness in the neck area, as well as stiffness and lack of mobility. Recommended treatment for arthritis of the back includes heat, ice, rest, exercising and stretches, and over the counter anti-inflammatories. In severe cases, patients seek surgery but sometimes, surgery does more harm than good.
Example: a friend of mine went to the hospital after a motorcycle accident. He’d flown over a car and landed hard on his head. Bizarrely, he was sent home with very little care, and no imaging of his back, even though he was complaining of severe lower back pain. A doctor reassured him that it was just muscle spasms. (This all happened at a hospital that was notorious for being over-crowded and poorly run.) The next day, still in agony, he went to see a doctor at a walk-in clinic, who immediately took him for an x-ray… which identified a serious lumbar fracture and imminent danger of paralysis. He had been lucky to get through the night without disaster! He was placed on a spine board immediately and sent for surgery. The moral of the story? Sometimes, when you’ve had a major trauma and your back really hurts, it’s because your back is broken. BACK TO TEXT
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Approximately 15 degrees of hip extension is required to walk normally. If hip flexors are tight then in order to walk, compensatory movement needs to take place through the lower back causing back pain and premature disc degeneration. Like other joints, if we fail to take them through their full range on a regular basis we eventually lose mobility.
This restorative pose will stretch your shins, knees, hips, spine, and arms. Start with your hands and knees on the mat. Point your toes behind you, allowing your big toes to touch, and spread your knees slightly wider than your hips. Keeping your back flat, sit back on your heels and lower your torso between the legs as you reach as far forward as you can with your arms. Keep your elbows elevated, and rest your forehead on your mat if you can. Take 10-15 breaths, and then release.
In the vast majority of patients with low back pain, symptoms can be attributed to nonspecific mechanical factors. However, in a much smaller percentage of patients, the cause of back pain may be something more serious, such as cancer, cauda equina syndrome, spinal infection, spinal compression fractures, spinal stress fractures, ankylosing spondylitis, or aneurysm.
The irritation of the sciatic nerve causes hip and lower back pain, which spreads downwards to the limbs and feet. It is estimated that 4 out of 10 people will develop sciatica or irritation of this nerve at some point in life. The sciatic nerve is located deep in the buttock, beneath the piriformis muscle, so its constriction and swelling can also cause sciatica pain and irritations.
The iliotibial band is a thickening of the fascia lata, the deep fascia of the thigh. Think of it as a thick long ligament like structure that connects the hip to the lower leg along the outside of the thigh. Tightness in the iliotibial band can cause patellofemoral pain, trochanteric bursitis, and friction syndromes at the knee. This is a hip stretch I commonly prescribe to runners and people suffering from knee pain.
Work on strengthening all of your core muscles and glutes. These muscles work together to give you balance and stability and to help you move through the activities involved in daily living, as well as exercise and sports. When one set of these muscles is weak or tight, it can cause injury or pain in another, so make sure you pay equal attention to all of them.