Acute and chronic lower back pain

Lower back pain can feel very different depending on the kind. It can range in intensity, be constant or sudden, be sharp, shooting, dull, burning, etc. So first of all, let’s differentiate between acute and chronic back pain. Acute back pain is short-term: it lasts from a few days to a few weeks, but the inflammatory phases normally last between 3 and 7 days. Most people who experience acute back pain tend to take care of it at home, and it resolves on its own.

However, if untreated it can lag to return to normal and/or create collateral damage, consequently turning into chronic back pain. Pain is considered chronic after 12 weeks of prolonged pain and can last for much longer. Roughly 20% of people with acute lower back pain develop chronic lower back pain. But other disorders can also create chronic pain. Chronic lower back pain does need special attention, and typically can be treated.

Muscle and lumbar strain

What it is: Lower Back Muscle Strain happens when a muscle fiber is overstretched or overused causing the muscle to begin to tear. A lumbar strain is when the ligaments of the lumbar region are overstretched or torn. Both result in inflammation and similar pain.

How it feels: The pain will most likely feel dull, achy and sore. When a muscle is inflamed it may feel tender to the touch, cramp, spasm, and contract. Pain is at its most intense in the first few hours or days, but stiffness and tenderness can continue on for 1 to 2 weeks. Certain movements can aggravate the pain.

Most of the time, this is a minor injury that can take 4 to 6 weeks to completely resolve, but in most serious cases where the muscle tears completely, for example, recovery can take months. Click here for more information.

Herniated/slipped disc

What it is: As mentioned above, each disc has a soft inner portion, and a tough outer ring. When the inner portion of the disc protrudes through and tears the outer ring, it is called a herniated, or slipped, disc. This can be due to your disc degeneration with age, wear and tear, and inactivity.

How it feels: While sometimes asymptomatic, a herniated disc can create pain, especially if it is compressing a nerve. You might feel numbness, tingling or weakness in your buttocks and legs

Herniated discs sometimes require surgery, and can cause complications. Click here for more information.

Sciatica

What it is: Sciatica is when part of your sciatic nerve is compressed, it can be due to a herniated disk, a bone spurs on a vertebra, spinal stenosis or other, causing inflammation and pain.  

How it feels: Pain associated with sciatica normally radiates from your lower back to your buttocks and down the back of one leg. Usually affecting only one side. The intensity of the pain can vary from mild to sharp, intense pain. It sometimes results in a feeling resembling an electric shock, numbness, tingling and muscle weakness in the leg or foot. Coughing, sneezing, and prolonged sitting can aggravate the pain.

While sciatica can cause complications, it mostly resolves on its own or with non-operative treatments in a few weeks. Click here for more information.

Lumbar stenosis

What it is: Lumbar stenosis is when the spaces within your lumbar spine, the spinal canal, narrows, which can put pressure on the nerves that go through them, most commonly due to wear and tear.

How it feels: This can lead to back pain, numbness, tingling and weaknesses in your legs or feet. Walking can make your calves cramp, and your pain may improve when bending forward, sitting or lying down.

There are many treatments for spinal stenosis, including anti-inflammatory medications, physical therapy and surgery. Click here for more information.

Stress

We know by now that stress causes physical damage to your body, and this could apply to your back pain as well. While still controversial, the late Dr. John Sarno put forward a theory that your back pain might be related to what he calls Tension Myositis Syndrome: a condition of musculoskeletal and nerve symptoms. He believed that your anxiety, stress, repressed anger and other psychological factors could cause back pain. In his bestselling book Healing Back Pain: The Mind-Body Connection, Dr Sarno outlines ways to get rid of TMS related back pain without drugs, physical therapy and surgery, and as quickly as 2 to 6 weeks. If you are struggling with lower back pain and haven’t found a source, or are struggling to find relief, consider looking into Dr. Sarno’s theory, as many swear his technique cured their long-standing back problems.

Short-term relief

There are 3 main things you can do when facing acute lower back pain:

• • Over-the-counter medications: for rapid relief you can take analgesics (aspirin, acetaminophen), non-steroidal anti-inflammatory drugs or NSAIDs (ibuprofen, naproxen), muscle relaxants, or topical pain relief (capsaicin, lidocaine)
  • Ice and heat: While using ice is controversial, most people agree that icing the painful area reduces inflammation and pain. You should use ice during the first 48 to 72 hours of the acute period, then switch to using heat.
  • Stop your normal activities only for a few days and gently stretch (do check with a health professional before stretching). Bed rest, however, is not advised for people with lower back pain.

Ergonomic furniture

Setting up an office with ergonomically designed furniture will change not only your relationship with work, but your overall quality of life. We spend so much time sitting at our desks, it is no wonder that ill-fitted office furniture contributes so strongly to the biggest work-related in-office pain complaint: lower back pain. We’ve compiled for you what we believe to be the foundation of an ergonomic office:

• • Sit-stand desk: If you are thinking of investing in a quality desk, consider buying a standing desk. Their height is adjustable, making sure it adapts to your particular height and allowing you to easily alternate between standing and sitting throughout the day. Movement will help rehydrate your discs and increase blood flow preventing back pain with the bonus of keeping you alert. If you already have a desk, here are some quick fixes to make it more ergonomic.
  • Ergonomic chair: Even if you have a standing desk, you will still spend half of your workday sitting in your chair, so it is crucial that you invest in a good one. An ergonomic chair supports the curve of your lumbar spine, while normal chairs tend to flatten that curve, directly leading to lower back pain. There is a lot to consider when buying an ergonomic chair, so here’s a guide to help you choose the right one, and to convince you it’s worth it! In the meantime, you can always adjust the one you have at home with these tips.
  • Monitor adjustment accessory: Protecting your eyes, head, and neck is the next thing to consider, because a neutral cervical spine is vital to your overall spine health. For the most neutral spine position, think about getting a monitor stand, desk shelf, or monitor arm. You also might want to get an independent keyboard, an ergonomic mouse, and an auxiliary screen for additional comfort. If you are working on a laptop, take a look at these tips, and consider using a laptop stand. These items will not only prevent pain due to bad posture, but also clear space on your desk. Also, consider your main light source, and make sure you are about a meter and a half away and perpendicular to a source of natural light (or any bright light source). 

We cannot stress the importance of having the proper equipment to work in your journey to get rid of, or prevent, lower back pain. Even if your lower back injury happened outside of work, working on ill-fitted unergonomic furniture creates weaknesses and imbalances that put you at higher risk of developing acute and chronic lower back pain.

Move!

Your body needs to move every 20-30 minutes. This allows your disc to regain the proper amount of fluid to stay healthy, and it increases blood flow throughout your body. A technique we rely on at ergonofis is the Pomodoro technique, which reminds you every 25 minutes to take a small break and move. This could mean switching between standing and sitting at your standing desk. Walking to get water, going for a stroll around the block, or heading over to your coworker’s desk when you need a question answered. You might also want to incorporate a few quick exercises to your work routine like these, or the yoga exercises proposed below.

Why Yoga is a great way to prevent and treat back pain

Yoga takes on a holistic approach maintaining health in the body and mind. Many Yoga poses and exercises stretch and strengthen the body in a way that can treat and prevent issues such as back pain.

Common back pain associated with sitting at a desk for long periods of time is likely a result of three factors: poor posture, tight muscles, and weak muscles. Yoga poses can be easily adapted in a modern context to balance out these factors. The greatest part is that your desk actually works as the ultimate Yoga prop – not only can you do a range of stretches at your desk, but your desk can help you stretch more effectively!

Likely culprits of back are tight hamstrings, shortened and weak hip flexors, tight abdominal muscles and weak back muscles, rounded shoulders, and an inflexible spine. The good news is that Yoga can help you address these problem areas and bring greater health and integrity into your body.

Pose/Stretch descriptions

Below are the descriptions for each of the Yoga inspired stretches/exercises that relate to corresponding photos and videos. All the information you need is there: when to do the stretches/exercises, how to do them, what they are addressing, and why they are beneficial.

Please note that the English names as well as the Yoga Sanskrit names are written. In Yoga, most of the classical poses have a Sanskrit name and an English translation – eg. Parsvottanasana translates to Pyramid Pose (“Asana” means “Pose” or “Posture”).

Yoga poses and stretches

Physiotherapy

Physiotherapists are strong allies in the prevention and rehabilitation of work-related injuries. They aim to promote the health and well-being of their patients by studying how their bodies move, making sure there are no imbalances or weaknesses that could create injuries or make them worse. They do this by using a combination of manual practices and exercises that you can do on your own. Naturally, this applies to how your spine works and the development of lower back pain.

Dominic Baillargeon, founder of Nxt Generation Physio, believes getting educated about how your body moves is crucial in preventing and repairing damages, and a physiotherapist can assist you with that.

He advises consulting a physiotherapist from one to four times a year as they can help you relieve pain, prevent future injuries and even assist you in making sure your office furniture is adapted to your body and how you move.

Acupuncture

Seeking pain relief is mostly why people consult acupuncturists. Acupuncture is said to unblock and move the body’s energy, known as Qi, through the body’s different systems, like the nervous, muscular, respiratory, digestive and circulatory system.

More practically, the method used in acupuncture of placing a number of needles on different acupuncture points on your body stimulates the nervous system. Consequently, releasing neurochemicals in your muscles, spinal cord and brain, and in turn releasing other chemicals and hormones that help regulate your system, relieve pain and promote physical and emotional well-being.

While acupuncture can get you relief from pain, it might not get to the cause of the pain, and will probably require follow-up visits.

Osteopathy

Osteopaths look at your body as a whole, they put importance on the relationship between the structure and the function of the human body, and its ability to self-heal and self-regulate. They focus mainly on manual techniques aimed to facilitate healing in your body.

Osteopaths see a lot of patients looking to treat or prevent lower back pain. Manipulations are often gentle and subtle, and involve stretching, massaging and moving muscles and soft tissues. They will give advice regarding posture, breathing, stress reduction as well as lifting techniques and stretching exercises.

Massage therapy

Massage therapist can also help relieve lower back pain, especially if your pain is muscular. Whether it's a strain, sprain or just a lot of accumulated tension in your back muscles, you can turn to massage therapy for help. Massages improve blood circulation, relax muscles and even increase your endorphin levels.

A study on massage and back pain done by the University of Miami has shown that massages lessened lower back pain, as well as depression, anxiety. It was shown to increase the levels of serotonin and dopamine while also improving the range of motion.

Lifestyle changes

• • Exercise and stretch regularly to strengthen your core and back muscles, and to promote flexibility.
  • Maintain a healthy weight and a nutritious diet with a sufficient intake of vitamins and minerals.
  • Work on your posture and body imbalances, consult a professional if need be.
  • Remember to move when spending a lot of time immobilized, like at work or watching TV.
  • Reduce stress in your daily life
  • If you smoke, stop!

Get equipped

• • Create an ergonomic design office space.
  • Invest in a supportive bed.
  • Wear appropriate shoes.

Protect your back during your everyday activities

• • Learn to lift heavy objects correctly.
  • Reduce everyday stresses on your lower back by dissipating activities that put a strain on your back like vacuuming, gardening or shovelling snow, and allow your back to rest after prolonged bending.
  • Be mindful that your discs are at a higher risk of injury when you wake up in the morning, so wait an hour or two upon waking before putting stress on your lower back.