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UNDERSTANDING BACK PAIN

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February 21, 2022 Posted By Maria Reese, MD

BODY

Almost everyone will experience low back pain. The good news is that whether
your back pain is mild or severe, short-lived or long-lasting, intermittent or
constant, most cases will improve within a few weeks. (That doesn't make the
experience any less challenging, however.)

To understand what causes back pain, it's important to first understand how the
spine works. 

 * The building blocks of the spine are vertebral bones, or vertebrae, stacked
   upon each other. 

 * Between these bones are intervertebral disks made of flexible, gelatinous
   material that provides cushioning and allows for movement. 

 * Muscles and ligaments stabilize the bones and disks.

 * The spinal cord and spinal nerves are located inside the spine and allow for
   communication between the brain and body. 

 * The lower end of the spine is called the sacrum. It meets the pelvis at the
   sacroiliac joint.


Now that you have a basic understanding of the components of your spine, here
are five common causes of low back pain:

 1. Strain/sprain. Muscles and ligaments can overstretch with activity, like
    shoveling snow, or returning to activity (i.e., dancing or golfing) after
    some time off. This resulting stiffness and soreness usually resolves within
    a few days.

 2. Disk injury. The disks of the spine are like jelly donuts—crusty fiber on
    the outside ("annulus fibrosus") and gelatinous material on the inside
    ("nucleus pulposus"). Common injuries to disks include a small tear to the
    annulus, the nucleus pushing ("herniating") into the annulus, or a herniated
    disk irritating a spinal nerve. This condition causes pain that radiates
    into the leg (“sciatica”). Disk-related pain often worsens with bending,
    twisting, or sitting and improves with standing or lying down.

 3. Disk aging and degeneration. The normal process of aging causes the disks of
    the spine to wear away, which causes added pressure and stress on the
    smaller joints of the spine ("facet joints"). The wear and tear on the disks
    and facet joints can cause osteoarthritis, leading to pain or stiffness.
    Prolonged sitting or standing can aggravate this pain, and movement can
    alleviate it.

 4. Spinal stenosis. This condition involves narrowing of the space around the
    spinal cord and spinal nerves. With osteoarthritis of the spine, bone spurs
    develop and contribute to this narrowing, causing back, buttock, and leg
    pain or fatigue. This pain, which stereotypically affects older patients, is
    usually worse while standing and walking and better while sitting and
    leaning forward.

 5. Sacroiliac (SI) joint pain. Too much or too little movement in the joint can
    cause SI joint pain. The pain is characteristically unilateral low back and
    buttock pain that may radiate into the leg. Women, especially those who are
    pregnant and post-partum, are most susceptible. This pain is typically worse
    with transitional movements, such as rolling over in bed or getting into or
    out of a car.  


No matter which of these conditions is causing your low back pain, treatment
options are similar: ice, moist heat, and over-the-counter medications such as
acetaminophen, non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and
naproxen, and topical pain relievers like lidocaine.

But, to truly prevent or minimize low back pain, good posture and optimal
ergonomics are important—when sitting, standing, lifting, and even walking.
Physical therapy can help by alleviating pain, restoring range of motion and
flexibility, and improving core stability.

Remember to fight gravity — sit and stand tall; lift with your legs, not with
your back; and bend forward at the hips, not at the back.

This blog was originally posted on https://chicagodancersunited.org/


MEET THE AUTHOR

MENTIONED PROFILE

MARIA REESE, MD

Attending Physician Medical Director, Performing Arts Medicine Program

mentioned in this article

BODY

Maria Reese, MD, is a sports medicine physician who specializes in non-operative
management of musculoskeletal injuries with a particular interest and skill for
treating performing artists. She completed her medical training at the Keck
School of Medicine of the University of Southern California, where she received
humanitarian and leadership awards. She completed her Physical Medicine and
Rehabilitation (PM&R) Residency and Sports Medicine Fellowship at Northwestern
University/Shirley Ryan AbilityLab, where she served as chief resident. She is
an Assistant Professor of PM&R at Northwestern University Feinberg School of
Medicine. She has served as the Medical Director of the Performing Arts Medicine
Program at Shirley Ryan AbilityLab since 2014. As part of this program, she
cares for amateur to elite performers from various theaters, pre-professional
schools, and the local and national community. The Journal of the American
Medical Association (JAMA) featured her dedication to performing artists in the
article “A Day in the Life: Performing Arts Physician Saves Careers by
Fine-tuning Artists’ Form” in its October 2019 edition. In addition to her
clinical skills, Dr. Reese offers bedside ultrasound evaluation and performs
ultrasound and fluoroscopically guided procedures to provide multiple treatment
options for her patients.

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