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Modifying activities and learning techniques to decrease stress on the back are important to resolving or controlling low back pain and sciatica. Since back pain tends to recur, lifestyle changes should become a way of life if you hope to avoid future episodes.
Prolonged bed rest is usually not advised. However, your doctor may recommend resting in bed for one or two days. Too much bed rest can weaken muscles and slow recovery. Doctors recommend staying active within the limits of your pain and avoiding activities that worsen back pain.
Guidelines for activity include:
Poor posture and slouching can put more pressure on your lower back. Stand and sit straight, and avoid sitting up in bed.
Exercises to stretch and strengthen back and stomach muscles should be done regularly. This may help to prevent back injuries.
A low-impact aerobic program will further improve your physical fitness and help you maintain a healthy weight. Choose exercises that you enjoy and that you can do on a routine basis. Activities that are “back-friendly” include walking, swimming, or biking. Exercise also can help you manage stress. Check with your doctor before starting any exercise program. The 2008 USDA Physical Activity Guidelines Advisory Committee Report recommends at minimum two hours and 30 minutes a week of moderate aerobic activity, and strengthening exercises at least two days a week.
Maintenance of good weight is important for your overall health. While scientific evidence is inconclusive as to how much obesity contributes to back pain in general, extra pounds can increase pressure on the spinal muscles and disks. Follow the dietary and exercise plan recommended by your doctor. To lose weight you have to consume fewer calories than you expend. To maintain a healthy weight, eat an equal number of calories to those you expend. Even more exercise than minimum recommendations may be required to lose weight.
Smoking may contribute to degeneration of the discs in the spine. Also, smokers risk possible re-injury to the back during a coughing attack. Smoking can adversely affect healing if you are having a back surgery. To heal properly, you should quit smoking two weeks before a spine fusion and stay tobacco-free for six months afterwards.
Stress can increase muscle tension. Take time out to relax, exercise, and practice relaxation techniques. If you need support or assistance in reducing stress, you may want to try some of the following techniques:
Certain changes to your workspace, attire, and home can reduce the stress on your back. Tips include:
While some people think that using shoe inserts will prevent back pain, so far there's not a lot of evidence to support this.
More serious symptoms associated with back pain that may require immediate medical attention include:
References:
Conn's Current Therapy 2001 . 53rd edition. WB Saunders Company; 2001.
Pain. National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/disorders/chronic_pain/detail_chronic_pain.htm#Spine . Accessed October 27, 2008.
Physical activity guidelines for Americans. US Department of Health and Human Services. http://www.health.gov/paguidelines/guidelines/chapter1.aspx . Accessed October 27, 2008.
Textbook of Primary Care Medicine . 3rd ed. Mosby, Inc.; 2001.
2/17/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Bigos SJ, Holland J, Holland C, Webster JS, Battie M, Malmgren JA. High-quality controlled trials on preventing episodes of back problems: systematic literature review in working-age adults. Spine J. 2009;9:147-168.
2/24/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Sahar T, Cohen M, Ne'eman V, et al. Insoles for prevention and treatment of back pain. Cochrane Database Syst Rev. 2009;(1):CD005275.
Last reviewed September 2009 by Jill D. Landis, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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