Postures and Low Back Muscle Strain

Photo by Larkery

One cause of low back muscle strain is having an unhealthy spine through habitual poor posture. If you sit all day in a slumped position, your low back is loaded into a forward or flexed position, and the muscles of your back are continually stretched. As a result, you may be more likely to strain a back muscle from light tasks such as loading/unloading the dishwasher. 

Not only does slouching affect your back muscles, but it causes your disks to bulge backwards. The more pressure from bad posture, the more likely your disks cannot realign properly. This leads to pinched nerves, which shoot pain or other symptoms down your leg(s), such as sciatica. 

On the other hand, those with a healthy spine (through repetitively good posture and exercise) may tolerate light tasks but strain their backs when doing more strenuous work such as moving furniture. It is important that both individuals practice good posture and body mechanics in order to avoid straining the low back during routine daily tasks, and especially during difficult physical activities.

What To Do for Sciatica in my Leg

Photo: John Ragal

There are multiple causes of sciatica or back pain that radiates down the leg(s). The most serious cause of sciatica is when a nerve root in the spine is being pinched by a bulging disc or by arthritis-type changes in the spine itself. Not only can this cause shooting pain into the leg(s) but also weakness in the leg and changes in the sensation in the leg (for example numbness or tingling in a portion of the leg or foot). If this is the case, it would be diagnosed through MRI and treatment options would be recommended by your doctor. 

Physical Therapists treat many patients with such sciatica. The key to relieving this type of sciatica is to stop the compression of the nerve root in the spine where it is being pinched. This can be done through positioning and exercises. If you are completely compliant with Physical Therapy and get no relief from any sciatica symptoms, then your doctor may try injections (usually with Cortisone) to provide some pain relief. This is a steroid, which provides an anti-inflammatory response. If you do not want injections, you may be prescribed oral medications for pain relief and/or anti-inflammation. 

Other conservative treatments for sciatica are going to a chiropractor, mechanical lumbar traction (requires a MD prescription) or getting acupuncture. Also some people get relief from inversion tables. Aquatic Physical Therapy (doing therapy inside a swimming pool) is another helpful tool for patients with sciatica.

Low Back Muscle Spasm

What Is Low Back Muscle Spasm?

One presentation of low back pain is muscle spasm. This can accompany a low back strain or many other lumbar spine diagnoses. Low back muscle spasm presents as sudden, severe pain in part of the low back with decreased ability to move it for a time. For example, you are in a bent position and you cannot straighten up. That muscle is hard/tight to the touch compared to the other back muscles. It may appear swollen; for example, the right side of your low back looks bigger than the left. This can be present for a few minutes-hours and can come repeatedly over a number of days to several months, depending on your activities, movements and postures.

How To Treat Low Back Muscle Spasm:

It usually requires you to change positions, and the severity decreases if you find a relieving position such as lying on your side or getting onto hands and knees. Any new injury needs to be treated with ice for at least 2-3 days to minimize swelling and inflammation. Muscle spasm can be decreased with the use of heat to relax the muscle. If there is not significant swelling or internal inflammation, you can use heat to treat the pain associated with muscle spasms.

Medical Treatments for Low Back Muscle Spasm:

For this diagnosis, you will likely be prescribed muscle relaxers, anti-inflammatory medicine and/or pain relievers. Certain movements, positions or activities may need to be limited to prevent the spasm from returning (for example walking less, decreasing housework, or not playing your sport for a time). Other treatment options are Physical Therapy, chiropractic care, massage, and acupuncture.

How To Prevent Low Back Muscle Spasm:

If you prevent all other forms of low back pain, you will prevent low back muscle spasms. This means:

1. Practice good postures.

2. Practice good ergonomics and body mechanics.

3. Exercise regularly for your overall spine health.

4. Avoid a sedentary lifestyle because all tissues, including your spine, thrive on movement.

5. Do back extension exercises (moving spine in backward direction).

Back Health Survey: Am I At Risk For Low Back Pain?

1. How frequently do you perform moderate-high intensity exercise?
     a. 5-7x/week
     b. 2-4x/week
     c. 1x/1-2 weeks
     d. rarely

2. How many hours/day do you sit on most days of the week?
    a. <4 hours/day
    b. 4-6 hours/day
    c. 7-10 hours/day
    d. >10 hours/day

3. How often do you perform back strengthening exercise or core strengthening?
    a. >3x/week
    b. 1-2x/week
    c. occasionally
    d. what do you mean by back or core strengthening exercise?

4. What is your usual sitting posture?
    a. upright, with extra lumbar support (lumbar roll, rolled towel, etc)
    b. upright, without lumbar support (decent chair but no additional lumbar roll or cushion)
    c. mildly slumped
    d. severely slumped or rounded

5. What is your present weight status?
    a. ideal body weight
    b. mildly overweight
    c. moderately overweight
    d. severely overweight

6. How many episodes of major low back pain have you had in your lifetime (enough to limit your usual functional activities)?
    a. no major episodes
    b. 1 major episode or injury
    c. 2-3 episodes
    d. >3 episodes

7. How far down did your low back pain symptoms radiate?
    a. no major low back pain in my past
    b. low back only
    c. low back and buttock(s)
    d. down to thigh (not below knee)
    e. down below the knee

8. How did your low back pain resolve?
    a. no major low back pain in my past
    b. completely resolved
    c. partially resolved
    d. never resolved

9. How often do you practice proper body mechanics during daily activities (such as squatting instead of bending, avoiding twisting, and good lifting techniques)?
    a. All the time; with both difficult and easy tasks
    b. Most of the time, especially difficult tasks
    c. Sometimes
    d. Rarely

10. How much heavy lifting do you regularly perform?
     a. occasionally-rarely. Always with good technique
     b. frequently. Always with good technique
     c. occasionally-rarely. Without considering technique
     d. frequently. Without considering technique

11. How often do you participate in high risk sports/activities (such as skiing, skydiving, skateboarding, 4-wheeling, etc)?
      a. rarely and not likely to in the future
      b. once every few years
      c. multiple times per year
      d. very frequently

12. How often do you perform standing forward bending exercises (such as touching the toes)?
      a. never. not since elementary school calisthenics
      b. occasionally, when I need to stretch my back
      c. frequently, during my usual workouts
      d. daily or multiple times daily


Score: Count your score by assigning points to each letter answer.
Legend
a: 0 points
b: 1 point
c: 2 points
d: 3 points
e: 4 points


Results:
>30 points: Get to know your Physical Therapist and spine surgeon. You will be seeing us a lot.
20-30 points: Moderate risk unless you make major changes immediately.
13-20 points: Mild-moderate risk. Consider ways to improve!
6-12 points: Mild risk. But beware and don't become complacent in these areas.
0-6 points: You have a healthy back and are at low risk as long as you continue good habits!

Tune in next time for more discussion about these questions/answers!

Post your answer in the comments section. There will be three prizes awarded!