Lower Back Pain: Causes, Treatments, and Prevention Tips

Low back pain

Hello Dr.
Kang,
I usually have a habit of exercising, and bending over is not an issue for me.
I often swim in the summer without any problems.
However, two months ago, after swimming the butterfly stroke, I seemed to have strained my lower back.
In the following days, I didn't rest properly due to work, and my back discomfort persisted.
Even sneezing or coughing causes pain, and while I can bend my back sideways, I cannot bend forward or backward.
Bending forward causes severe pain.
After seeing a doctor, he assessed my symptoms and pressed on my lower back without finding any tender points.
He suggested that I might have a herniated disc and arranged for me to undergo heat therapy and spinal traction physical therapy.
After five sessions, there was no significant improvement.
I recently found a new job, so I don't have time to continue seeking treatment.
However, the pain still troubles me and causes inconveniences in my daily life: I can't bend over to put on my shoes, riding a bike on uneven roads is painful, I can't sleep on my stomach during naps, and I can't sit for more than 15 minutes.
Currently, I wear a lumbar support brace (imported from Japan, costing about 2000 NTD, claiming to have therapeutic effects), but it doesn't seem to help much; it only reminds me not to bend over freely and makes it difficult to wear clothes.
I have a few questions:
1.
Will wearing a lumbar support brace long-term have any side effects?
2.
Could my poor posture while reading in the past have led to this situation? My sister has a similar posture, but why doesn't she have back pain?
3.
Now that I have back pain, I am hesitant to move around, but I occasionally need to lift some moderately heavy items at work.
I try to squat down to lift them.
Five years ago, my right knee hurt severely after cycling on the Central Cross-Island Highway, but it improved after seeing a traditional Chinese medicine doctor.
I'm worried that if my knee pain recurs and I can't bend over, it would be terrible.
What should I do?
Thank you for your response.

Lulu, 20~29 year old female. Ask Date: 2001/02/02

Dr. Pan Yingda reply Rehabilitation

It really seems like a herniated disc.
First, to answer your questions: 1.
Prolonged use of a lumbar support can lead to stiffness in the lumbar spine and weakness in the back muscles, making it harder to tolerate prolonged sitting or standing; therefore, it should not be used for extended periods.
2.
Everyone has different strengths and weaknesses in their musculoskeletal system, as well as varying degrees of flexibility and coordination, so not everyone will have the same outcome.
3.
In daily life or when lifting heavy objects, it is important to distribute the weight evenly across all joints rather than concentrating it on certain joints, as this can lead to excessive load and injury in those joints.
How to ensure that each joint experiences balanced forces (or minimize stress) in daily life is a complex subject, primarily involving the positioning and coordination of each joint.
The Alexander Technique studies how to effectively use our body mechanics; you can find related books on this topic, which are available at the Eslite bookstore in Dun-Nan.
Please refer to the advice regarding "whether rehabilitation is needed after surgery." If you have further questions, feel free to ask.

Reply Date: 2001/02/02

More Info

Lower back pain is a common issue that can arise from various causes, including muscle strain, herniated discs, and poor posture. Understanding the underlying causes, treatment options, and preventive measures can significantly improve quality of life for those affected.

Causes of Lower Back Pain
1. Muscle Strain: This is often the result of lifting heavy objects improperly or sudden awkward movements. In your case, the butterfly stroke may have caused a strain, especially if your technique was not optimal or if you were fatigued.

2. Herniated Discs: When the discs between the vertebrae bulge or rupture, they can press on nearby nerves, leading to pain, numbness, or weakness in the legs. Your doctor’s suspicion of a disc issue aligns with your symptoms, especially since you experience pain when sneezing or coughing.

3. Poor Posture: Long periods of sitting or standing with poor posture can lead to muscle imbalances and strain on the lower back. If you have a tendency to slouch while reading or working, this could contribute to your pain.

4. Degenerative Conditions: Conditions such as osteoarthritis or degenerative disc disease can also lead to chronic back pain, especially as one ages.

Treatment Options
1. Physical Therapy: While you have started physical therapy with heat treatment and traction, it may take more sessions to see significant improvement. Consistency is key, and if possible, try to continue therapy even with your new job.

2. Pain Management: Over-the-counter pain relievers like NSAIDs (e.g., ibuprofen) can help manage pain and inflammation. Always consult with a healthcare professional before starting any medication.

3. Exercise: Gentle stretching and strengthening exercises can help alleviate pain and prevent future issues. Focus on core strengthening exercises, as a strong core supports the spine.

4. Posture Correction: Be mindful of your posture while sitting, standing, and lifting. Ergonomic adjustments to your workspace can also help reduce strain.

5. Heat and Cold Therapy: Applying heat can relax tight muscles, while cold packs can reduce inflammation. Alternating between the two may provide relief.

Prevention Tips
1. Proper Lifting Techniques: Always bend at the knees and keep the load close to your body when lifting. Avoid twisting your torso while lifting.

2. Regular Exercise: Engage in regular physical activity that includes strength training, flexibility exercises, and cardiovascular workouts. Swimming is excellent for back health as it strengthens muscles without putting stress on the spine.

3. Maintain a Healthy Weight: Excess weight can put additional strain on your back. A balanced diet and regular exercise can help maintain a healthy weight.

4. Ergonomic Adjustments: If you spend long hours sitting, ensure your chair supports your lower back, and your feet are flat on the floor. Consider using a lumbar roll or cushion.

5. Sleep Position: Ensure you have a supportive mattress and pillow. Sleeping on your side with a pillow between your knees can help maintain spinal alignment.

Addressing Your Concerns
1. Long-term Use of a Back Brace: While a back brace can provide support, long-term use may weaken your core muscles. It’s essential to balance its use with exercises that strengthen your back and core.

2. Posture and Genetics: Poor posture can contribute to back pain, but genetics also play a role. Some individuals may have a predisposition to back issues regardless of their posture.

3. Managing Activities: When lifting at work, continue to use proper techniques. If your knee pain resurfaces, consult a healthcare provider for a tailored approach to managing both knee and back pain.

In summary, lower back pain can stem from various causes, and addressing it requires a multifaceted approach that includes treatment, preventive measures, and lifestyle adjustments. If your symptoms persist or worsen, consider seeking further evaluation from a specialist to explore additional treatment options.

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