1. Low Back Pain

2. Spinal Anatomy Overview
The spine consists of four main areas
Cervical
Thoracic
Lumbar
Sacrum/coccyx

3. Spinal Anatomy
The spine is a remarkable combination of strong bones, flexible ligaments and tendons, large muscles and highly sensitive nerves. It is designed to be incredibly strong, protecting the highly sensitive nerve roots yet being highly flexible providing for mobility on many different planes.

4. If This Is You, You Are Not Alone

5. Quick Back Facts
80% of Americans will experience back pain in their lives
Second most common reason for doctors visit
Total cost exceeds $100 billion per year
90% of people will recover within 6 weeks with conservative care
Second only to the common cold for work sick days

6. Symptoms Depending on the cause, symptoms can vary
Dull, sharp or burning
Felt at a single point or over a broad area
Occurs suddenly or comes on gradually
Occurs with spasms or stiffness
Associated leg symptoms such as pain, numbness or tingling

7. Red Flag Symptoms History of cancer
Progressive motor or sensory deficit
Prolonged steroid use, IV drug use
Major trauma
Numbness in groin/saddle
Bilateral leg weakness
Fever and chills
Unrelenting severe pain with rest
Loss of bowel or bladder function

8. Cauda Equina
A serious problem that can occur if the nerves at the end of the spinal cord are squeezed
Seek emergency treatment if you experience any red flag Symptoms

9. Causes of Back Injuries
Most back injuries can be attributed to one of these five causes
Poor posture
Improper body mechanics/work habits
Stressful living
Loss of flexibility
Poor conditioning/overweight

10. “Your back went out because your front went out.”

11. Obesity World Health Organization (WHO)
Overweight: BMI 25-29
Obese: BMI 30 and above
By 2015: 700 million will be obese
Overweight and obesity lead to serious health consequence
Cardiovascular disease
Diabetes
Musculoskeletal disorders
Some cancers

12. Body Types

13. Diagnostic Testing
Physicians will not generally order diagnostic tests in the first six weeks of low back pain
Most of the time, the causes for back pain cannot be found by x-ray, CT scan or MRI

14. “I’m the one with the medical degree, I’ll determine if your back is bothering you or not.”

15. The intensity of the pain does not equal the severity of the injury

16. Intervertebral Disks
Acts like a cushion between the bony vertebrae that make up the spine
90% water
Wears with age

17. Potential Disk Problems
Degenerated disks
Thinning disks
Bulging disks
Herniated disks
Osteophyte (bone spur) formation

18. Why does back pain seem to always come back?
The disks between our vertebrae act like shock absorbers
When disks are injured from either wear and tear or a sudden force, they are unable to repair themselves very well because they lack the rich blood supply needed for healing

19. Sciatica Set of symptoms - not a disease in itself
When the sciatic nerve is irritated or compressed
Causes shock like or burning low back pain that can extend down to the foot
Extreme cases can cause loss of motor control

20. Sciatica

21. Sciatica Treatment Self care under a doctor’s care Chiropractic
Prescription medications
Epidural steroid injections
Physical therapy program

22. Piriformis Syndrome Muscle that runs above the sciatic nerve.
When the muscle becomes tight, causes sciatica like pain down the leg
Prolonged sitting, car accidents, falls

23. Piriformis Syndrome Treatment
Stretching- #1 treatment
Physical therapy
Massage therapy
Anti-inflammatory medications
Temperature treatments

24. Spinal Stenosis
Congenital or age related narrowing of the spinal canal

25. Spinal Stenosis
Risk of developing increases after 50 years of age, severity can increase with age
Treatments include
Pilates or yoga to stretch and strengthen the spine.
Physical therapy
Epidural steroid Injections

26. Spondylosis Spinal arthritis
Can allow for a forward slippage of the vertebrae onto the vertebrae below it

27. Helping prevent spinal osteoarthritis
Stay ahead of the game!
Get up and go!
Cut the fat!
Sit smart
Stand smart too!
Save those joints
Only eat the good stuff
Kick the habit, don’t smoke!
No pain, all gain!
Be good to yourself

28. Muscle Strains The majority of back pain is caused by muscle strains
Usually heals with conservative treatments and time
Muscles in the lower back have an excellent blood supply bringing it the necessary nutrients for healing to occur

29. Exercise and Low Back Pain
The natural stimulus for healing process is active exercise
The majority of people do not get enough exercise from daily activities to support their lower back muscles.
While some of these muscles are used in everyday life, a complete exercise program for optimal lower back health is needed

31. Treatment Options Exercise Temperature treatments Physical therapy
Chiropractic
Acupuncture
Massage therapy
Water therapy

32. Medications Over the counter Narcotic pain relievers Muscle relaxants
- Acetaminophen, ibuprofen, aspirin
Narcotic pain relievers
- Not recommended for long term use
Muscle relaxants
- Treats muscle spasms

33. Did you notice surgery was not included?

34. Healthy Living Exercise regularly Maintain or achieve a healthy weight
Regular core strengthening exercises
Eat healthy, drink plenty of water
Practice good body mechanics
Good quality sleep

35. Sleeping Easier with Back Pain
No perfect position for everyone – Listen to your body
Pillow between your legs
Firmer mattress
Egg crate or pillow top if it helps
Good sleep routine

36. Four things to take away
Chances are you will experience back pain at some point in your life
Expensive diagnostic tests cannot always identify the cause of your pain
There is no quick fix
Establish a healthy lifestyle

37. Resources