Many people who consult a chiropractor for back pain are concerned with lumps of soft tissue in the lower back. Most instances of soft lumps under the skin in the lower back are due to lipomas. Lipomas are benign fatty tumors and not related to the disc or spine. Men seem to have a higher incidence of these fatty benign tumors. Lipomas are not a direct cause of sciatica or leg pain. Some people are concerned that a fatty tumor is a disc herniation. Disc herniations are not able to be felt under the skin.
Chiropractic care for lower back pain is most effective in combination with therapeutic exercise. Lower impact exercises such as walking or sitting on a gym ball are beneficial even in the initial stages of an episode of lower back pain. Movement within the pain free range is recommended in the initial stages of an episode of back pain. The primary focus of exercise in lower back pain is to strengthen the abdominals and stretch the muscles of the back. Secondary to strengthening the muscles general endurance and functional movement patterns are emphasized.
Balance exercises on the gym ball (Swiss ball) are an important part of prevention and treatment of lower back pain. The gym ball is effective for both strength and proprioception. Easy exercises that stress balance such as sitting on the gym ball while moving the hips are effective for prevention and treatment of back pain. The gym ball is also great for exercises of the neck and stretching the hamstrings.
Proper lifting is essential for lower back pain prevention. The spine is the most susceptible to injury after extended sitting or lying. Twisting while lifting is also associated with back injury. All lifting should be accompanied by contraction of the back and abdominal muscles.
Sitting positions can also put extra stress on the discs of the lower back and lead to back pain. Lumbar supports that support the natural curve of the lower back are helpful while sitting. Foam wedges with tail bone cutouts are also helpful in sitting to maintain the proper lower back curvature.
It has been estimated about a third of cases of lower back pain are due to disc problems. One of the key signs of a disc problem is pain that travels below the knee. Pain that travels below the knee is suggestive of a problem with the disc. The pain from a lumbar disc problems usually travels down the back of the leg and is known commonly as sciatica. Numbness in the foot or ankle is another common sign of a disc problem. Persons with disc problems usually have a history of recurrent episodes of back pain without leg pain. Most often disc problems effect those between 30 and 50. In younger people with disc problems the pain is usually worse with sitting and less with walking or standing. In older persons with disc problems the reverse is usually true and walking or standing is more painful. MRI is the preferred method to determine the status of the disc. MRI is usually reserved for those who cannot get relief through conservative means such as Chiropractic or who have severe pain or muscle involvement.
One of the most common presentations of lower back pain is the scenario of sharp pain in the back after straightening from a stooped position. The S-I joints are known to be susceptible to acute episodes of back pain with radiation into the leg or buttocks. In this way pain from a S-I joint is similar to pain from a disc problem. The pain from an S-I joint problem is often sharp and stabbing and can be relieved by sitting or lying down. Posture is less of a factor with S-I joint problems.
It has been estimated that S-I joint problems account for up to half of cases of back pain seen by Chiropractors. Persons with an S-I joint problem are often able to point right to the painful joint. In younger persons, the pregnant or with degenerative arthritis prolonged or sudden lifting or bending is known to be a risk factor for S-I joint sprain and acute back pain.
Persons with S-I joint problems often have dramatic pain relief with Chiropractic adjustments.
Chiropractors provide the majority of care for persons suffering from neck and back pain due to whiplash. Chiropractors have always focused primarily on the spine which is unique among health care providers. Chiropractic adjustments are especially effective in reducing spinal splinting due to neck injury. Spinal splinting and lack of mobility reduced the range of motion of injured spinal areas. Reduced range of motion in injured spinal areas imposes more stress on normal areas of the spine. Spinal adjustments aim to restore normal motion to the spine and allow joints to heal in a normal fashion.
Long term immobilization of the spine has been linked to arthritic changes (spondylosis) in studies.