Low back pain is the most common form of physical disability. Low back pain means a pain or ache somewhere between the bottom of the ribs, at the back, and the top of the legs. The pain often begins suddenly, and may follow an obvious strain or injury, but may seem to come on "out of the blue", or come on slowly. The main cause for low back pain is a strain of the muscles, or other soft structures (eg ligaments and tendons) connected to the back bones (vertebrae). Sometimes it is the cushion between the bones (intervertebral disc) which is strained, and which bulges out (herniates) and presses on the nearby nerves. Low back pain may be acute (short-term), lasting less than one month, or chronic (long-term, continuous, ongoing), lasting longer than three months. Chronic lower back pain usually has a more insidious onset, occurring over a long period of time. Physical causes may include osteoarthritis, rheumatoid arthritis, degeneration of the discs between the vertebrae, or a spinal disc herniation, a vertebral fracture (such as from osteoporosis), or rarely, a tumor (including cancer) or infection. Low back pain is either acute or chronic. Acute LBP may begin suddenly with intense pain usually lasting less than 3 months. Low back pain from any cause usually involves spasms of the large, supportive muscles alongside the spine. Back pain associated with weight loss, or difficulty controlling bowel or bladder function, may be caused by a serious disorder, so it's important to get immediate medical advice. Pain may radiate down the back of the leg to the foot and be accompanied by numbness or tingling when a disc prolapses and puts pressure on the nerves, causing sciatica. A sharp pain may appear in a localised area or, more commonly, be felt as a generalised ache in the lower back and buttocks. There are plenty of medical causes, from arthritis to muscle tears, to abnormal curvature of the spine known as scoliosis. Leg symptoms can include pain, numbness, or tingling, usually below the knee, and/or weakness in one leg. Low-impact activities such as swimming, walking, and bicycling can increase overall fitness without straining the low back. Weakness and/or numbness in both legs, along with loss of bladder. Lumbar surgery is indicated when conservative treatment is not effective in reducing pain or when the patient develops progressive and functionally limiting neurologic symptoms such as leg weakness, bladder or bowel incontinence, which can be seen with severe lumbar disc herniation, spinal abscess or cauda equina syndrome. Regular exercise to keep generally fit is more important than any specific exercises aimed at the back muscles. The pain may force you to rest, but this is a result of the pain, and not a good treatment for back pain. If you have to take to your bed, limit it, if possible, to a day or two at the most. Use simple pain killers, such as paracetamol or ibuprofen if necessary. Avoid activities likely to put unnecessary strain on your back. Back exercises: patients who have not returned to ordinary activities within 6 weeks should be referred for reactivation/rehabilitation. Low Back Pain Reducing Tips 1. Avoid standing for long periods of time. 2. Do not wear high heels. Use cushion soles when waking. 3. Use a stool under your feet while sitting so that your knees are higher than your hips. 4. Apply ice for the first 2 or 3 days after you hurt your back, then switch to heat. 5. Take over-the-counter pain medicine, such as acetaminophen or an anti-inflammatory drug such as aspirin or ibuprofen. 6. Quit smoking. 7. Lose weight.
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