If you are an athlete but have back pain, you will most likely want to return to your sport as soon as possible. But where to start?
Visiting your doctor can help you identify any serious health problems.
A clear diagnosis will help you start treatment faster, which will lead to a speedy recovery.
There is a wide range of treatment options available, from simple things like heat or ice to more complex and risky procedures like back surgery. So which one is better? This depends on several factors.
Warming up
Use of ice or heat for acute back injury? Experts don't always agree.
If you are using an ice pack to relieve back pain, cold therapy can help reduce swelling and inflammation, as well as damage to stem tissue. Ice can cause numbness, which may help relieve pain.
Ice is usually recommended immediately after the injury and for up to 72 hours.
It has long been believed that applying heat in such cases may lead to inflammation.
After selecting data from several small studies, a 2006 Cochrane Review found evidence suggesting that heat therapy reduces acute and subacute back pain immediately after an injury or incident, also for up to seven days.
How to avoid back pain after exercise
The basic rule is uniform loads. You should not develop some muscle groups while neglecting others.
It is very important to gradually increase the intensity and duration of training, since sudden physical activity after a long break can provoke injury, including stretching and tearing of soft tissues.
Before going to the gym, stretching is mandatory, since the muscles need to be prepared for intense work.
We recommend training under the supervision of an experienced instructor. However, if you have curvature, deformation or other pathologies of the spine, classes should be carried out with a physical therapy doctor.
Spinal manipulation therapy
Although usually associated with chiropractic care, spinal manipulative therapy (spinal adjustments) can also be performed by a physical therapist or osteopath.
Spinal manipulative therapy has been the subject of many research projects and has proven to be a good short-term treatment for acute low back pain.
For chronic low back pain, treatment can be as effective as anti-inflammatories and better than physical therapy in the long term.
The manipulation was also found to be more effective than Mackenzie's exercise system, medical care, soft tissue treatments, and training in medical research.
However, a 2004 Cochrane review, “Spinal manipulative therapy for low-backpain,” found no difference between spinal manipulative therapy and traditional, conservative treatments such as pain medications, exercise, physical therapy, or regular medical care. The measures the researchers looked at included pain reduction and ability to perform daily activities.
Material and methods
The observation included 212 patients - athletes and ballet dancers with PCBS caused by spondylolysis (in 171) and spondylolisthesis of I-II degrees (in 41) of the lumbar vertebrae. The examination revealed spondylolysis of the vertebrae LV (in 139), LIV (in 68), LIII (in 4) and in one patient, a ballet soloist, vertebra LII. Among the patients there were 103 (48.6%) men and 109 (51.4%) women aged 15–32 years. The average age was 20.7 years.
Research methods: clinical neurological, radiological, ultrasonography, computed tomography (CT), scintigraphy, as well as the study of markers of bone tissue resorption (calcium in the urine) and bone formation (alkaline phosphatase).
Painkillers
Nonsteroidal anti-inflammatory drugs, or NSAIDs, are a pain reliever for athletes and people who are injured. This class of medications includes ibuprofen, including Advil and Motrin, naproxen (Aleve), celecoxib (Celebrex), and aspirin. Tylenol is not considered an NSAID because the active ingredient, acetaminophen, is only a pain reliever.
Some NSAIDs are available over-the-counter in pharmacies, while others are available by prescription only. Check with your doctor if you are unsure how to take NSAIDs or other pain medications.
The benefits of taking NSAIDs included not only overall improvement, but also a reduction in the need for any type of pain medication.
However, the side effects of COX-2 inhibitors are sometimes very serious and even fatal.
Advil and other NSAIDs with ibuprofen as an active ingredient may also increase the risk of fatal cardiovascular events.
Muscle spasm provides protection for damaged or unprotected joints; the immobility it provides limits further tissue damage.
But this limitation can hamper all of your physical therapy efforts. Left unchecked, spasms can also create an imbalance in flexibility throughout the body. Imbalance affects your posture, causes pain, and will likely affect your competitive advantage in your chosen sport.
For these reasons, injured athletes sometimes turn to skeletal muscle relaxers for help.
Several studies have shown that muscle relaxants may be effective for the treatment of nonspecific low back pain. However, the authors remind us that there are side effects associated with this class of medications and that caution should be exercised when using muscle relaxants.
Why are the lumbar muscles injured?
From a physiological point of view, there are three main predisposing factors to injury: 1) heavy load, 2) weak muscle in 3) a state of stretch. If the range of motion is within physiological limits and the brain does not send signals to lift too much weight, then injury will not occur. However, if you try to lift more than the loaded muscle can, you run the risk of tearing the fibers and causing severe pain.
Another mechanism for the appearance of pain is that under high loads, part of it is taken over by small intervertebral muscles, which are not adapted for this type of work. This model works most often in the case of incorrect exercise technique, when a smaller and weaker muscle works instead of a large one. And a weaker muscle is much easier to injure.
If you train without warming up, cold muscle fibers respond much less well to the load. Not only their strength decreases, but also their ability to stretch, which significantly increases the likelihood of injury. That's why the best prevention of lumbar pain and injury during exercise is:
- Always warm up the muscles you are going to train - a couple of approaches with light weights.
- Maintain proper technique.
- Do not take a weight that you are not used to.
Other Spine Treatments
Other spinal treatments include both holistic methods and traditional medical procedures.
Injections
While injections of steroids, local anesthetics and other drugs are commonly used for back pain, a 2008 Cochrane review failed to find strong evidence for or against their use. An older study published in the American Journal of Sports Medicine looked at 32 athletes with back pain and sciatica who received injections and found that only fourteen (or less than half) experienced rapid improvement and a rapid return to play.
Exercises
While many people strongly advocate exercise as the best way to relieve back pain, research does not provide detailed statistics. A 2012 meta-analysis found that core stability exercises may be an effective treatment for chronic low back pain.
But these results showed effectiveness only in the short term. Over the long term, there were no differences between those who worked in general and those who focused their efforts specifically on their main job.
Acupuncture and massage
While acupuncture may be better than nothing in the short term, other treatments, both traditional and alternative, have been more successful in relieving pain. However, acupressure may be more effective than regular massage.
Research also shows that massage may be helpful for subacute and chronic pain, but not for acute pain immediately following an injury. Massage therapy seems to do its job better when combined with exercise.
Lumbar Corsets
In most cases of spinal disease, belts and corsets will not help support the back or prevent pain. And there is no evidence that they help prevent back pain, according to the Centers for Disease Control.
The only exception is in the case of adolescent spondylolysis, where several studies have found that there is an effect with limited activity.
Spondylolysis is an injury to the lower back caused by sports that require repeated hyperextension and hyperflexion of the spine. Examples include gymnastics, soccer, and others.
If left untreated, spondylolysis can develop into spondylolysis, which is a stress-induced breakdown of couples, and then spondylolisthesis, where the spine becomes unstable.
Yoga. Causes of pain in the lumbar region
Particular attention should be paid to poses with deflection. The main rule when mastering them is do not overdo it. Especially if your back muscles are not trained and tight. Start with the lightweight version. “So, when mastering the bow pose, which is performed while lying on your stomach, bend back using the strength of your chest and back muscles (but not through the strength of your legs!) and cross your arms behind your back,” advises Alexey Vladovsky. - Do not try to grab your legs with your hands. After some time, you can move on to the classic version, but again remember - you cannot pull your legs towards you with your hands.” Another bending asana is camel pose. If your back is not flexible enough, it is better to place yoga bricks between your heels - place your palms on this elevation or rest your hands on the lumbar region and bend in the thoracic region.
Additional stress on the lower back can be created by dynamic exercises, which are found in kundalini yoga. For example, the practice of moving from a lying position to a plow pose (legs lowered behind the head) and back can be dangerous for a beginner if he does it in full. “In this case, I recommend doing the asana with bent knees,” says Alexey Vladovsky. - Essentially, you will not enter into a plow pose, but simply pull your bent knees to your chest and lower them back. This exercise helps you to feel the importance of the correct position of the arms in this practice: they lie along the body, and while moving your legs you rely on them.”
Duration of treatment
Some athletes play through pain.
Others start skipping therapy sessions as soon as they feel better. Whether playing with pain will be harmful to you will likely depend on the nature of your injury and the types of tissue that are affected.
The potential for further damage is significant if the spine is unstable.
An example of spinal instability is spondylolisthesis, a condition in which one spinal bone slips forward or backward relative to the next.
Spinal discs are another structure that will likely require sufficient time to heal before it is safe to play again.
But if your chronic lower back pain is caused by a soft tissue strain, with a little care and a little aspirin, you can manage it.
Impact cardio loads. Causes of pain in the lumbar region
Jumping, skipping, and running are elements of many workouts. Still, the most popular form of fitness that involves impact is running. Undoubtedly, if you move with the correct technique, there will be no harm to the lower back. However, according to experienced coaches, highly technical runners are rare.
So, when worrying about your lower back, you need to focus on the amount of training. It’s good if you exercise 2-3 times a week, but if 6, it may be too much stress for the spine, which will sooner or later lead to a problem. And, of course, it is important to choose the right shoes. “Before you buy it, think about what kind of surface you will be practicing on,” adds Olga Kochetova. “Sneakers that are good for running on a rubber treadmill will not be suitable for asphalt: the cushioning will be insufficient.”
Visit to the doctor, diagnostics and examinations
Making a diagnosis due to the nonspecificity of symptoms and its polyetiology is difficult. A detailed history taking, analysis of the patient’s complaints, as well as a thorough examination are necessary.
Laboratory methods include general and biochemical blood and urine tests, as well as blood tests for tumor markers.
Frequently used instrumental research methods include radiographic and endoscopic techniques, ultrasound of the abdominal cavity and retroperitoneal space, CT and MRI.
Girdle pain
More typical for acute pancreatitis, cholecystopancreatitis, cholelithiasis, acute cholecystitis and intercostal neuralgia. If the liver and pancreas are affected, the pain may radiate to the chest area.
Cholecystitis or pancreatitis is rarely isolated. More often, the pathology is combined and takes on the character of cholecystopancreatitis. A differentiating sign may be a feeling of bitterness in the mouth, as well as discomfort in the right hypochondrium.
Considering the seriousness of possible nosological pathologies when girdling pain manifests itself, antispasmodics (Papaverine, Platiphylline) should be used to relieve it. NSAIDs (non-steroidal analgesics) should not be used due to the fact that their use can change symptoms and make diagnosis difficult for the surgeon.