Back & Spine Pain

There are many exercises and stretches that can help alleviate back pain and promote flexibility, strength, and stability. However, it’s important to note that the specific exercises and stretches that are most beneficial for you may depend on the underlying cause and severity of your back pain.  We can help you focus on those exercises and stretches that will be safe and effective for your condition.  It’s always a good idea to consult with a healthcare professional, such as a BHS provider, who can assess your condition and provide personalized recommendations. Here are some commonly recommended exercises and stretches for back pain:

• Pelvic tilts: Lie on your back with knees bent and feet flat on the floor. Gently flatten your lower back against the floor by tightening your abdominal muscles. Hold for a few seconds, then release. Repeat for several repetitions.
• Cat-Camel stretch: Start on your hands and knees with a neutral spine. Slowly round your back toward the ceiling (like a cat stretching) and hold for a few seconds, then gently arch your back, dropping your belly toward the floor (like a camel) and hold for a few seconds. Repeat this movement for several repetitions.
• Knee-to-chest stretch: Lie on your back with knees bent and feet flat on the floor. Slowly bring one knee up towards your chest and grasp it with your hands. Hold for 20-30 seconds, then release and repeat with the other leg.
• Child’s pose: Begin on your hands and knees, then sit your hips back onto your heels while reaching your arms forward, resting your forehead on the floor. Hold this position and focus on deep breathing for 20-30 seconds.
• Bird dog exercise: Start on your hands and knees with a neutral spine. Extend your right arm straight forward while simultaneously extending your left leg straight back. Hold for a few seconds, then return to the starting position and repeat on the opposite side. Perform several repetitions on each side.
• Bridge exercise: Lie on your back with knees bent and feet flat on the floor. Lift your hips off the floor while keeping your shoulders and feet grounded. Hold this position for a few seconds, then slowly lower your hips back down. Repeat for several repetitions.
• Trunk rotation stretch: Lie on your back with knees bent and feet flat on the floor. Gently rotate your knees to one side, keeping your shoulders grounded. Hold for 20-30 seconds, then return to the starting position and repeat on the opposite side.

Remember to start slowly and gently with these exercises and stretches, and listen to your body. If any exercise or stretch increases your pain or discomfort, stop and consult with a healthcare professional. They can guide you in performing the exercises correctly and provide modifications or additional exercises based on your specific needs.

Breathing is a critical component of any exercise or stretch.  As a general rule, it is recommended that you do a minimum of three breaths for each stretch extending the stretch on each exhale and holding the position during your inhales.

Several risk factors can contribute to the development of back pain. Understanding these factors can help you identify potential risks and take preventive measures. Here are some common risk factors for developing back pain:

• Age: Back pain becomes more common as we age. Degenerative changes in the spine, such as disc degeneration and osteoarthritis, are more likely to occur over time, increasing the risk of back pain.
• Sedentary lifestyle: Lack of physical activity and prolonged periods of sitting or inactivity can weaken the muscles that support the spine, leading to increased vulnerability to back pain.
• Poor posture: Slouching, hunching over desks, and maintaining poor posture can strain the muscles and ligaments of the back, increasing the risk of developing pain and discomfort.
• Excess weight: Being overweight or obese puts extra stress on the spine and supporting structures, increasing the likelihood of developing back pain.
• Lack of exercise or weak core muscles: Inadequate exercise, particularly neglecting core-strengthening exercises, can lead to weak abdominal and back muscles, which are crucial for maintaining proper spinal alignment and stability.
• Improper lifting techniques: Lifting heavy objects incorrectly, especially with improper lifting techniques, can strain the back muscles and lead to acute or chronic back pain.
• Occupational factors: Certain occupations that involve heavy lifting, repetitive movements, or prolonged standing or sitting can increase the risk of developing back pain. Jobs with exposure to vibrations or frequent bending and twisting motions also pose a higher risk.
• Smoking: Smoking can impair blood flow to the spine and inhibit the delivery of nutrients and oxygen to the spinal tissues, potentially contributing to the development of back pain.
• Psychological factors: Psychological factors such as stress, anxiety, and depression can contribute to the experience and perception of pain, including back pain.
• Previous back injury: A history of previous back injuries, such as sprains, strains, or fractures, can increase the risk of future episodes of back pain.

By adopting a healthy lifestyle, including regular exercise, maintaining proper posture, managing body weight, and practicing safe lifting techniques, you can help reduce your risk of experiencing back pain. If you have specific concerns about your risk factors or back pain, it’s advisable to consult with a BHS professional for further evaluation and guidance.

Making certain lifestyle changes can help reduce back pain and improve your overall spine and musculoskeletal health. Here are some lifestyle modifications that are beneficial:

• Regular exercise: Engaging in regular physical activity can help strengthen the muscles that support your spine, improve flexibility, and promote overall spine health. Focus on exercises that target the core muscles, such as abdominal and back muscles, as well as activities that improve cardiovascular fitness, such as walking, swimming, or cycling. Consult with a healthcare professional to determine which exercises are safe and suitable for your condition.
• Maintain a healthy weight: Excess body weight puts additional strain on the spine and can contribute to back pain. Strive to maintain a healthy weight through a balanced diet and regular exercise. Losing weight, if necessary, can help alleviate pressure on the spine and reduce the risk of back pain.
• Practice good posture: Maintaining good posture throughout the day is crucial for reducing unnecessary stress on the spine. When sitting, ensure that your feet are flat on the floor, your back is supported, and your shoulders are relaxed. When standing, distribute your weight evenly on both feet, avoid slouching or excessive leaning, and keep your shoulders back. Ergonomic adjustments, such as using a supportive chair or adjusting computer/workstation setup, can also help maintain proper posture.
• Avoid prolonged sitting or standing: Prolonged periods of sitting or standing can strain the muscles and discs of the spine. If your job requires long hours of sitting, take regular breaks to stand, stretch, and move around. If you have to stand for extended periods, try to shift your weight from one leg to another or use a footrest for support.
• Lift objects properly: When lifting heavy objects, use your legs instead of your back to lift the load. Bend your knees, keep your back straight, and lift with your leg muscles. Avoid twisting your spine while lifting, and consider asking for help or using assistive devices if the object is too heavy.
• Practice stress management techniques: Stress and tension can contribute to muscle tightness and increase the risk of back pain. Engage in stress reduction techniques such as deep breathing, meditation, yoga, or other relaxation exercises to help manage stress levels and promote muscle relaxation.
• Quit smoking: Smoking can impair blood flow to the spinal tissues, hinder the healing process, and increase the risk of back pain. Quitting smoking can improve blood flow and overall health, including spine health.
• Maintain a healthy sleep posture: Choose a supportive mattress and pillow that are suitable for your preferred sleep position. Maintaining a neutral spine position while sleeping can help reduce strain on the back. Avoid sleeping on your stomach as it can strain the neck and spine.

Stress and emotional factors can contribute to back pain or exacerbate existing back pain. The mind and body are interconnected, and psychological factors can have a significant impact on physical well-being, including the experience of pain. Here’s how stress and emotional factors can influence back pain:

• Muscle tension: Stress and emotional factors can cause muscle tension and tightness. When you’re stressed or anxious, your muscles tend to contract and remain tense, including those in your back. Prolonged muscle tension can lead to discomfort and contribute to the development or worsening of back pain.
• Altered pain perception: Stress and emotional distress can affect your perception of pain. When you’re under stress, your pain threshold may decrease, making you more sensitive to pain stimuli. This means that even minor discomfort in your back may be perceived as more intense or bothersome.
• Impaired sleep: Stress and emotional factors can interfere with sleep quality and duration. Lack of adequate sleep can contribute to increased sensitivity to pain and make existing back pain feel more severe. Additionally, poor sleep can affect your body’s ability to heal and recover from injuries or inflammation that may be contributing to your back pain.
• Posture and movement: When you’re stressed or experiencing emotional distress, you may adopt poor postures or engage in abnormal movement patterns. Slouching, hunching, or tensing your body can put additional stress on your back, leading to increased discomfort or pain.
• Coping mechanisms: Some individuals may resort to unhealthy coping mechanisms when dealing with stress or emotional challenges, such as excessive sitting, inactivity, or poor dietary choices. These behaviors can contribute to the development or worsening of back pain.

Addressing stress and emotional factors is an important part of managing back pain. Here are some strategies that may help:

• Practice stress management techniques: Engage in relaxation exercises, deep breathing, meditation, mindfulness, or activities that help reduce stress levels.
• Seek support: Talk to a therapist, counselor, or support group to help address underlying emotional issues that may be contributing to your back pain.
• Improve sleep hygiene: Establish a regular sleep schedule, create a relaxing bedtime routine, and ensure your sleep environment is conducive to quality sleep.
• Engage in regular physical activity: Exercise can help reduce stress levels, improve mood, and promote overall well-being. Choose activities that you enjoy and that are appropriate for your fitness level and back condition.
• Incorporate mind-body practices: Consider practices such as yoga, tai chi, or Pilates, which can help improve flexibility, strength, and promote relaxation.
• Take breaks and stretch: Incorporate short breaks throughout the day to stretch and move your body, especially if you have a sedentary job.
• Practice self-care: Engage in activities that bring you joy, relaxation, and promote a sense of well-being. This may include hobbies, spending time with loved ones, or engaging in activities that help you unwind and recharge.

While addressing stress and emotional factors can be helpful, it’s also essential to seek appropriate medical care and consult with a healthcare professional for a comprehensive evaluation and management plan for your back pain.

There are ergonomic tips you can follow to maintain good posture and reduce back pain. Here are some recommendations:

• Sit with proper posture: Use a chair that provides good lumbar support or consider using a lumbar cushion. Sit with your back against the chair and your feet flat on the floor. Keep your knees at a 90-degree angle and your thighs parallel to the floor. Maintain a small gap between the back of your knees and the edge of the seat. Avoid crossing your legs, as it can contribute to poor posture.
• Set up your workstation ergonomically: Adjust the height of your chair so that your elbows are at a 90-degree angle and your forearms are parallel to the floor. Position your computer monitor at eye level, directly in front of you, to avoid straining your neck. Use a document holder if you frequently refer to documents while working on the computer. Place frequently used items within easy reach to minimize unnecessary twisting or reaching.
• Use an ergonomic keyboard and mouse: Use a keyboard that allows your wrists to remain in a neutral position, avoiding excessive bending or extension. Consider using a mouse pad with a wrist rest to support your wrist during mouse usage. Take regular breaks and perform stretching exercises for your hands, wrists, and fingers.
• Stand with proper posture: If you have a standing desk, ensure that it is adjusted to the appropriate height so that your wrists are in a neutral position when typing. Stand with your weight evenly distributed on both feet and avoid leaning forward or backward. Use a footrest if necessary to provide support and reduce fatigue.
• Lift objects correctly: Bend your knees and hips while keeping your back straight when lifting objects from the ground. Hold objects close to your body and avoid twisting or jerking motions. If the object is too heavy, ask for assistance or use lifting aids or equipment.
• Take regular breaks and move: Avoid prolonged periods of sitting or standing. Take short breaks every 30 minutes to stand up, stretch, and move around. Perform gentle stretching exercises for your back, neck, and shoulders to relieve tension and improve circulation.
• Use supportive footwear: Wear comfortable shoes with good arch support and cushioning to maintain proper alignment and reduce strain on your back.
• Maintain a neutral sleeping position: Use a mattress and pillow that provide adequate support for your spine. Avoid excessively firm or sagging mattresses. Choose a pillow that keeps your neck in alignment with your spine and supports the natural curvature of your neck.

It is important to adjust your ergonomic setup based on your individual needs and preferences. If you have specific concerns about your posture or back pain, it’s advisable to consult with a healthcare professional or an ergonomic specialist who can provide personalized recommendations and further guidance.

Certain occupations and activities can increase the likelihood of experiencing back pain. Jobs or activities that involve repetitive movements, heavy lifting, prolonged sitting or standing, or awkward postures can put additional stress on the spine and its supporting structures. Here are some examples:

• Manual labor jobs: Occupations that involve heavy lifting, repetitive bending, twisting, or carrying heavy loads can strain the muscles, ligaments, and discs of the back. Construction workers, warehouse workers, nurses, and landscapers are examples of professions that may have a higher risk of back pain.
• Office jobs: Prolonged sitting and poor ergonomics at a desk are by far the largest contributor to back pain. Office workers who spend long hours sitting without proper posture support, use poorly designed chairs or desks, or do not take regular breaks to move and stretch may be at increased risk.
• Driving jobs: People who spend significant amounts of time driving, such as truck drivers or taxi drivers, are often seated for extended periods, which can lead to muscle stiffness and back pain. Poor driving posture, inadequate lumbar support, and vibration from the vehicle can also contribute to discomfort.
• Healthcare professions: Healthcare workers, including nurses and caregivers, are often required to lift and move patients, which can lead to overexertion and increased risk of back injuries and pain.
• Sports and physical activities: Certain sports and physical activities, especially those involving repetitive or high-impact movements, can increase the risk of back pain. Examples include weightlifting, contact sports, gymnastics, and activities with frequent bending, twisting, or sudden movements.
• Sedentary lifestyle: Jobs or activities that involve prolonged sitting or a sedentary lifestyle, such as desk jobs, can contribute to muscle imbalances, weak core muscles, and poor posture, all of which can increase the risk of back pain.
• Caregiving or parenting: Activities that involve frequent bending, lifting, and carrying, such as caring for young children or elderly family members, can strain the back and lead to back pain if not done with proper body mechanics.
• Repetitive movements: Any job or activity that involves repetitive movements, such as assembly line work, can contribute to muscle fatigue and strain, increasing the risk of back pain.

While these occupations or activities may increase the likelihood of experiencing back pain, it doesn’t mean that everyone in these roles will develop back pain. Proper body mechanics, ergonomic considerations, regular exercise, and taking breaks for stretching and movement can help reduce the risk of back pain in these situations. If you have concerns about back pain related to your occupation or activity, it’s recommended to consult with a healthcare professional or ergonomic specialist for personalized advice and guidance.

Chronic back pain, if left untreated or unmanaged, can lead to several potential complications and long-term effects. Here are some examples:

• Decreased quality of life: Chronic back pain can significantly impact your overall quality of life. It may limit your ability to engage in daily activities, work, exercise, and participate in social or recreational activities. The persistent pain and discomfort can also affect your mood, sleep patterns, and emotional well-being.
• Physical deconditioning: Chronic back pain can lead to a decrease in physical activity and mobility. This can result in muscle weakness, reduced flexibility, and loss of endurance. Over time, physical deconditioning can further exacerbate back pain and make it more challenging to perform routine tasks.
• Depression and anxiety: Living with chronic pain can take a toll on your mental health. It’s not uncommon for individuals with chronic back pain to experience symptoms of depression, anxiety, or other mood disorders. The constant pain, limitations in daily activities, and disruption of normal routines can contribute to emotional distress.
• Sleep disturbances: Chronic back pain can disrupt sleep patterns and lead to insomnia or poor-quality sleep. Lack of restorative sleep can exacerbate pain, affect cognitive function, and contribute to fatigue and daytime drowsiness.
• Reduced work productivity: Back pain can interfere with your ability to perform job-related tasks and impact your work productivity. It may result in missed workdays, decreased efficiency, or the need for workplace accommodations. This can have financial implications and may affect career advancement.
• Medication dependence: Long-term reliance on pain medications to manage chronic back pain can lead to medication dependence or potential side effects. Over time, the effectiveness of certain medications may decrease, requiring higher doses or different treatment approaches.
• Changes in posture and movement patterns: Chronic back pain can cause individuals to adopt altered posture and movement patterns in an attempt to avoid pain or discomfort. These changes can lead to muscle imbalances, joint stiffness, and further strain on the back, potentially exacerbating the pain and limiting functional abilities.
• Structural changes in the spine: In some cases, chronic back pain may be associated with underlying structural issues in the spine, such as disc degeneration, herniated discs, or spinal stenosis. These conditions can lead to further complications and may require specific medical interventions or surgical procedures.

Chronic back pain can have significant negative effects on quality of life, and appropriate management and treatment can help mitigate these complications. Seeking early medical intervention, developing a comprehensive treatment plan, and adopting lifestyle modifications can improve outcomes and minimize long-term consequences. If you are experiencing chronic back pain, it’s advisable to consult with a healthcare professional who can assess your condition, provide a proper diagnosis, and recommend appropriate treatment options.

The insurance coverage for any treatment, including those for back pain medicine, varies depending on several factors, including the insurance provider, the specific services or treatments being sought, and the healthcare provider’s credentials and billing practices. Here are a few points to consider:

• Insurance Providers: Some insurance providers may offer coverage for treatment services and testing, while others may have more limited coverage or none at all. It’s important to review your insurance policy or contact your insurance provider directly to understand what services are covered and to what extent.
• Most musculoskeletal health and pain practitioners may not accept insurance directly and operate on a fee-for-service basis. In such cases, individuals may need to pay for services out of pocket and seek reimbursement from their insurance providers, if applicable.
• In-Network vs. Out-of-Network Providers: Insurance coverage may be influenced by whether the provider is in-network or out-of-network. In-network providers typically have negotiated contracts with insurance companies, which may result in more favorable coverage. Out-of-network providers may have different coverage terms, potentially resulting in higher out-of-pocket costs for individuals.
• Covered Services: Insurance coverage may vary depending on the specific services or treatments being sought within the realm of pain management and surgery avoidance conservative care. For example, certain diagnostic tests or procedures may be covered, while others may not. It’s important to review your insurance policy or contact your insurance provider to understand the coverage for specific services.
• Prior Authorization and Medical Necessity: Insurance providers often require prior authorization for certain services or treatments, including functional medicine. Additionally, they may require documentation of medical necessity to determine coverage eligibility. Musculoskeletal health and pain practitioners may be able to assist with obtaining prior authorizations and providing necessary documentation.
• Out-of-Pocket Expenses: Even if services are partially covered by insurance, individuals may still be responsible for out-of-pocket expenses, such as copayments, deductibles, and coinsurance. It’s important to understand and budget for these potential costs.

The cost of back pain treatment can vary significantly depending on various factors, including the severity of the condition, the type of treatment required, geographical location, healthcare provider fees, insurance coverage, and any additional diagnostic tests or procedures. At BHS we prioritize the lowest cost and most effective treatment based on your symptoms and condition.  Here are some common components that can contribute to the overall cost of back pain treatment:

• Medical consultations: The cost of visiting a healthcare professional, such as a general practitioner, orthopedic specialist, or physiatrist, for an initial evaluation and follow-up visits.
• Diagnostic tests: This may include X-rays, MRI scans, CT scans, or other imaging studies to help diagnose the cause of back pain. The cost of these tests can vary based on the type of imaging, facility fees, and interpretation by a radiologist.
• Medications: The cost of prescribed pain medications, anti-inflammatory drugs, muscle relaxants, or other medications that may be necessary for managing back pain. Costs can vary depending on the type of medication, dosage, and whether generic or brand-name drugs are used.
• Physical therapy: If physical therapy is recommended, the cost will depend on the number of sessions required, the duration of treatment, and whether it is done in a clinic or as part of home-based exercises. Insurance coverage may also affect the out-of-pocket costs.
• Injections or procedures: If corticosteroid injections, nerve blocks, or other interventional procedures are deemed necessary, they can contribute to the overall cost. These procedures may involve facility fees, anesthesia fees, and the expertise of specialists performing them.
• Alternative therapies: Costs associated with alternative or complementary therapies, such as acupuncture, chiropractic care, massage therapy, or other forms of therapy mentioned earlier, will depend on the number of sessions and the provider’s fees.
• Surgical interventions: In cases where surgery is necessary to address underlying causes of back pain, the cost can vary widely based on the type of procedure, surgeon fees, hospital fees, anesthesiologist fees, and post-operative care.

It’s important to note that the cost of back pain treatment can be significantly influenced by the healthcare system and insurance coverage in your country or region. Having health insurance coverage can help mitigate the out-of-pocket expenses, but specific coverage and reimbursement policies can vary.

To determine the exact cost of back pain treatment, it is recommended to consult with BHS providers, and your primary care physicians, specialists, or insurance representatives, who can provide more specific information based on your individual circumstances. Knowing more information about treatment options and their associated costs will help you make an informed decision about your care.

There can be contraindications or situations where specific treatments for back pain may not be advisable or require caution. It’s important to consult with a BHS provider to assess your individual condition and determine the most appropriate treatment options. Here are some general contraindications for certain back pain treatments:

For Conservative Care therapies:

• Open wounds, infections, or skin conditions at the site of treatment (e.g., shockwave, fascial massage therapy).
• Allergies or sensitivities to substances used in certain therapies or treatments.

For Medications:

• Allergies or hypersensitivity to specific medications or their ingredients.
• Pre-existing medical conditions or medications that may interact negatively with prescribed medications for back pain.
• Pregnancy or breastfeeding, as certain medications may not be safe for use during these periods.

For Injections or procedures:

• Active infection or skin condition at the injection site.
• Bleeding disorders or being on blood-thinning medications, as these can increase the risk of complications during invasive procedures.
• Allergies or hypersensitivity to specific medications or substances used in injections, such as corticosteroids or local anesthetics.
• Certain medical conditions, such as uncontrolled diabetes, compromised immune system, or severe osteoporosis, which may increase the risk of complications during injections or procedures.

For Surgical interventions:

• Advanced age or significant underlying health conditions that make surgery high-risk or less beneficial.
• Poor overall health or presence of other medical conditions that may impact the ability to tolerate surgery or the post-operative recovery process.
• Specific anatomical or structural factors that make certain surgical procedures inappropriate or less effective.

Contraindications can vary depending on the specific treatment modality, individual health status, and other factors. Always consult with a healthcare professional who can evaluate your condition, review your medical history, and provide personalized recommendations regarding any potential contraindications for treating your back pain. They will be able to consider your specific circumstances and advise on the most appropriate and safe treatment options for you.