Transcutaneous electrical nerve stimulation (TENS) involves wearing a battery-powered device consisting of electrodes placed on the skin over the painful area that generate electrical impulses designed to block incoming pain signals from the peripheral nerves. The theory is that stimulating the nervous system can modify the perception of pain. Early studies of TENS suggested that it elevated levels of endorphins, the body’s natural pain-numbing chemicals. More recent studies, however, have produced mixed results on its effectiveness for providing relief from low back pain.
Rest. If your back hurts a lot, take a break. But try not to let too much time pass before you get moving again. Instead, return to your activities slowly, and avoid things that make your pain worse. Studies show that bed rest doesn't relieve back pain better than staying active. And bed rest of more than a couple of days can make your back pain worse and lead to other problems, such as stiff joints and muscle weakness.
The lumbar spine (lower back) consists of five vertebrae in the lower part of the spine between the ribs and the pelvis. The bones (vertebrae) that form the spine in the back are cushioned by small discs. These discs are round and flat, with a tough, outer layer (annulus) that surrounds a jellylike material called the nucleus. Located between each of the vertebra in the spinal column, discs act as shock absorbers for the spinal bones. Thick ligaments attached to the vertebrae hold the pulpy disc material in place. Of the 31 pairs of spinal nerves and roots, five lumbar (L1-L5) and five sacral (S1-S5) nerve pairs connect beginning in the area of the lower back.
In such cases, even though you feel it in your back, the problem that actually needs the treatment will likely be located elsewhere in your body. For this reason, it’s working with your doctor, and possibly a specialist as well, is key. Going to see a chiropractor, taking pain meds and waiting for the pain to go away and/or trying exercise may not fully resolve the issue, especially if the pain is due to a systemic health issue or problems with an organ.
I highly recommend K-Laser because it is the only Class 4 therapy laser that utilizes three infrared wavelengths that can deeply penetrate into your body to reach areas like your spine and hip. It also costs just a fraction of surgery and does not have any detrimental side effects – a great advantage, since surgery can not only have life-threatening side effects, but also exposes you to dangerous hospital infections.
What to know about menstrual cramps Menstrual cramps can be a monthly trial for many people when they approach menstruation, as well as in the first few days of their period. Find out why cramps happen and what can aggravate the symptoms. This article explains the treatments available from the doctor and what you can do at home to lessen their impact. Read now
2009 — New section: Today I found a way to say some simple things about the power of self-treatment that have been “on the tip of my tongue” for years now. It all evolved from writing about an important bit of research, showing that manual therapists cannot (reliably) diagnose trigger points. [Section: Limitations of trigger point therapy, and how to take advantage of them.]
Things get a little more complicated if one of the other issues on this list is causing your back pain, because they all come with a wealth of treatment options. They include cortisone injections to calm disc-related inflammation to laparoscopic surgery to remove endometrial lesions to shock wave therapy that can smash a kidney stone into smaller pieces so you can pee them out. If you suspect one of these issues is at the root of your lower back pain, you’re not going to be able to tackle it on your own. Loop in your doctor so you can create an expert-approved treatment plan that will get you back on your feet.
Degenerative disc disease. At birth, intervertebral discs are full of water and at their healthiest. As people age over time, discs lose hydration and wear down. As the disc loses hydration, it cannot resist forces as well, and transfers force to the disc wall that may develop tears and cause pain or weakening that can lead to a herniation. The disc can also collapse and contribute to stenosis.
Complaints of low back pain are one of the most common reasons people visit doctors.[9][42] For pain that has lasted only a few weeks, the pain is likely to subside on its own.[43] Thus, if a person's medical history and physical examination do not suggest a specific disease as the cause, medical societies advise against imaging tests such as X-rays, CT scans, and MRIs.[42] Individuals may want such tests but, unless red flags are present,[10][44] they are unnecessary health care.[9][43] Routine imaging increases costs, is associated with higher rates of surgery with no overall benefit,[45][46] and the radiation used may be harmful to one's health.[45] Fewer than 1% of imaging tests identify the cause of the problem.[9] Imaging may also detect harmless abnormalities, encouraging people to request further unnecessary testing or to worry.[9] Even so, MRI scans of the lumbar region increased by more than 300% among United States Medicare beneficiaries from 1994 to 2006.[11]
Overall, the outcome for acute low back pain is positive. Pain and disability usually improve a great deal in the first six weeks, with complete recovery reported by 40 to 90%.[2] In those who still have symptoms after six weeks, improvement is generally slower with only small gains up to one year. At one year, pain and disability levels are low to minimal in most people. Distress, previous low back pain, and job satisfaction are predictors of long-term outcome after an episode of acute pain.[2] Certain psychological problems such as depression, or unhappiness due to loss of employment may prolong the episode of low back pain.[13] Following a first episode of back pain, recurrences occur in more than half of people.[23]
For about one month, off and on, gradually getting worse everyday, I have had upper back pain. A sharp, radiating pain. It hurts when I move, stretch, breathe or bend. I cant lay down in bed without it hurting. I have to catch my breath when i turn or sit or lay and cease movement for a minute because of the pain. It almost feels like there is a big bubble of air in there trapped. Im taking vicodan and percocet for pain, however, when it wears off the pain is back. What is this. I havent had any accidents or picked up anything?
Muscle strain: Whether your job involves heavy lifting or you practice weight-lifting in the gym, ensuring you do so using correct form is crucial to preventing middle back pain. The pain experienced in the middle back associated with lifting improperly is due to muscle strain that can make your job or fitness routine extremely difficult and painful. Be sure to use the proper lifting technique to prevent this—bend at the knees and use your legs to help lift the weight, and carry the heavy mass close to your body to reduce the risk of painful muscle strain.
When a herniated disc is compressing the nerve roots, hemi- or partial- laminectomy or discectomy may be performed, in which the material compressing on the nerve is removed.[41] A mutli-level laminectomy can be done to widen the spinal canal in the case of spinal stenosis. A foraminotomy or foraminectomy may also be necessary, if the vertebrae are causing significant nerve root compression.[41] A discectomy is performed when the intervertebral disc has herniated or torn. It involves removing the protruding disc, either a portion of it or all of it, that is placing pressure on the nerve root.[55] Total disc replacement can also be performed, in which the source of the pain (the damaged disc) is removed and replaced, while maintaining spinal mobility.[56] When an entire disc is removed (as in discectomy), or when the vertebrae are unstable, spinal fusion surgery may be performed. Spinal fusion is a procedure in which bone grafts and metal hardware is used to fix together two or more vertebrae, thus preventing the bones of the spinal column from compressing on the spinal cord or nerve roots.[57]
Bone scans are used to detect and monitor infection, fracture, or disorders in the bone. A small amount of radioactive material is injected into the bloodstream and will collect in the bones, particularly in areas with some abnormality. Scanner-generated images can be used to identify specific areas of irregular bone metabolism or abnormal blood flow, as well as to measure levels of joint disease.

Injury to Aorta: One of the most dangerous causes of mid-back pain is a problem with the aorta, the large artery that carries blood from the heart to the rest of the body [4]. The lining of the artery can tear, resulting in aortic dissection. Severe, sharp pain to the mid-back is a symptom of aortic dissection. People with high blood pressure are at higher risk. Aortic dissection can be a life-threatening condition needing immediate evaluation.


One potential cause of back pain is a condition called costochondritis, an inflammation of the cartilage connecting your ribs to your breastbone. While lifting heavy items, respiratory infections, and chest injuries can cause it, often the source of the pain is unclear. You may feel pain that travels from your chest to your back. Definitely get checked out by your doctor, it often goes away without any treatment.
Individuals should not postpone seeing a doctor about kidney pain or flank pain. Although flank pain is often seen in underlying problems with the kidney, there are many other diseases that can mimic kidney pain, and a physician can help with an accurate diagnosis of underlying problems that result in kidney or flank pain. Any acute onset of intense kidney or flank pain should be evaluated immediately.

Low and lower back pain can vary from dull pain that develops gradually to sudden, sharp or persistent pain felt below the waist. Unfortunately, almost everyone, at some point during life will experience low back pain that may travel downward into the buttocks and sometimes into one or both lower extremities. The most common cause is muscle strain often related to heavy physical labor, lifting or forceful movement, bending or twisting into awkward positions, or standing in one position too long.
This myth of “mechanical” failure of the low back has many unfortunate consequences, such as unnecessary fusion surgeries — a common and routinely ineffective procedure — and low back pain that lasts for years instead of months or weeks. The seriousness of chronic low back pain is often emphasized in terms of the hair-raising economic costs of work absenteeism, but it may well be far worse than that — a recent Swedish study shows that it probably even shortens people lives.5 The stakes are high. “Tragedy” is not hyperbole.
Polycystic kidney disease (PKD) is characterized by numerous cysts in the kidneys. Polycystic kidney disease is a genetic disorder. There are two major inherited forms of PKD, autosomal dominant PKD, and autosomal recessive PKD. Symptoms include headaches, urinary tract infections, blood in the urine, liver and pancreatic cysts, abnormal heart valves, high blood pressure, kidney stones, aneurysms, and diverticulosis. Diagnosis of PKD is generally with ultrasound, CT or MRI scan. There is no cure for PKD, so treatment of symptoms is usually the general protocol.

Before examining your back, your doctor will ask you several questions about your back pain, like when it started, what makes it worse and better, and whether you have any associated symptoms like numbness or tingling. In order to speed up this process, it may be helpful to come to your appointment with a written description of your pain (as best as you can).
Myofascial pain affects the fascia (the connective tissue in and between muscles), and is characterized by knotty “trigger points” that hurt if pressed. If your middle back pain is a burning, tingling sensation, it may be myofascial in nature, especially if you play sports that require heavy use of the large shoulder muscles. A physical therapist can show you exercises to stretch and strengthen your muscles, and your middle back pain also may respond to massage, trigger-point therapy (pressure applied to areas of knotted muscle), and trigger point injections (lidocaine shots directly into the trigger points).

The treatment of lumbar strain consists of resting the back (to avoid reinjury), medications to relieve pain and muscle spasm, local heat applications, massage, and eventual (after the acute episode resolves) reconditioning exercises to strengthen the low back and abdominal muscles. Initial treatment at home might include heat application, acetaminophen (Tylenol) or ibuprofen (Advil, Motrin), and avoiding reinjury and heavy lifting. Prescription medications that are sometimes used for acute low back pain include non-steroidal anti-inflammatory medications, such as sulindac (Clinoril), naproxen (Naprosyn), and ketorolac (Toradol) by injection or by mouth, muscle relaxants, such as carisoprodol (Soma), cyclobenzaprine (Flexeril), methocarbamol (Robaxin), and metaxalone (Skelaxin), as well as analgesics, such as tramadol (Ultram).
This is especially true in the latter part of your trimester when your back may get strained because of carrying your baby. It is already normal for the ligaments in some areas of the back to become stretched and become inflamed but you can usually lessen the pain by applying hot compress on the lower right part of your back if that is the part causing you discomfort. If in case the pain persists, that is the time when you should see your doctor immediately.
Long periods of inactivity in bed are no longer recommended, as this treatment may actually slow recovery. Spinal manipulation for periods of up to one month has been found to be helpful in some patients who do not have signs of nerve irritation. Future injury is avoided by using back-protection techniques during activities and support devices as needed at home or work.
“The Pain Perplex,” a chapter in the book Complications, by Atul Gawande. Gawande’s entire book is worth reading, but his chapter on pain physiology is certainly the best summary of the subject I have ever read, and a terrific reminder that good writing for a general audience can be just as illuminating for professionals. Anyone struggling with a pain problem should buy the book for this chapter alone, though you are likely to enjoy the whole thing. Much of the chapter focuses on one of the most interesting stories of low back pain I’ve read, and it is a responsible and rational account — although Gawande, like most doctors, seems to be unaware of the clinical significance, or even existence, of myofascial trigger points.
I’m writing to congratulate and thank you for your impressive ongoing review of musculoskeletal research. I teach a course, Medicine in Society, at St. Leonards Hospital in Hoxton. I originally stumbled across your website whilst looking for information about pain for my medical students, and have recommended your tutorials to them. Your work deserves special mention for its transparency, evidence base, clear presentation, educational content, regular documented updates, and lack of any commercial promotional material.
This is one tough group of patients – yet Dr. Sarno has a greater than 80 percent success rate! He uses techniques like the Emotional Freedom Technique (EFT), an acupuncture-like technique that stimulates meridian points throughout your body. Read more about EFT. Sadly, many people dismiss these types of treatment strategies simply because they seem "too simple to be effective." Unfortunately, they believe that in order to get back pain relief, they need to undergo radical treatment or take medications.
Upper back pain on the left side is a common complaint encountered by physicians. Upper left back pain is pain felt in the area extending from the neck to the end of the rib cage on the left side. The upper left back area includes left lower portion of the neck, the left shoulder area, shoulder blades, region behind the chest and ribs on the left side and middle portion of the back.

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Infrared K-Laser therapy works by stimulating the cytochrome oxidase enzyme in your cells' mitochondria. It enhances microcirculation and stimulates the red blood cell flow in the area being treated. K-Laser therapy helps reduce pain and inflammation and enhances tissue healing in hard and soft tissues, including your muscles, bones, and ligaments. It also returns venous and lymphatic function, as your tissues become oxygenated.
I recently went on a coast to coast, 6,000 mile tour, and decided to try an experiment: I avoided sitting as much as I could. For example, in one room, I placed the mini fridge on the desk to make a modified standing desk. In the other room, I used a waste paper basket on another desk. By doing this, I was able to reduce my 12 to 14 hours of daily sitting to just under an hour.
Few people need surgery for back pain. If you have unrelenting pain associated with radiating leg pain or progressive muscle weakness caused by nerve compression, you might benefit from surgery. Otherwise, surgery usually is reserved for pain related to structural problems, such as narrowing of the spine (spinal stenosis) or a herniated disk, that hasn't responded to other therapy.
Participating in a regular regimen of back exercises can help make your muscles stronger and better able to support your spine. You should perform these exercises in sessions of 15 to 30 minutes a day, at least two or three times each week, experts say. Be sure to consult your doctor before starting such a program, however, especially if you're already experiencing from upper back pain.

Back pain related to a spinal fracture should also make your doctor think of lung cancer. With metastatic lung cancer, bone metastases occur in around 40 percent of people. The most common sites of spread are the spine (occurring in at least 50 percent) and large bones of the legs. Cancer which as invaded the vertebrae results in brittleness and weakness of the bone and compression fractures may commonly occur. Fractures that occur in a bone weakened by cancer are referred to as pathologic fractures. A sign that suggests that a compression fracture in the spine is related to lung cancer (instead of osteoporosis) is a fracture which occurs with only minimal trauma.
Neck and upper back pain can limit your movements and capabilities. If you don’t do anything about your pains, they can get worse, spread, and limit you further. This is usually because the muscles around your immediate area of pain have tensed up to protect that one spot. That expansion limits movement and can turn one clenched muscle under your shoulder blade into a painful shoulder and a tension headache.
Stand against a wall with your feet shoulder-width apart. Begin with your arms dangling at your sides and your shoulders relaxed. Put your arms out like Frankenstein then pull your elbows back to the wall next to your ribcage. Next, try to bring the backs of your hands and your wrists to the wall to the sides of your shoulders. You’re making the shape of a W, with your torso as the center line. Hold it for 30 seconds. Do three rounds, at least once and up to three times per day.

If you can’t set up an ergonomic workstation, Dr. Oberle recommends taking regular breaks to stretch and move around. Though this of course varies by individual, she suggests doing so every 15 minutes. (This is her recommendation for generally healthy people—if you have health issues that don’t make this feasible, check in with your doctor for specific guidelines.) Even if you can’t actually move this often, you should be checking your posture regularly and adjusting accordingly.

Sit in a chair with good lumbar support and proper position and height for the task. Keep shoulders back. Switch sitting positions often and periodically walk around the office or gently stretch muscles to relieve tension. A pillow or rolled-up towel placed behind the small of the back can provide some lumbar support. During prolonged periods of sitting, elevate feet on a low stool or a stack of books.

I am a science writer, former massage therapist, and I was the assistant editor at ScienceBasedMedicine.org for several years. I have had my share of injuries and pain challenges as a runner and ultimate player. My wife and I live in downtown Vancouver, Canada. See my full bio and qualifications, or my blog, Writerly. You might run into me on Facebook or Twitter.
If you spend most of your time sitting, pay careful attention to consciously sucking in your belly and rotating your pelvis slightly up. At the same time, you should keep your head back, with your ears over your shoulders and your shoulder blades pinched. This posture will keep your spine in proper alignment. Do this every hour you’re sitting, holding the muscles tight for several minutes.
Age: The first attack of low back pain typically occurs between the ages of 30 and 50, and back pain becomes more common with advancing age. As people grow older, loss of bone strength from osteoporosis can lead to fractures, and at the same time, muscle elasticity and tone decrease. The intervertebral discs begin to lose fluid and flexibility with age, which decreases their ability to cushion the vertebrae. The risk of spinal stenosis also increases with age.
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