American Medical Association Family Medical Guide - American Medical Association [709]
Prone press-ups
Lie on your stomach with your elbows bent and hands meeting in front of you. Rest your forehead on your hands (top). Slowly straighten your arms, raising your torso from the waist while keeping your pelvis on the floor (bottom). Relax, allowing your back to sag from your shoulders and pelvis. Hold this position for 5 seconds. Return to starting position. Do one set of 10.
Curl-ups
Lie on your back with your knees bent, feet flat on the floor, and your arms crossed with hands on the opposite shoulder. Tighten your abdominal muscles and press your lower back into the floor as you lift your head and shoulders from the floor, keeping your chin tucked and looking at your abdomen. Hold for 5 seconds, then release. Do three sets of 10.
Extension
Get on your hands and knees on the floor, centering your shoulders over your wrists (top). Keeping your back straight and your abdomen lifted, lift one leg and the opposite arm at the same time, straightening the leg and lifting the arm forward and upward (bottom). Hold for 5 seconds. Return to the starting position and repeat with the other arm and leg. Do three sets of 10.
Self-Help for Backaches
Whatever the cause of your backache, you can take steps to ease the pain and speed healing. But if your backache persists for more than 3 or 4 days, see your doctor.
• Use pain relievers such as aspirin, ibuprofen, naproxen, or ketoprofen.
• For the first 24 to 48 hours, apply cold packs for 10 to 20 minutes at a time to reduce swelling and relieve pain. After a day or two, apply heat to the painful area to relax the muscles and promote healing.
• Lie flat on your back on a firm mattress or on the floor. If you are lying on your back, don’t use a pillow, or use only a single, flat pillow under your head. You might get relief by putting a pillow under your knees. If you are lying on your side, try putting a pillow between your knees and one under your head to keep your spine straight. Lying on your stomach is usually not recommended if you have a backache. While resting your back during the day, don’t stay in bed for prolonged periods; get up and walk around for at least a few minutes every hour or two.
• For some types of back pain, doctors recommend wearing a special brace that supports the back.
• An osteopathic physician, a chiropractor, or a physical therapist may be able to manipulate the vertebrae of the spine enough to take pressure off the adjacent nerves and relieve pain temporarily.
Diagnosis and Treatment
If you have symptoms of a prolapsed disk, your doctor will carefully examine your back and legs and may order X-rays, a CT scan (see page 112), an MRI (see page 113), and tests of the nerves of your spine.
How a Prolapsed Disk Causes Pain
The flexible disks between your vertebrae act as shock absorbers. Each disk has a hard outer layer and a jellylike core. When your back is strained, pressure may push some of the jellylike core through a weak point in the hard outer layer. If the jellylike core presses against a nerve where it leaves the spinal cord, it can cause pain.
Prolapsed disk
Common site of pain from a prolapsed disk
Treatment of a prolapsed disk varies, depending on the location of the prolapse along the spine. Resting flat on your back is usually the best treatment. Applying heat to the painful area may help relieve the pain. If the prolapsed disk is in your neck, you may need to wear a support collar for several weeks.
Your doctor may inject a corticosteroid drug into the area of the compressed nerve to reduce inflammation, or inject an anesthetic into the lower part of your spine to relieve pain. He or she may recommend traction, a technique to align the bones by gradually applying tension through a system of weights and pulleys. In some cases,