About Back Pain

What Are The Different Types of Back Pain?

Back pain can be divided into two types: Central (axial) pain and Peripheral (radicular/radiating) extremity pain. Many patients have both types.

What Causes Back Pain?

Back pain can have several causes. However the most common cause of back pain is age. Other lifestyle choices can also result in back pain: poor posture, ill-advised or awkward lifting, being overweight, or an accident.

How Can I Prevent Back Pain? 

To prevent back pain maintain good posture, exercise to keep your core flexible and strong, follow a healthy diet, and pay attention to your weight.

What Causes Acute Painful Vertebral Compression?

The most common reason for vertebral compression fractures is the presence of osteoporosis; other less common causes are trauma and cancer.

What Causes Facet Joints Issues?

The facet joints in our back and neck have cartilage that allows our back/neck to bend, twist, and flex. As we age, these joints can become degenerative or arthritic – the cartilage loses fluid and height, which can lead to a bone-on-bone condition often resulting in bone spur formation and chronic neck or lower back pain. Facet joint arthritis is one of the most common causes of chronic neck or lower back pain.

What Causes SI Joint Issues?

Degenerative arthritis/inflammation of the SI joints is a common cause of chronic low back/buttock pain. Patients often complain of chronic low back pain, groin pain, and sitting intolerance without associated leg pain.

Bicycling: An Exercise Option For Lower Back Pain

Bicycling is a popular form of exercise and is a good option for people who have problems with low back pain. Biking is less jarring to the spine than many other forms of exercise, such as running or aerobics. Stationary bicycling is particularly gentle on the spine, and spinning classes can be a good workout option without causing too much stress on the back. Reclining bicycles, also called recumbent bikes, can also help those with lower back pain who feel better in a reclining position.

Although biking can be a good exercise option for those with existing back pain, it can also cause back pain if not done properly.

How Biking Can Cause Back Pain
Poor posture on the bicycle can strain the back. Leaning over, with the back arched and head up, can strain both the back and neck. Riding on rough terrain can jar and compress the spine, which can also lead to back pain. A poorly fitting bike and weak core muscles can also contribute to a cyclist’s back pain.

How to Prevent Back Injuries from Biking
Cycling doesn’t have to be hard on the back…if you do it right. Follow these tips to help prevent back pain while biking.

  • Choose the Right Bike. Select the best bicycle for your purpose. For instance, if you are a casual bike rider, you don’t need a racing-style bike. A bicycle with higher, straighter handlebars will allow you to ride with a more upright posture, and bigger tires can provide more shock absorption. Buying a bike with some sort of suspension or other shock absorbing accessories can also help lessen back pain and injury.
  • Buy from a cycling shop, instead of a department store, so you can be properly fitted for the bike. Choosing one that is too big for you will cause you to hunch over to reach the handlebars, eventually leading to back pain. A trained salesperson can also properly adjust the height and angle of the seat and handlebars, providing the least amount of strain on your back.
  • After choosing the bike, take it on an extended ride to see how your back responds. Most cycling stores have areas specifically designed for test rides.
  • Maintain Proper Form When Biking. Proper posture while cycling is crucial if you want to avoid back pain. Try to keep your back straight, and avoid slouching or hunching your shoulders while riding. Distribute some of the weight to your arms and hands while keeping your chest and head up.
  • Keep your arms slightly bent while riding, which allows your upper body, rather than your spine, to absorb some of the vibrations and impact. Maintaining a 90-degree knee angle at the top of the stroke is more efficient and best for your hips and low back. Additionally, shifting positions and changing the angle of your upper body periodically will help prevent muscle fatigue.
  • Strengthen and Stretch. Biking does not specifically strengthen the body’s core muscles (the abdominals and back muscles), which most doctors feel are a critical component of preventing lower back pain. Even if you have strong legs—a cyclist’s most obvious source of power—a weak core can slow you down. Any exercise that strengthens your core, such as planks or swimming, will help reduce your potential for back injury while biking.
    Strengthening your buttocks and legs can also help reduce the risk of back pain. Weak and tired leg muscles can negatively impact a cyclist’s posture, putting him or her at risk for back pain. Increasing the strength in your legs and glutes before you begin cycling can reduce that risk.
  • Having a flexible back, in addition to a strong one, is crucial for enduring the posture required of cycling without leading to strains. Regular stretching, combined with yoga, can be a great way to keep your back limber, improve your posture, and avoid back pain.

Tips for Avoiding Back Pain While Gardening

A beautiful, warm spring day is perfect for heading outside to tend to your yard and garden. After a long winter, it feels great to be out sprucing up the landscaping or planting flowers. Unfortunately, though, many of us might not feel quite so great the next morning, as an entire day of yard work has resulted in aches, pains, and muscle stiffness.

Gardening can be especially hard on the back, but it doesn’t have to be. If you take the following precautions, you can have a beautiful garden—as well as a healthy back—this spring.

Pace yourself. Set attainable goals, and don’t feel you have to finish every project in one day. Work steadily, but don’t push yourself to finish big projects that can be broken up over several days. It’s also important to take frequent breaks. Take a five-minute break every hour to stretch, relax, and drink water.

Lift with your knees. Gardening can involve some heavy lifting, whether it’s moving large pots or carrying bulky bags of soil or mulch. Bending over to pick up large items puts extra stress on the back, so be sure to bend at the knees when lifting heavy objects. Also, position yourself close to the object or task. Bring a heavy object closer to you before lifting, or walk over to what you need, rather than bending or reaching, which can put undue strain on the back.

Raise your garden. Growing flowers and vegetables in raised beds helps reduce the need to bend over for weeding and cultivating. Creating a tabletop garden or planting in pots, which you can place where they are comfortable for you to reach, are also good options, especially if you already suffer from back pain. Placing pots on caddies with casters can make the plants even easier to move.
Use long-handled tools. Look for tools with a 3- to 4-foot-long handle that can help you stay more upright—or even work while sitting down—while weeding, cultivating, or watering.

Loosen up. Remember that gardening and yard work can be strenuous activities; therefore, treat them as you’d treat any exercise or physical activity. Stretch your muscles thoroughly beforehand, and be sure to cool down when you’re done, as well, to avoid strained muscles.
Switch it up. Avoid repetitive-motion injuries by dividing up each task into sections that will allow you to switch activities, as well as your posture, often. For instance, if you’re kneeling down to weed, take a break to stand up and water some plants before starting on another section of weeding.

Listen to your body. If you garden for pleasure, it won’t be fun if you’re too sore or injured to do it. If your back (or another part of your body) starts to hurt, it’s sending you a message that it’s time to take a break. Don’t push yourself so hard that you’re hurting too much to enjoy the hobby!

Tennis and Back Pain

Tennis can be hard on a player’s body. While most people associate tennis with injuries to the wrist and arm—hence the term, “tennis elbow”—low back pain is also very common among tennis players.
How Does Tennis Cause Back Pain?

Low back pain associated with tennis can have various causes:

  • The hard surface of the court and uneven nature of the sport, which places most of the burden on one side of the body, can cause
aches and pain in the neck, shoulders, and back.
  • Bad posture is a common culprit of back pain for tennis players. Many players keep their heads forward with their upper backs
rounded, placing undue stress on the lower back.
  • Forehand and backhand shots require a large amount of trunk rotation, which twists the spine.
  • The tennis serve hyperextends the lower back and can compress lumbar discs. This hyperextension can stress the small joints in the  spine, lumbar discs, and muscles, ligaments, and tendons around the spine.
  • During the game, back muscles must support continual and sudden forward and lateral movements. These start-and-stop motions
are, of course, hard on the back.

What Symptoms Should Tennis Players Watch For?

Back pain symptoms experienced by tennis players include a sudden and sharp, or a persistent, dull pain in the lower back. The pain is sometimes only on one side and tends to worsen with movement and activity. The pain may also radiate to the hips, buttocks, or back of the thigh.

How Can I Prevent Back Pain While Playing Tennis?

Prevention goes a long way in avoiding any kind of injury, and following these tips can decrease your chances of back injury when hitting the tennis court:

  • Get fitted by a professional for a racket appropriate for you. A more flexible racket requires more trunk rotation than a stiffer racket with less tension in the strings. Also make sure the racket is the right size for you, as an improperly sized racket can place undue stress on the elbow and/or back.
  • Consider using a slice serve rather than a kick serve to reduce the degree of back arch.
  • Use proper form—bending the knees and holding in the abdominal muscles. Watch your posture, making sure to keep your shoulders back and avoiding rounding your upper back. It may be beneficial to have a tennis professional check your form and posture, especially if you are new to the game. A pro can teach proper form and make suggestions on how to avoid back injuries.
  • Exercise your core regularly. As in all sports, strong core body muscles are essential and can help prevent injuries to other parts of the body, including the back.
  • Wearing the right tennis shoe can help you avoid back injury. Look for shoes with good shock absorption and good traction.
  • As with any physical activity, be sure to stretch well both before and after you play tennis to avoid tight or pulled muscles.

Avoid Back Pain by Strengthening Your Core

Approximately 25 percent of Americans are affected by back pain in any given year, spending more time at the doctor’s office for back pain than for any other medical condition except high blood pressure and diabetes.

Back pain sufferers can potentially avoid those doctor visits, as well as costly prescriptions and surgery, by doing simple exercises at home.

A weak core is one of the most common causes of low back pain. Building strength and stamina in your core—the muscles between your chest and butt—can go a long way in preventing back pain.

Strong core abdominal muscles help stabilize your spine. When these muscles are weak, the long, strap-like muscles in the back—whose function is to help us rotate, twist, and bend—instead begin to take over the stabilizing function. The back muscles tighten and contract, which can lead to painful spasms and potential injury.

One simple way to strengthen your core is by slowly pulling your belly button in to engage the abdominal muscles. Becoming conscious of engaging those muscles while you perform everyday activities will go a long way to improve your core. Engage the muscles, while still breathing normally, as you go about your day—while rising to a standing position, lifting your child or a heavy object, or bending down to pick something up off the floor.

Two other easy exercises to strengthen your core are the plank and the “Superman.” To do a plank, lie down on the floor on your stomach and raise yourself up on your forearms and toes. Squeeze your butt and suck in your gut, while holding your head in a neutral position. For the “Superman,” lie on your stomach, while raising your legs and arms a couple of inches off the floor, again, holding your head neutral.

Hold each position for as long as you can. It’s perfectly fine if you can only hold for five seconds at first. Repeat several times a day until you can work up to a minute or longer.

Other exercises to strengthen the core include partial crunches, wall sits, and pelvic tilts. Some movements in exercise programs such as Pilates, Tai Chi, and some forms of yoga can also focus on building strong abdominal muscles.

Without specific back and abdominal exercises to target these muscles, they will naturally weaken over time, increasing the chance of developing or worsening back pain. Conversely, developing combined strength in stomach and back muscles can reduce the likelihood and severity of back pain and injury, improve posture, facilitate healing from back injury, and help avoid back surgery in some cases.

Exercising your core should be included as a part of your daily routine of good health and should only take a few minutes out of your day to complete.

Running and Back Pain

In recent years, running has seen a huge spike in popularity. More and more athletes are participating in half and full marathons, as well as “fun” running events—where runners are doused with colorful powders, run through muddy obstacle courses, or have to outrun “zombies.” Besides the “fun” element added to running in recent years, running remains popular due to its affordability and accessibility. All you really need is a good pair of running shoes and a road (or treadmill!).

Although running is an easy and excellent form of aerobic exercise, it can be a source of back pain for many athletes. The repetitive jarring of the spine from the up-and-down motion, combined with a hard running surface, can worsen a current or emerging back problem.

How Can Running Cause Back Pain, and What Can I Do to Avoid it?

By knowing what can cause back pain while running and improving your technique, you can help decrease your chances of experiencing painful symptoms.

The Problem: Force and jarring.

Joints and discs are jarred and compressed by the force of the body leaving the ground and landing on every stride when running or jogging. Running on hard surfaces, such as concrete or asphalt, can be especially jarring to the back.

The Solution: Use proper form and vary your training ground.

Use form that reduces the up-and-down stride motion and focuses on forward motion while running; this means leading with the chest, keeping the head tall and balanced over the chest. Grass, trails, padded tracks, and treadmills soften the force of impact and also produce stronger legs. Because your feet sink into soft surfaces, your body works harder to push off than when running on concrete. Try to maintain a flat running course, as leaning forward to climb a tall hill can put pressure on the back, and avoid slanted sidewalks and road shoulders, as running on an uneven surface can also cause damage.

The Problem: Weak core and leg muscles.

The back muscles have to work to keep the body upright and in good posture during the run. Weak abdominal muscles don’t support the back well, thus straining the hip muscles and putting tension on the lower back. Also, as you run, your gluteals and hamstrings don’t get worked as hard as your hip flexors or quadriceps. This imbalance can put extra pressure on your back to make up for weaker leg muscles.

The Solution: Build strong abs, glutes, and hamstrings.

Do specific exercises to target weaker muscles. Cross training can also give you a break from running—and possible back pain—by working other muscle groups and avoiding repetitive overuse. Also be sure to stretch your muscles completely before beginning each run to avoid additional injury from tight muscles.

The Problem: Bad feet.

Flat feet, fallen arches, and weakness in the feet can also be to blame for back pain. The arch absorbs shock and takes the weight and pressure from each foot strike. If the arch has fallen, it sends a ripple effect up the back, causing undue stress and possible injury.

The Solution: Wear proper running shoes.

Visit a specialty running store to be fitted with shoes for your foot type. Employees can assess your running technique and recommend the right shoes or insoles, if needed, for your technique and training goals.

Running can cause back pain that ranges from a dull and achy back to decreased flexibility and mobility to injured discs and fractures. While some injuries can be treated at home, others may require a doctor’s care. If you have followed the above suggestions and still suffer from chronic back pain, it’s time to give us a call.

Snow Shoveling: Tips for Avoiding Back Pain this Winter

Winter is upon us, and, like it or not, winter means snow—and consequently, snow shoveling—here in Central Indiana.

Did you know that shoveling snow is a frequent cause of injury, causing thousands of back and shoulder injuries each year? Below are a few tips on how you can be safer this winter and take precautions to avoid injury while shoveling.

☞ Stretch first. Snow shoveling can be compared to weight lifting, and the aerobic aspect of this activity is similar to the workout one gets on a treadmill. Tight muscles are more prone to injury; thus, as with any exercise, it is important to first stretch your muscles before heading out to the driveway.

☞ Wear proper attire. Being cold will tighten up your muscles and leave you vulnerable to painful muscle strains. Therefore, wear warm layers that you can shed should you become too hot. Thick gloves will keep your hands warm and dry and will also allow for a good grip on the shovel’s handle. And boots with good traction will help you maintain your balance, preventing unfortunate slips and falls.

☞ Pace yourself. Snow shoveling is strenuous work. Be sure to take frequent breaks to rest, stretch, and drink plenty of water. If you experience pain of any kind, stop immediately and seek assistance.

Create better traction. If the ground is icy or slick, spread sand or salt over the area to help create foot traction. While shoveling itself can cause damage to the back if done incorrectly, slipping and falling can also obviously cause injury; therefore, it is important to watch your footing and do your best to prevent falls in the first place.

☞ Choose the right shovel. Using an ergonomically correct shovel—one with a curved handle—allows you to keep your back straighter while shoveling, thus reducing spinal stress. Choosing a shovel made to push snow is also a good option. Consider using a shovel with a plastic blade, which will be lighter weight than one with a metal blade. Finally, a smaller blade may be preferable over a wider one. You will not be able to shovel as much snow per load, but the loads will weigh less, putting less strain on your spine with each pass.

☞ Use proper technique. Use good posture and maintain the natural curve of your spine while shoveling. Keep the shovel close to your body, and create some distance between your hands while gripping the handle. This will give you more leverage and make it easier to lift the snow. Lift with your legs—not your back—and tighten your stomach muscles as you lift. Don’t throw the snow over your shoulder or twist your body while dumping snow; instead, dump it in front of you. If you must dump it in another spot, walk over, as opposed to leaning over or throwing the snow. Rotating or twisting your body, especially with a shovelful of heavy snow, can be an easy way to injure your back.

☞ Shovel early, shovel often. Snow becomes more dense as it compacts on the ground, and wet snow is very heavy, weighing as much as 20 pounds per shovelful! Fresh snow is lighter in weight, so clear snow as soon as it has fallen. As snow continues to fall, you may find yourself outside several times, but it is much easier to clear fresh, lighter snow than dense, heavy, wet snow.

☞ Consider a snowblower. If shoveling is too strenuous for you, using a snowblower can be a good option. However, if not used correctly, it can still cause back strain. Snowblowers are designed to remove snow at a particular rate of speed, so pushing or forcing the equipment to go faster defeats the purpose—and puts you at risk of injury.

Overall, the best thing to do while shoveling snow is to use common sense. Stop shoveling if you feel any pain at all, and don’t feel you have to tackle the whole job all at one time. If you are out of shape or have had back injuries in the past, it is best to check with your doctor before shoveling. (Or, better yet, consider hiring the job out!)

You May Be Able to Treat Your Back Pain for Little Out-of-Pocket Cost

The year is winding down, and although it’s likely a very busy time of the year for you, it’s also a good time to think about your health and do something about that back pain that’s been keeping you from enjoying everyday activities.

The end of the year is the time to make sure you are getting the most out of your health insurance plan. If you have met your deductibles or have funds remaining in your Health Flexible Spending Account (FSA), you may be able to treat your back pain for little out-of-pocket cost to you.

Deductibles, Maximum Out-of-Pocket Expenses and FSA Funds
Most insurance policies calculate deductibles and maximum out-of-pocket expenses based on the calendar year. Medical expenses incurred during the year are applied to your deductible and are paid out-of-pocket until that deductible is met.

Once your deductible is met, you incur little or no out-of-pocket for covered medical expenses.

So if you’ve met or nearly met your 2105 medical deductible, now is the perfect time to take care of any medical procedures you may have been putting off. But don’t wait, copays, deductibles, and out-of-pocket expenses are reset on January 1, 2016.

As the end of the year approaches, it’s also a good time to check your policy and balances. If you’ve already met your deductible or if you have funds left in your FSA, and you’ve been putting off treating your back pain, now is the time.

Schedule now to get your procedure before the end of the year. Don’t wait because medical facilities typically experience a heavy demand for procedures towards the end of the year as patients try to maximize their benefits.

Stop suffering, and schedule your back pain relieving, minimally invasive, non-surgical treatments including: kyphoplasty, epidural steroid injections (ESIs), selective nerve root block (SNRB), medical brand (facet joint) denervations, or sacroiliac (SI) joint injections AND maximize your insurance benefits and FSA account funds.

Chronic Back Pain? Make The Most of Your FSA Balance

Start off 2016 pain-free by using your remaining 2015 FSA savings to schedule that chronic back pain treatment you’ve been putting off.

The new year is just around the corner. If you have a health Flexible Spending Account (FSA), it’s time to check your balance and start thinking about how you can use, not lose, the money you’ve put into your account.

With the introduction of minimally invasive, non-surgical back pain treatment procedures, you could be pain-free (with little down time and almost immediate back pain relief) before the end of the year.

If you’ve been considering any of the following procedures, you now have a very important motivator to schedule your appointment: money.

☤ Kyphoplasty
☤ Epidural steroid injections
☤ Selective nerve root blocks
☤ Facet joint (medial branch) blocks
☤ Denervations
☤ Sacroiliac (SI) joint injections

Medical facilities typically experience a heavy demand for procedures toward the end of the year as patients try to maximize their benefits, so the sooner you schedule your appointment, the better.

The fact that your procedure may be of little or no cost to you could be just the motivation you need to take care of those nagging aches and pains.  You don’t need to wait to schedule your non-surgical, minimally invasive back pain treatments, such as kyphoplasty, epidural steroid injections (ESIs), selective nerve root block (SNRB), medical brand (facet joint) denervations, or sacroiliac (SI) joint injections.

Take action now. Make the most of your benefits and make the most of the funds that are just waiting to relieve your back pain this year. Start off 2016 without back pain.

Golf and Back Pain

Golf is a great sport for all ages to enjoy. It’s an excellent form of exercise, especially if the golfer skips the cart and walks the course. As with any sport, though, there is risk of injury.

How Golf Causes Low Back Pain

For golfers, the most common ailment is lower back pain. Amateur golfers who do not play frequently often demonstrate multiple inconsistencies in their swing, leading to injury resulting from poor mechanics.

Repeated twisting, combined with the force inherent in a golf swing, leaves the lower back susceptible to injury. Spinal muscles and facet joints work to help provide force during the golf swing. Overuse can cause stiffness and irritation in these joints and the surrounding muscles.

Abnormal motions coming from other areas of the body, including the hips and shoulders, can force the golfer’s lower back to do unnecessary, excessive work and may also cause harm.

While walking the course provides much more exercise than riding in a cart, carrying the golf bag in an improper manner can cause undue strain on back muscles. Likewise, bending over to pick up the bag, or even the golfball or club, may also stress the back.

Preventing Back Injuries from Golf

As with many health conditions, a little effort to prevent back injury and pain can go a long way.

  • Warm up prior to playing.

Heading directly to the course first thing in the morning and hitting the ball as hard as you can is probably the easiest way to strain your back muscles and end up in pain. Instead, start with stretches that emphasize the shoulders, torso, and hips. Light, gentle warm-up swings will do wonders to loosen up your back before playing and will help prevent injury during your round. Overall, muscles that have been stretched and gradually loaded are less prone to being injured while playing golf and can take more stress before being strained or sprained.

  • Learn and use proper form.

The objective of a golf swing is to develop significant club head speed, and to do this, a great deal of torque and torsion are applied to the lower back. With a proper swing, the shoulders, hips, chest, and lower spine all rotate to share the load of the swing. A fluid, rhythmic swing produces less stress and less low back pain. It is also important to remember to bend at the knees while picking up your ball, as repeated bending at the waist can cause unnecessary stress on the back.

To avoid back injury, beginners would be well advised to work with a golf pro when starting out, especially since most aspects of a golf swing are not natural or intuitive. Additionally, senior golfers with decreased flexibility and strength and anyone with lower back problems would benefit from lessons with a professional who is experienced at teaching golfers with bad backs.

  • Carry your bag safely.

Choose a golf bag with a built-in stand. Repeated bending over to pick up a golf bag from the ground can stress the low back and lead to muscle strain. Bags that place all the pressure on one shoulder can also be hard on the back. Choosing a bag that has dual straps evenly divides the weight across the back and reduces the chances of developing low back pain from an uneven load.

A little knowledge and preparation can help keep you in the game.

Don’t let back pain keep you from enjoying the sport you love.

Interventional Physicians of Indiana is a leading provider of kyphoplasty and back pain relief services. We have served Central Indiana since 2003.

Our Indianapolis radiologists offer state-of-the-art, minimally invasive, nonsurgical procedures, and have accumulated one of the largest single center practices in the country.

Indiana Back Pain Center has convenient locations in the Indianapolis metro area and we offer convenient scheduling options. Get your life back and quit suffering from acute back pain.