How do I place an order?

If you are suffering from Sacroiliac Joint Dysfunction and/or Symphysis Pubis Dysfunction and you would like to order an ACTIVE SI BELT®, you may place an order with us, or you can contact one of our online distributors.

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How common is back pain?
If you have lower back pain, you are not alone. Nearly everyone at some point has back pain that interferes with work, routine daily activities, or recreation. Americans spend at least $50 billion each year on low back pain, the most common cause of job-related disability and a leading contributor to missed work. Back pain is the second most common neurological ailment in the United States — only headache is more common. Fortunately, most occurrences of low back pain go away within a few days. Others take much longer to resolve or lead to more serious conditions.

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What causes low back pain?
There are two primary causes of back pain: mechanical back pain and medical disease.

1. Mechanical low back pain happens when excessive and/or prolonged stress is placed on your back due to an unstable core (meaning that you are unable to prevent your spine and pelvis from going into positions of excessive flexion, extension and rotation during normal functional movements), improper lifting techniques, poor posture, abdominal/back muscle weakness, lower crossed syndrome, trauma, auto injuries, sports injuries and work injuries. Another common cause of low back pain is muscular imbalances where a muscle group like the hip flexors or hamstrings is shortened or tight and another muscle group like the abdominals is weak. Over time, these imbalances place great stress on the ligaments, discs and muscles in your low back and can result in back pain and sacroiliac joint pain. Spinal disorders such as arthritis, degenerative joint disease, degenerative disc disease, disc herniations, spondylosis, spondylolysis and spondylolisthesis can all cause back pain. Many people who have not taken care of their back problems earlier in life may develop these types of spinal disorders over time.

2. Many medical conditions can cause back pain, please contact your doctor if you have any questions about why you have back pain

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Pain can occur when, for example, someone lifts something too heavy or overstretches, causing a sprain, strain, or spasm in one of the muscles or ligaments in the back. If the spine becomes overly strained or compressed, a disc may rupture or bulge outward. This rupture may put pressure on one of the more than 50 nerves rooted to the spinal cord that control body movements and transmit signals from the body to the brain. When these nerve roots become compressed or irritated, back pain results.

Occasionally, low back pain may indicate a more serious medical problem. Pain accompanied by fever or loss of bowel or bladder control, pain when coughing, and progressive weakness in the legs may indicate a pinched nerve or other serious condition. People with diabetes may have severe back pain or pain radiating down the leg related to neuropathy. People with these symptoms should contact a doctor immediately

What structures make up the back?
The back is an intricate structure of bones, muscles, and other tissues that form the posterior part of the body’s trunk, from the neck to the pelvis. The centerpiece is the spinal column, which not only supports the upper body’s weight but houses and protects the spinal cord — the delicate nervous system structure that carries signals that control the body’s movements and convey its sensations. Stacked on top of one another are more than 30 bones — the vertebrae — that form the spinal column, also known as the spine. Each of these bones contains a roundish hole that, when stacked in register with all the others, creates a channel that surrounds the spinal cord. The spinal cord descends from the base of the brain and extends in the adult to just below the rib cage. Small nerves (“roots”) enter and emerge from the spinal cord through spaces between the vertebrae. Because the bones of the spinal column continue growing long after the spinal cord reaches its full length in early childhood, the nerve roots to the lower back and legs extend many inches down the spinal column before exiting. This large bundle of nerve roots was dubbed by early anatomists as the cauda equina, or horse’s tail. The spaces between the vertebrae are maintained by round, spongy pads of cartilage called intervertebral discs that allow for flexibility in the lower back and act much like shock absorbers throughout the spinal column to cushion the bones as the body moves. Bands of tissue known as ligaments and tendons hold the vertebrae in place and attach the muscles to the spinal column.

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How is back pain treated?
Exercise may be the most effective way to speed recovery from low back pain and help strengthen back and abdominal muscles. Maintaining and building muscle strength is particularly important for persons with skeletal irregularities. Doctors and physical therapists can provide a list of gentle exercises that help keep muscles moving and speed the recovery process. A routine of back-healthy activities may include stretching exercises, swimming, walking, and movement therapy to improve coordination and develop proper posture and muscle balance. Yoga is another way to gently stretch muscles and ease pain. Any mild discomfort felt at the start of these exercises should disappear as muscles become stronger. But if pain is more than mild and lasts more than 15 minutes during exercise, patients should stop exercising and contact a doctor.

Medications are often used to treat acute and chronic low back pain. Effective pain relief may involve a combination of prescription drugs and over-the-counter remedies. Patients should always check with a doctor before taking drugs for pain relief. Certain medicines, even those sold over the counter, are unsafe during pregnancy, may conflict with other medications, may cause side effects including drowsiness, or may lead to liver damage.

Spinal manipulation is literally a "hands-on" approach in which professionally licensed specialists use leverage and a series of exercises to adjust spinal structures and restore back mobility.

When back pain does not respond to more conventional approaches, patients may consider the following options:
Acupuncture involves the insertion of needles the width of a human hair along precise points throughout the body. Practitioners believe this process triggers the release of naturally occurring painkilling molecules called peptides and keeps the body’s normal flow of energy unblocked. Clinical studies are measuring the effectiveness of acupuncture in comparison to more conventional procedures in the treatment of acute low back pain.

Biofeedback is used to treat many acute pain problems, most notably back pain and headache. Using a special electronic machine, the patient is trained to become aware of, to follow, and to gain control over certain bodily functions, including muscle tension, heart rate, and skin temperature (by controlling local blood flow patterns). The patient can then learn to effect a change in his or her response to pain, for example, by using relaxation techniques. Biofeedback is often used in combination with other treatment methods, generally without side effects.

Interventional therapy can ease chronic pain by blocking nerve conduction between specific areas of the body and the brain. Approaches range from injections of local anesthetics, steroids, or narcotics into affected soft tissues, joints, or nerve roots to more complex nerve blocks and spinal cord stimulation. When extreme pain is involved, low doses of drugs may be administered by catheter directly into the spinal cord. Chronic use of steroid injections may lead to increased functional impairment.

Traction involves the use of weights to apply constant or intermittent force to gradually “pull” the skeletal structure into better alignment. Traction is not recommended for treating acute low back symptoms.

Transcutaneous electrical nerve stimulation (TENS) is administered by a battery-powered device that sends mild electric pulses along nerve fibers to block pain signals to the brain. Small electrodes placed on the skin at or near the site of pain generate nerve impulses that block incoming pain signals from the peripheral nerves. TENS may also help stimulate the brain’s production of endorphins (chemicals that have pain-relieving properties).

Ultrasound is a noninvasive therapy used to warm the body’s internal tissues, which causes muscles to relax. Sound waves pass through the skin and into the injured muscles and other soft tissues.

Minimally invasive outpatient treatments to seal fractures of the vertebrae caused by osteoporosis include vertebroplasty and kyphoplasty. Vertebroplasty uses three-dimensional imaging to help a doctor guide a fine needle into the vertebral body. A glue-like epoxy is injected, which quickly hardens to stabilize and strengthen the bone and provide immediate pain relief. In kyphoplasty, prior to injecting the epoxy, a special balloon is inserted and gently inflated to restore height to the bone and reduce spinal deformity.

In the most serious cases, when the condition does not respond to other therapies, surgery may relieve pain caused by back problems or serious musculoskeletal injuries. Some surgical procedures may be performed in a doctor’s office under local anesthesia, while others require hospitalization. It may be months following surgery before the patient is fully healed, and he or she may suffer permanent loss of flexibility. Since invasive back surgery is not always successful, it should be performed only in patients with progressive neurologic disease or damage to the peripheral nerves.

• Discectomy is one of the more common ways to remove pressure on a nerve root from a bulging disc or bone spur. During the procedure the surgeon takes out a small piece of the lamina (the arched bony roof of the spinal canal) to remove the obstruction below.
  
• Foraminotomy is an operation that “cleans out” or enlarges the bony hole (foramen) where a nerve root exits the spinal canal. Bulging discs or joints thickened with age can cause narrowing of the space through which the spinal nerve exits and can press on the nerve, resulting in pain, numbness, and weakness in an arm or leg. Small pieces of bone over the nerve are removed through a small slit, allowing the surgeon to cut away the blockage and relieve the pressure on the nerve.
  
• IntraDiscal Electrothermal Therapy (IDET) uses thermal energy to treat pain resulting from a cracked or bulging spinal disc. A special needle is inserted via a catheter into the disc and heated to a high temperature for up to 20 minutes. The heat thickens and seals the disc wall and reduces inner disc bulge and irritation of the spinal nerve
  
• Nucleoplasty uses radiofrequency energy to treat patients with low back pain from contained, or mildly herniated, discs. Guided by x-ray imaging, a wand-like instrument is inserted through a needle into the disc to create a channel that allows inner disc material to be removed. The wand then heats and shrinks the tissue, sealing the disc wall. Several channels are made depending on how much disc material needs to be removed.
  
• Radiofrequency lesioning is a procedure using electrical impulses to interrupt nerve conduction (including the conduction of pain signals) for 6 to12 months. Using x-ray guidance, a special needle is inserted into nerve tissue in the affected area. Tissue surrounding the needle tip is heated for 90-120 seconds, resulting in localized destruction of the nerves.
  
• Spinal fusion is used to strengthen the spine and prevent painful movements. The spinal disc(s) between two or more vertebrae is removed and the adjacent vertebrae are “fused” by bone grafts and/or metal devices secured by screws. Spinal fusion may result in some loss of flexibility in the spine and requires a long recovery period to allow the bone grafts to grow and fuse the vertebrae together.
  

Spinal laminectomy (also known as spinal decompression) involves the removal of the lamina (usually both sides) to increase the size of the spinal canal and relieve pressure on the spinal cord and nerve roots.

Other surgical procedures to relieve severe chronic pain include rhizotomy, in which the nerve root close to where it enters the spinal cord is cut to block nerve transmission and all senses from the area of the body experiencing pain; cordotomy, where bundles of nerve fibers on one or both sides of the spinal cord are intentionally severed to stop the transmission of pain signals to the brain; and dorsal root entry zone operation, or DREZ, in which spinal neurons transmitting the patient’s pain are destroyed surgically.

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Can back pain be prevented?
Recurring back pain resulting from improper body mechanics or other nontraumatic causes is often preventable. A combination of exercises that don't jolt or strain the back, maintaining correct posture, and lifting objects properly can help prevent injuries. Many work-related injuries are caused or aggravated by stressors such as heavy lifting, vibration, repetitive motion, and awkward posture. Applying ergonomic principles — designing furniture and tools to protect the body from injury — at home and in the workplace can greatly reduce the risk of back injury and help maintain a healthy back. More companies and homebuilders are promoting ergonomically designed tools, products, workstations, and living space to reduce the risk of musculoskeletal injury and pain.

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What is the most common cause of mechanical back pain or injury?
The short answer to that question is having an unstable core (meaning that you are unable to prevent your spine and pelvis from going into positions of excessive flexion, extension and rotation during normal functional movements). While there are countless reasons for you to develop back pain, including weakness in the abdominals and back, hamstring tightness, hip flexor tightness, hip joint stiffness, poor body mechanics, poor posture, muscle imbalances, lower crossed syndrome, etc, the existence of any of these joint or muscle abnormalities will typically not cause back pain or injury unless you also have an “Unstable Core”.

What is meant by the terms Unstable Core and Stable Core?
An unstable core means that you are unable to prevent your spine and pelvis from going into positions of excessive flexion, extension and rotation during normal functional movements of your upper and lower extremities. Over time these excessive movements will cause excessive and/or prolonged stresses on the structures that support your spine – spinal discs, ligaments and muscles. Having a stable core means that you have the ability to control the position of your spine and pelvis with normal functional movements. As Shirley Sahrman (well known Physical Therapist and Educator) has said “the dog should wag the tail, not the other way around”; and if the position of your spine and pelvis is being controlled by the position and movement of your arms and legs, you are probably going to develop back pain. You want to develop core stability because it will allow you to support and protect your spine despite having less than ideal flexibility, posture or body mechanics.

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What does it mean to have “Good Posture”?
When you have good posture it means that each section of your axial skeleton including the head, neck, upper/mid back, lower back and pelvis are aligned in their neutral resting position. The head should be balanced on top of the neck. In the neck it is important to have a slight inward curve at the back of the neck, this is called lordosis. In the upper and middle back, a slight outward curve or kyphosis is necessary for normal function. In the lower back a slight inward curve (lordosis) is needed to protect the lumbar discs and a neutral pelvis is required to be the foundation upon which the spine and head balance.

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1. Sleeping with your spine in an unnatural posture, placing abnormal stress on your spinal discs, ligaments or muscles.
2. Arthritis of the spine can cause increased pain or stiffness in the morning.
3. Your spinal discs will enlarge somewhat as you are sleeping so herniated discs can become more painful by morning.

Why is my back pain better when lying down and worse when standing?
Decreased pain when lying down and increased pain in standing usually indicates that your spine is “load sensitive” which means that you have difficulty stabilizing your spine against the force of gravity. In other words your unstable core (usually due to weak abdominals and/or back muscles) is unable to keep your spine in good posture when the spine is in an upright position. Treatment for load sensitivity is building a stable core with abdominal and back muscle exercise, postural retraining and body mechanics education with a physical therapist

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Why does bending at my waist hurt my low back so much?
Back pain with bending at the waist usually occurs due to an unstable core (meaning that you are unable to prevent your spine and pelvis from going into positions of excessive flexion, extension and rotation during normal functional movements) along with tightness in the hamstrings and hips. Simply put if your hips are too in-flexible to bend, and you have an unstable core, your spine is going to bend excessively, placing great load on the spinal discs, and great tension on the spinal ligaments and muscles.

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Why does lifting cause so much back pain?
Protecting the low back / sacroiliac joints from lifting injury and pain requires great flexibility and stability in the hips and core respectively. Specifically, the hips need to be flexible enough to allow you to squat without your back moving out of good posture (you must maintain a lumbar lordosis – or slight inward curve of the spine when lifting). Then your low back then needs to remain fully erect and stable for lifting. This requires great strength and stability of the abdominals and back muscles. When you do not possess these correct physical attributes while lifting a heavy object, low back injury or sacroiliac joint injury becomes virtually inevitable.

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Why do I have so much back pain in sitting?
The majority of sitting related back pain happens due to rounding forward of the back while seated. While this may seem like a natural position, our bodies were never intended for prolonged sitting. In fact your body is the same physical structure from many thousands of years ago when our ancestors were hunting and gathering not driving cars and sitting at computers. So when you sit with your back rounded forward you are placing enormous compression on your spinal discs which can cause herniated discs, along with great tension on the spinal ligaments and muscles of the low back. If you want to decrease back pain and prevent yourself from developing a herniated disc, sit with good posture!

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What causes back pain when I am standing for a long time?
Most back pain that happens with prolonged standing occurs because of “sway back posture”, where your lower spine leans back with belly protruding forward due to poor control and stability of you abdominal and back muscles, and your head hangs forward. Sometimes this will happen with an increased curve in your low back (lordosis) and other times this will happen with a decreased curve in your low back. In either position, excessive stress is placed on the soft tissues, ligaments, discs and musculature of your low back resulting in back pain. Painful sway back posture often occurs in people with an unstable core who also have back pain in sitting.

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What is the best exercise that I can do to get rid of my back pain?
This is a trick question because there is no ‘best exercise’ for treating low back pain. The best long term solution for back pain is to develop a stable core (meaning that you develop the ability to prevent your spine and pelvis from going into positions of excessive flexion, extension and rotation during normal functional movements) through proper exercise. This usually means progressively training the abdominals and back muscles with pain-free movement patterns. A skilled physical therapist or trainer will be able to help. In the short term, the best immediate treatment for back pain is to place the spine in a pain-free position, usually where there is a slight curve in the small of the back. This should relive pressure on the spinal discs and take tension off the ligaments and spinal musculature. The next step would be to begin pain-free stability training of the core including the abdominals and back muscles. Please contact a doctor or physical therapist for assistance if you are currently suffering from back pain.

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What is meant by the terms ‘correct body mechanics’ and ‘body mechanics training’?
One of the best solutions for treating back pain is to develop correct body mechanics which means learning to move in a way that places minimal stress on your spine and back. This can be done through developing a stable core, improving lower body flexibility and then working with a physical therapist or trainer to improve techniques of lifting, bending, pushing, pulling, climbing, etc. After having back pain for many years, many people literally need to “re-learn’ how to move correctly.

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Can I change my posture even if I have been standing and sitting the same way for many years?
No matter what your age you can change your posture! The process is simple, but not necessarily easy. Put plainly, it can be done but it takes work. You need to:

1. Improve your flexibility enough to place your spine in good posture.
2. Develop a stable core so that you can maintain this improved position.
3. Consciously think about how you are sitting/standing over the next few weeks.

Over time, just like honing any new skill you can learn to have posture that will relieve your back pain. You will probably need a physical therapist to help you with this process because everybody has different areas that need to be stretched and strengthened; and you will need some guidance regarding what is good posture. You may need the assistance of a back brace to assist you in the early stages of changing your posture, as a reminder of good posture and assistance for your unstable core.

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What is a herniated disc?
A herniated disc (also called protruding, bulging, or ruptured disc). The intervertebral discs are under constant pressure. As discs degenerate and weaken, cartilage can bulge or be pushed into the space containing the spinal cord or a nerve root, causing pain. Studies have shown that most herniated discs occur in the lower, lumbar portion of the spinal column.

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What is Degenerative Disc Disease?
Degenerative disc disease or spinal degeneration occurs from disc wear and tear can lead to a narrowing of the spinal canal. A person with spinal degeneration may experience stiffness in the back upon awakening or may feel pain after walking or standing for a long time.

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What is Spinal Stenosis?
Spinal stenosis is related to congenital narrowing of the bony canal and can predispose some people to pain related disc disease, leg pain and sciatica.

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What is Osteoporosis?
Osteoporosis is a metabolic bone disease marked by progressive decrease in bone density and strength. Fracture of brittle, porous bones in the spine and hips results when the body fails to produce new bone and/or absorbs too much existing bone. Women are four times more likely than men to develop osteoporosis. Caucasian women of northern European heritage are at the highest risk of developing the condition.

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What is the difference between Scoliosis, Kyphosis and Lordosis?
Skeletal irregularities produce strain on the vertebrae and supporting muscles, tendons, ligaments, and tissues supported by spinal column. These irregularities include scoliosis, a curving of the spine to the side; kyphosis, in which the normal curve of the upper back is severely rounded; lordosis, an abnormally accentuated arch in the lower back

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Can Fibromyalgia be associated with back pain?
Fibromyalgia is a chronic disorder characterized by widespread musculoskeletal pain, fatigue, and multiple “tender points,” particularly in the neck, spine, shoulders, and hips. Additional symptoms may include sleep disturbances, morning stiffness, and anxiety. In some people, mechanical spinal pain can aggravate their fibromyalgia, therefore amplifying the pain experienced from this condition.

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What is Lower Crossed Syndrome?
Lower crossed syndrome is a very common pattern of muscular imbalances that Vladamir Janda, a physical therapist from the Czech Republic observed many years ago. It is a combination of tight hip flexors, shortened lower back muscles, weak abdominals and weak gluteal muscles leading to excessive arching of your lower back, protruding abdomen, and rounding forward of the middle and upper back. Over time this condition will place great mechanical stress on the spine and often results in back pain.

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What is sciatica?
Sciatica is a condition in which a herniated or ruptured disc presses on the sciatic nerve, the large nerve that extends down the spinal column to its exit point in the pelvis and carries nerve fibers to the leg. This compression causes shock-like or burning low back pain combined with pain through the buttocks and down one leg to below the knee, occasionally reaching the foot. In the most extreme cases, when the nerve is pinched between the disc and an adjacent bone, the symptoms involve not pain but numbness and some loss of motor control over the leg due to interruption of nerve signaling. The condition may also be caused by a tumor, cyst, metastatic disease, or degeneration of the sciatic nerve root.

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Why do I have leg pain which seems to come from my lower back?

1. Radicular Pain – anything that places stress, tension or pressure on a spinal nerve root can cause radiating leg pain, also known as radiculopathy, radiculitis or sciatica. Radicular leg pain radiates into the thigh, calf, and occasionally the foot along the course of a spinal nerve root. Common causes of radicular leg pain include herniated discs, arthritis, bone spurs and spinal stenosis. Radicular leg pain must be addressed quickly to prevent progression to a pinched nerve which can cause leg weakness.
   
2. Referred pain – the source of leg pain can also be structures other than the spinal nerve roots. Conditions such as sacroiliac (SI) joint irritation, arthritis of the spine or SI joints, hip arthritis or even fractures of the hip and pelvis can cause referred pain, the same way that a heart attack victim will feel pain down their left arm.

How can leg weakness come from a pinched nerve in my back?
A pinched nerve results after prolonged compression of a spinal nerve root that damages the nerve so that it no longer carries adequate quantities of the electrical impulses needed to power the muscles of your legs. Sciatica, numbness, burning, tingling, and leg pain will often precede leg weakness secondary to a pinched nerve. Areas of weakness will depend on the specific nerve that is being compressed, and can include the quadriceps, hamstrings, calf, and foot. Get your leg pain treated early to prevent this problem from progressing. Common causes of leg weakness from a pinched nerve include herniated discs, arthritis, bone spurs and spinal stenosis.

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How does Spondylosis cause back pain?
Spondylosis (spinal osteoarthritis) is a degenerative disorder that can cause back pain along with a loss of normal spinal structure and function. Although aging is the primary cause, the location, rate of degeneration and degree of back pain is individual. The degenerative process may impact the cervical, thoracic, and/or lumbar regions of the spine affecting the intervertebral discs and facet joints.

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Why does Spondylolysis and Spondylolisthesis cause back pain?
Spondylolysis is a condition where there is a crack in a small piece of bone in your spine called the ‘pars interarticularis’. We have a “pars” on each side of each of our vertebrae. These bones are what connect the front of an individual vertebrae to the back of the vertebrae. When a spondylolysis occurs on both sides of the spine, Spondylolisthesis can result where the top vertebra slips forward on the one below, and great pressure and stress is placed across the spinal segment, causing pain at the facet joints, spinal ligaments and discs, as well as the back muscles. Spondylolisthesis can cause back pain over time as changes occur to the bones, joints, and ligaments that hold the vertebral column together. This condition is a common cause of back pain in children secondary to a congenital defect in the spine or as the result of repetitive microtrauma during childhood. Some sports are thought to make children more susceptible to developing spondylolysis and spondylolisthesis, including gymnastics, diving, and football.

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What are the symptoms of spondylolisthesis?
The symptoms of spondylolisthesis can be wide ranging from no symptoms at all, to severe back and leg pain with nerve damage. Back pain is often found when hyperextending (arching) the back. When the nerves exiting the spinal cord, or the spinal cord itself, become pinched by the spondylolisthesis, then back pain or nerve symptoms can result. Common nerve symptoms seen are similar to symptoms seen with a herniated disc. The symptoms include:

• Leg pain
• Electric shock-like pain traveling down the leg
• Numbness or tingling in the legs and feet
• Muscle weakness of the legs
• Other symptoms can occur. If you experience any symptoms of problems with bowel or bladder function, or any numbness around the genitals, you should alert your doctor immediately. These symptoms may be a sign of cauda equina syndrome, and may be a medical emergency.

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What is the treatment for spondylolisthesis?
Treatment of spondylolisthesis is wide ranging, and can include physical therapy, exercise, use of back support belts and braces to surgical stabilization of the spine. Determining the appropriate treatment plan is most dependent on the age of the patient, the type of slip, and the symptoms experienced by the patient.

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How common is back pain during pregnancy?
Back pain or discomfort is common during pregnancy and should be expected to some degree by most women. Back pain may be experienced during any point of your pregnancy; however, it most commonly occurs later in the pregnancy as the weight of the baby increases. Back pain can disrupt your daily routine or interfere with a good night of sleep. The good news is there are steps you can take to manage the back pain that you experience.

You are not alone if you are experiencing back pain during your pregnancy. The prevalence varies with reports, showing between 50 to 70 percent of all pregnant women having back pain.

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What causes back pain during pregnancy?
Back pain during pregnancy is related to a number of factors. Some women begin to experience lower back pain with the onset of pregnancy. Women who are most at risk for back pain are those who are overweight or had back pain prior to pregnancy. Here is a list of potential causes of back pain or discomfort during pregnancy:

• Increase of hormones – hormones released during pregnancy allow ligaments in the pelvic area to soften and the joints to become looser in preparation for the birthing process of your baby; this shift in joints and loosening of ligaments may affect the support your back normally experiences
  
• Center of gravity – your center of gravity will gradually move forward as your uterus and baby grow, which causes your posture to change
  
• Additional weight – your developing pregnancy and baby create additional weight that your back must support
  
• Posture or position – poor posture, excessive standing, and bending over can trigger or escalate the pain you experience in your back
  
• Stress – stress usually finds the weak spot in the body, and because of the changes in your pelvic area, you may experience an increase in back pain during stressful periods of your pregnancy

How can you treat, minimize or prevent back pain during pregnancy?
There are a number of things you can do to treat, minimize and prevent back pain during pregnancy.

• Use Ice or Heat
• Use exercises approved by your health care provider that support and help strengthen the back and abdomen
• Squat to pick up something versus bending over
• Avoid high heels and other shoes that do not provide adequate support
• Avoid sleeping on your back
• Wear a support belt under your lower abdomen
• Use a physical therapist skilled in treating pregnancy related back pain

If back pain occurs during pregnancy when should you contact your health care provider?
Back pain by itself is usually not a reason to contact your health care provider, but there are situations where contacting your provider is necessary. You want to contact your health care provider if you are experiencing any of the following:

• Severe back pain
• Increasingly severe or abrupt-onset of back pain
• Rhythmic cramping pains; this could be a sign of preterm labor
• Also: Severe back pain may be related to pregnancy-associated osteoporosis, vertebral osteoarthritis, or septic arthritis. These are not common, but it is something your health care provider will examine if you are experiencing severe back pain.

Can women use back supports like the ACTIVE SI BELT® to treat back pain and SI joint pain during pregnancy?
Yes, many women have use products like the ACTIVE SI BELT® to treat their back pain while pregnant. With that said, we recommend that women speak with their doctor prior to using any back brace, including the ACTIVE SI BELT® during their pregnancy.

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What can I do to prevent back pain, back injury and sacroiliac joint injury?

• Work with a physical therapist or trainer to get strong and flexible. Generally most people need abdominal & back strength/stability, along with flexibility in the hips, hip flexors and hamstrings.
  
• Learn how to lift, sit and stand: see a physical therapist to learn about correct body mechanics, lifting techniques, Good Posture and alignment.
  
• Get in better shape: each pound of extra weight on your body is an extra pound that you have to move around every time that you lift something, run, play a sport or even get out of a chair. These extra pounds place added stress on your body and back.
  
• Evaluate your work station or desk: Correct posture while sitting is critical because most people sit much longer than what our bodies were designed for. See this website for correct sitting posture and office ergonomics information. http://www.nismat.org/ptcor/ergo/
  
• Always stretch before exercise or other strenuous physical activity.
  
• Don’t slouch when standing or sitting. When standing, keep your weight balanced on your feet. Your back supports weight most easily when curvature is reduced.
• At home or work, make sure your work surface is at a comfortable height for you.
  
• Sit in a chair with good lumbar support and proper position and height for the task. Keep your 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 your back can provide some lumbar support. If you must sit for a long period of time, rest your feet on a low stool or a stack of books
  
• Wear comfortable, low-heeled shoes.
  
• Sleep on your side to reduce any curve in your spine. Always sleep on a firm surface
  
• Ask for help when transferring an ill or injured family member from a reclining to a sitting position or when moving the patient from a chair to a bed.
  
• Don’t try to lift objects too heavy for you. Lift with your knees, pull in your stomach muscles, and keep your head down and in line with your straight back. Keep the object close to your body. Do not twist when lifting.
  
• Maintain proper nutrition and diet to reduce and prevent excessive weight, especially weight around the waistline that taxes lower back muscles. A diet with sufficient daily intake of calcium, phosphorus, and vitamin D helps to promote new bone growth.
  
• If you smoke, quit. Smoking reduces blood flow to the lower spine and causes the spinal discs to degenerate.
  
• Ask your doctor or physical therapist for a list of low-impact exercises appropriate for your age and designed to strengthen lower back and abdominal muscles.

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What research is being done?
The National Institute of Neurological Disorders and Stroke, a component of the National Institutes of Health (NIH) within the U.S. Department of Health and Human Services, is the nation’s leading federal funder of research on disorders of the brain and nervous system and one of the primary NIH components that supports research on pain and pain mechanisms. Other institutes at NIH that support pain research include the National Institute of Dental and Craniofacial Research, the National Cancer Institute, the National Institute on Drug Abuse, the National Institute of Mental Health, the National Center for Complementary and Alternative Medicine, and the National Institute of Arthritis and Musculoskeletal and Skin Diseases. Additionally, other federal organizations, such as the Department of Veterans Affairs and the Centers for Disease Control and Prevention, conduct studies on low back pain.

Scientists are examining the use of different drugs to effectively treat back pain, in particular daily pain that has lasted at least 6 months. Other studies are comparing different health care approaches to the management of acute low back pain (standard care versus chiropractic, acupuncture, or massage therapy). These studies are measuring symptom relief, restoration of function, and patient satisfaction. Other research is comparing standard surgical treatments to the most commonly used standard nonsurgical treatments to measure changes in health-related quality of life among patients suffering from spinal stenosis. NIH-funded research at the Consortial Center for Chiropractic Research encourages the development of high-quality chiropractic projects. The Center also encourages collaboration between basic and clinical scientists and between the conventional and chiropractic medical communities.

Other researchers are studying whether low-dose radiation can decrease scarring around the spinal cord and improve the results of surgery. Still others are exploring why spinal cord injury and other neurological changes lead to an increased sensitivity to pain or a decreased pain threshold (where normally non-painful sensations are perceived as painful, a class of symptoms called neuropathic pain), and how fractures of the spine and their repair affect the spinal canal and intervertebral foramen (openings around the spinal roots).

Also under study for patients with degenerative disc disease is artificial spinal disc replacement surgery. The damaged disc is removed and a metal and plastic disc about the size of a quarter is inserted into the spine. Ideal candidates for disc replacement surgery are persons between the ages of 20 and 60 who have only one degenerating disc, do not have a systemic bone disease such as osteoporosis, have not had previous back surgery, and have failed to respond to other forms of nonsurgical treatment. Compared to other forms of back surgery, recovery from this form of surgery appears to be shorter and the procedure has fewer complications.

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How do I find a Physical Therapist, Physician or Chiropractor who specializes in the treatment of low back pain, sacroiliac joint dysfunction, pelvic girdle problems or symphysis pubis dysfunction?

Start with Find a Specialist to search the Directory of Certified Clinical Specialists in Physical Therapy.

Search under Orthopedic, to find a PT that is an Orthopedic Certified Specialist – who specializes in low back pain, SI joint dysfunction, pelvic girdle problems or symphysis pubis dysfunction.

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Additional Search Tools

Find a PT, from the American Physical Therapy Association.

Find a Physician or Find a Chiropractor from Spine Universe.

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