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Medical Professionals prefer ACTIVE SI Belt for Sacroiliac PainWHEN TO SEE A DOCTOR
How do I place an order?
What causes back pain?
What structures make up the back?
What do you mean by the term Spinal Stability?
How is back pain treated?
Can back pain be prevented?
What does it mean to have “Good Posture”?
Why is my back pain worse in the morning?
Why is my back pain better when lying down and worse when standing?
Why does bending at my waist hurt my low back so much?
Why does lifting cause so much back pain?
Why do I have so much back pain in sitting?
What causes back pain when I am standing for a long time?
What is the best exercise that I can do to get rid of my back pain?
What is meant by the terms ‘correct body mechanics’ and ‘body mechanics training’?
Can I change my posture even if I have been standing and sitting the same way for many years?
What is a herniated disc?
What is Degenerative Disc Disease?
What is Spinal Stenosis?
Does osteoporosis cause back pain?
Can Scoliosis, Kyphosis or Lordosis cause back pain?
Can Fibromyalgia be associated with back pain?
Does Lower Crossed Syndrome cause back pain?
What is sciatica?
Why do I have leg pain that gets worse when my lower back hurts?
How can leg weakness result from a pinched nerve in my back?
What is Piriformis Syndrome?
How does Spondylosis cause back pain?
Does Spondylolysis or Spondylolisthesis cause back pain?
What are the symptoms of Spondylolisthesis?
What is the treatment for Spondylolisthesis?
How common is back pain during pregnancy?
What causes low back pain during pregnancy?
How can you treat, minimize or prevent back pain during pregnancy?
If back pain occurs during pregnancy when should you contact your health care provider?
What can I do to prevent back pain, back injury and sacroiliac joint injury?
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?

 

WHEN TO SEE A DOCTOR
While most back pain is mechanical in nature, some back pain may be occurring due to a more serious medial condition.

Please consult with a physician if:

  1. You are experiencing severe back pain that is stopping you from being able to walk and function.
  2. Your back pain does not diminish in any position, even lying down.
  3. Your back pain gets worse when trying to sleep.
  4. You should see a physician immediately if you are experiencing any of the symptoms below
    · Pain in one or both legs that starts in the buttocks and travels down the back of the thighs and legs, often referred   to as sciatica.
    · Numbness or tingling in the groin, inner thighs or the buttocks (the same area that would be in contact if you were   sitting on a saddle). Otherwise known as saddle paresthesia.
    · Incontinence: unable to control function of bowel or bladder.
    · Weakness: loss of muscle strength or sensation in one or both lower extremities.
    · Reduced or absent lower extremity reflexes.

The symptoms in item #4 may indicate Cauda Equina Syndrome , a serious medical condition that requires immediate medical attention. Please see a physician immediately if you are experiencing any of these symptoms.

MOST IMPORTANT
Do not use the internet as a substitute for medical advice! Consult you’re your doctor or physical therapist if you have specific questions about your pain, health status or medical condition.

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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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What causes back pain?
Most back pain is mechanical in nature when excessive and/or prolonged stress is placed on the structures that make up your spine due to poor control of spinal stability. Associated mechanical causes include: 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/or sacroiliac joint pain. Spinal disorders such as arthritis, degenerative joint disease, degenerative disc disease, disc herniations and stenosis 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.

While mechanical stresses are the most common cause of back pain, occasionally, low back pain may indicate a more serious medical problem. Pain accompanied by 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.

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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 together 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. The spaces between the vertebrae are maintained by round, spongy pads of gel filled 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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What do you mean by the term Spinal Stability?
When you have good spinal stability or stabilization, you are able to prevent your spine and pelvis from going into positions of excessive and/or prolonged flexion, extension and rotation during normal functional movements including, squatting, bending, reaching, twisting, lifting, playing sports, work activities, sitting, etc. In the absence of ‘good control of spinal stability’, repeated movements will cause back injury and pain due to the excessive and/or prolonged stresses on the structures that support your spine – spinal discs, ligaments and muscles. Having spinal stability means that you are able to prevent or at least minimize the stress on your spine thereby minimizing or even eliminating low back pain. As Dr. Shirley Sahrman (noted physical therapist and educator) has said “the dog should wag the tail, not the other way around”. What Dr. Sahrman means is that if the position and movement of your arms and legs are controlling your spine and pelvis, you are probably going to develop back pain. You want to develop spinal stability because it will allow you to support and protect your spine even if you have less than ideal flexibility or body mechanics.

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How is back pain treated?
Exercise may be the most effective way to speed recovery from low back pain. It is most important to develop good control of spinal stability through development of core strength and better posture with exercise. Maintaining and building muscle strength is particularly important for persons with mechanical low back pain to prevent more serious spinal degeneration (see ‘Degenerative Cascade’ below). A routine of back-healthy activities may include spinal stabilization exercises, stretching, swimming, walking, and movement therapy to improve coordination and develop proper posture and muscle balance. 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 or after exercise, patients should stop exercising and contact a doctor.

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Can back pain be prevented?
Recurring back pain resulting from poor control of spinal stability, improper body mechanics or other non-traumatic causes is often preventable. A combination of exercises that focus on development of neuromuscular spinal stabilization, 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.

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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 or at least close to 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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Why is my back pain worse in the morning?
There are several reasons why you may have increased back pain in the morning including:

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

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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 you have poor control of spinal stability (usually due to weak abdominals and/or back muscles) and are unable to keep your spine in good posture when in an upright position. Treatment for load sensitivity involves developing good control of spinal stability with abdominal and back muscle exercise, postural retraining and body mechanics education often 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 poor control of spinal stability along with tightness in the hamstrings and hips. Simply put if your hips are too inflexible to bend, and you have poor control of spinal stability, 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?
The problem is usually poor control of spinal stability. Protecting the low back / sacroiliac joints from lifting injury and pain requires great flexibility in the hips/legs and good control of spinal stability. Specifically, the hips need to be flexible enough to allow you to squat without your back moving out of good posture and you must maintain a lumbar lordosis – or slight inward curve of the spine when lifting. 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 backward 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 during prolonged standing occurs because of “sway back posture”, where your upper spine leans back with belly protruding forward and your head hangs forward due to poor control of spinal stability. Usually this happens 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 discs, ligaments and muscles of your low back resulting in back pain. Painful sway back posture often occurs in people 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 good control of spinal stability (meaning that you develop the ability to prevent your spine and pelvis from going into positions of excessive and/or prolonged 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. 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 spinal stabilization training of the core including the abdominals and back muscles. Please contact a doctor or physical therapist specialized in treating back pain for assistance if you have specific questions regarding exercises for your 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 low back. This is done through developing good control of spinal stability, improving lower body flexibility and then working 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:

  • Improve your flexibility enough to allow your back to be placed in good posture/alignment.
  • Develop good control of spinal stability so that you can maintain the improved position of your low back.
  • Consciously think about how you are sitting/standing over the next few weeks.
  • After about three weeks your improved posture can become a new and healthy habit.

You may need a physical therapist to help you with this process because everybody has different areas that need to be stretched and strengthened. You may also need some guidance regarding what is good posture and the correct exercises for untrained muscles.

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What is a herniated disc?
Also known as a protruding disc or ruptured disc. The intervertebral discs are under constant pressure. Pressure on the discs is increased with poor posture, especially rounded back or slouched posture, poor lifting techniques, especially with combined twisting/bending, poor control of spinal stability, etc. As discs degenerate and weaken, disc material can bulge or be pushed back into the space containing the spinal cord or a nerve root, causing low back pain and sometimes pain down the legs (sciatica). Studies have shown that most herniated discs occur in the lower portion of the spinal column. L5-S1 and L4-L5 disc herniations are most common.

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What is Degenerative Disc Disease?
Degenerative disc disease or spinal degeneration occurs from disc wear and tear due to poor control of spinal stability. As the discs degenerate, they lose their water content and narrow. This narrowing causes the spinal vertebral bodies and facet joints to come into closer contact with one another causing joint inflammation/arthritis, back pain and immobility. Smoking, poor nutrition and obesity have been shown to contribute to disc degeneration. A person with spinal degeneration may experience low back pain and stiffness upon awakening or may feel pain after standing or sitting for a long time.

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What is Spinal Stenosis?
Spinal stenosis is often the final stage of the degenerative process in mechanical spinal disorders. Over time, poor control of spinal stability can cause more than just back pain. Disc herniation will often lead to disc degeneration, which can lead to narrowing of disc spaces & facet joint arthritis. When disc space narrowing and facet joint arthritis has become so severe that there is excessive pressure on spinal nerve roots, a patient can have pain into both legs simply from standing. There will often be increased pain after walking for a certain amount of time and less lower extremity pain will be felt when sitting. Essentially, the spine has ‘collapsed’ at that intervertebral segment. Over time this ‘collapse’ can occur at multiple segments and eventually lead to neurological dysfunction including lower extremity weakness, loss of sensation, loss of reflexes and severe disability. Progression of spinal stenosis occurs over many years but often begins with poor control of spinal stability and mechanical back pain. This "Degenerative Cascade" (see figure below)

 

was first described by William Kirkaldy-Willis who conceptualized and published his theories in the textbook "Managing Low Back Pain" in 1983. According to Charles V. Burton, M.D. , this original work still remains the single most brilliant correlation of pathophysiologic observations on spinal dysfunction and back pain.

Another cause of spinal stenosis is that some people are simply born with a narrow spinal canal, which can predispose them to pain related to degenerative disc disease, leg pain and sciatica.

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Does osteoporosis cause back pain?
Osteoporosis is a disease marked by progressive decrease in bone density and strength. Fracture of brittle, porous bones in the spine 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. Osteoporosis does not directly cause back pain but poor control of spinal stability together with osteoporosis can be debilitating with vertebral deformity and severe forward curvature of the spine.

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Can Scoliosis, Kyphosis or Lordosis cause back pain?
Any skeletal irregularity or curvature that produces strain on the vertebrae and supporting muscles, tendons, ligaments and discs can be a cause of back pain. 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; and lordosis, an abnormally accentuated arch in the lower back. Each of the above curvatures will be worsened with poor control of spinal stability and should be addressed with spinal stabilization training along with traditional therapies for back pain.

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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 back pain can aggravate their fibromyalgia, therefore amplifying the pain experienced from this condition.

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Does Lower Crossed Syndrome cause back pain?
Another cause of lower back pain is “Lower Crossed Syndrome” which results in poor control of spinal stability. Vladamir Janda, a physical therapist from the Czech Republic, first described this very common pattern of muscular imbalances. 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 causing lower back pain, upper back pain and neck pain.

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What is sciatica?
Sciatica is a condition often associated with lower back pain in which 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) gets irritated or pinched from a herniated or ruptured disc, sacroiliac ligament inflammation or tight muscles in the back of the hip (piriformis syndrome). Associated causes of sciatica include poor control of spinal stability, poor posture/body mechanics, prolonged sitting and repetitive lifting. Sciatic nerve compression and or irritation/inflammation causes burning low back pain combined with pain, numbness, tingling or burning 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 only pain but numbness and 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 that gets worse when my lower back hurts?
There are two types of pain into the legs that can be associated with back pain:

  1. Radicular Pain – Anything that places stress, tension or pressure on a spinal nerve root can cause radiating leg pain, also known as radiculopathy or radiculitis. Radicular or radiating leg pain travels into the thigh, calf, and occasionally the foot along the course of a specific 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 neurological dysfunction in the leg including loss of sensation, loss of reflexes and/or leg weakness. The most common lower extremity radicular pain affects the Sciatic Nerve although other nerves can be affected including the Femoral Nerve.
  2. Referred pain – Another cause of leg pain from the back is known as referred pain. Conditions such as facet joint syndrome, spinal arthritis or sacroiliac (SI) joint irritation can cause referred pain into different parts of the legs. This pain is usually a more deep ache, rather than the burning pain most often associated with radicular pain.

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How can leg weakness result 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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What is Piriformis Syndrome?
There is a muscle that is responsible for rotating your hip, located deep in the back of your hip (piriformis) that can be a cause of hip pain and sciatica (see above for sciatica definition). Piriformis syndrome can occur with or without low back pain and is often associated with sacroiliac joint dysfunction or SI joint pain. This ‘external rotator’ of the hip can get tight and compress the sciatic nerve after it exits out of the sciatic notch at the back of the pelvis. The causes of piriformis syndrome are similar to the causes of low back pain: poor control of spinal stability, poor posture, reduced flexibility in the hips and poor body mechanics.

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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. Much spinal degeneration and related low back pain is the result of poor control of spinal stability. Although closely associated with aging, the location, rate of degeneration and degree of back pain is individualized. Over time, the degenerative process may impact the cervical, thoracic, and/or lumbar regions of the spine affecting the intervertebral discs and facet joints causing progressively more back pain.

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Does Spondylolysis or Spondylolisthesis cause back pain?
Spondylolysis (different from the above spondylosis) 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 vertebra, to the back of the vertebra. 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 low 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 micro-trauma during childhood. Despite the congenital nature of this disorder, symptoms are made worse with poor control of spinal stability, poor posture/body mechanics, prolonged sitting and core weakness. 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 worse when hyper-extending (arching) the back. When the slipping vertebra pinches the nerves exiting the spinal cord, or the spinal cord itself, 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 your inner thigh and buttocks, 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 is most dependent on the age of the patient, the type of slip, and the symptoms experienced by the patient. In many cases, treatment is very similar to caring for mechanical low back pain and is focused on developing good control of spinal stability. Treatment can include physical therapy, exercise, use of back support belts and braces to surgical stabilization of the spine.

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How common is back pain during pregnancy?
Back pain and sacroiliac (SI) joint dysfunction 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. 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 your back pain (see below).

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What causes low 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:

  • Poor control of spinal stability – despite the changes your body is going through, some of your back/sacroiliac pain may be the result of inadequate postural/core control of your spine during functional movements.
  • Hormonal changes – 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 loosening of ligaments may affect the normal level of spinal stability your back normally has.
  • Center of gravity – your center of gravity will gradually move forward as your uterus and baby grow, which causes your posture to change, often causing an increased lumbar lordosis.
  • Additional weight – your developing pregnancy and baby create additional weight that your back may have difficulty supporting.
  • 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.

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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.

  • The best prevention is to develop good control of spinal stability through development of core strength and better posture with exercise before your 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
  • Get plenty of rest

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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.

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

  • Develop good control of spinal stability through an exercise program focused on core strengthening, postural correction and development of better body mechanics
  • 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. Those extra pounds place added stress on your body and back.
  • Evaluate your workstation 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.
  • 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 your body is in a balanced posture.
  • 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 properly position seat 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 or under your buttocks can provide some lumbar support.
  • 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 legs, stabilize your core, keep your back straight and 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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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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