Definition: Back pain is not a diagnosis but is a symptom of an underlying condition.
Causes: There are many causes for back pain – too many for this to be a complete list. Some of the things listed here may not be direct causes of the back pain but it is a good place to start.
Low Back Pain Causes : Herniated discs, kidney stones, strains, sprains, misalignment of the spine, muscle spasms, muscle tightness, overdeveloped muscles, nerve impingement, spinal stenosis, spinal degeneration, disc compression, fibromyalgia, scoliosis, piriformis syndrome or false sciatica.
Upper Back Pain : Muscle spasms, spinal misalignment, heart attacks, indigestion, heart burn.
Signs/Symptoms: back stiffness, back pain, back tightness, hip pain, sciatica, pain down legs into feet, numbness in legs – to feet, limited range of motion.
Most Back injuries result from trauma from car accidents, work injuries, lifting injuries and psychological stress.
Muscles to be addressed with massage therapy.
Massage therapy for back pain will address some of the back, abdomen, hip and leg muscles to provide relief for back pain. Some of the muscles that will be worked on are:
- Back muscles: Erector Spinae, Quadratus Lumborum
- Abdominal muscles: rectus abdominus, iliopsoas, External and Internal Obliques, transverse abdominal muscles.
- Hip muscles: Piriformis, Gluteal muscles
- Sacrotuberous ligament
- Leg Muscles
Front of the leg muscles: Quadriceps.
Side of the leg muscles: Iliotibial band
Back of the leg muscles: Hamstrings
Medial leg muscles: Adductors, Gracilis
Understanding Back Pain
The amount of pain that you are feeling does not usually indicate a serious injury or condition.
What the research says:
The following Systematic Reviews which are the highest level of research.
Clinical practice guidelines for the noninvasive management of low back pain: A systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration
Conclusions
Most high‐quality guidelines target the noninvasive management of nonspecific low back pain and recommend education, staying active/exercise, manual therapy, and paracetamol or NSAIDs as first‐line treatments. Wong JJ, Côté P, Sutton DA, et al. Clinical practice guidelines for the noninvasive management of low back pain: A systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration. Eur J Pain. 2017;21(2):201-216. doi:10.1002/ejp.931
Evidence-based Evaluation of Complementary Health Approaches for Pain Management in the United States Richard L. Nahin, Ph.D., M.P.H., Robin Boineau, M.D., M.A., Partap S. Khalsa, D.C., Ph.D., Barbara J. Stussman, B.A., and Wendy J. Weber, N.D., Ph.D., M.P.H.
We summarize seven RCTs studying the use of massage for LBP (total participants = 829). Massage types included Swedish/relaxation, structural, structural integration, and muscle energy; sessions varied in duration from 15 – 90 minutes. For chronic LBP (cLBP), 2 larger studies reporting massage compared to usual care resulted in modest improvements in pain and function at 10 weeks, but the benefit was not sustained at 52 weeks. Three smaller studies compared massage to either usual outpatient rehabilitation or relaxation2 and did not observe significant between-group differences for pain and/or function. For acute or subacute LBP, 2 smaller studies found significant, albeit modest, improvements in pain compared to no treatment (−1.5 pts. NRS) or function (−18% ODI)compared to a putative placebo. No RCTs reported significant adverse events. Nahin RL, Boineau R, Khalsa PS, Stussman BJ, Weber WJ. Evidence-Based Evaluation of Complementary Health Approaches for Pain Management in the United States. Mayo Clin Proc. 2016;91(9):1292-1306. doi:10.1016/j.mayocp.2016.06.007
Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians FREE Amir Qaseem, MD, PhD, MHA, Timothy J. Wilt, MD, MPH, Robert M. McLean, MD, … View all authors Author, Article and Disclosure Informationhttps://doi.org/10.7326/M16-2367
Recommendation 1:
Given that most patients with acute or subacute low back pain improve over time regardless of treatment, clinicians and patients should select nonpharmacologic treatment with superficial heat (moderate-quality evidence), massage, acupuncture, or spinal manipulation (low-quality evidence). If pharmacologic treatment is desired, clinicians and patients should select nonsteroidal anti-inflammatory drugs or skeletal muscle relaxants (moderate-quality evidence). (Grade: strong recommendation)
Recommendation 2:
For patients with chronic low back pain, clinicians and patients should initially select nonpharmacologic treatment with exercise, multidisciplinary rehabilitation, acupuncture, mindfulness-based stress reduction (moderate-quality evidence), tai chi, yoga, motor control exercise, progressive relaxation, electromyography biofeedback, low-level laser therapy, operant therapy, cognitive behavioral therapy, or spinal manipulation (low-quality evidence). (Grade: strong recommendation)
Timothy J. Wilt, Robert M. McLean, Mary Ann Forciea, et al. Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians. Ann Intern Med. 2017;166:514-530. [Epub ahead of print 14 February 2017]. doi:10.7326/M16-2367
Nonpharmacologic Therapies for Low Back Pain: A Systematic Review for an American College of Physicians Clinical Practice Guideline Roger Chou, MD, Richard Deyo, MD, MPH, Janna Friedly, MD, Andrea Skelly, PhD, MPH, … View all authors Author, Article and Disclosure Informationhttps://doi.org/10.7326/M16-2459
Conclusion: Several nonpharmacologic therapies for primarily chronic low back pain are associated with small to moderate, usually short-term effects on pain; findings include new evidence on mind–body interventions.