Running with back pain...ouch!
 By
Michael Gordon, MD, Milwaukee Orthopaedic Group, Ltd. Orthopedic
Surgery, Sports Medicine Fellowship
We've all experienced it… that sudden sharp pain in our back or waking
up with a sense of stiffness in the low back that just won't go away.
Back pain, a fairly common complaint amongst runners, can be attributed
to a number of possible sources. However, it's important to distinguish
the pain that shoots down a person's leg (“sciatica”) from “back pain”
which stays in the lower back.
Sciatica – or radiating pain, is generally associated with an
irritation of a nerve exiting from the spine. In most cases, this is due
to a herniated disc or arthritis of the spine. On the other hand, pain
that lingers in an athlete's back is almost always due to a
“musculoskeletal” source triggered by a strain of the many muscles used
to stabilize the spinal column. Other causes of this pain can also
include arthritis of the spinal column or a degeneration of the discs
that act as shock absorbers throughout the spine.
Here's another one of my quick anatomy lessons: The spine is
composed of a column of 24 bones separated by gel-like discs. Running
through the middle of these bones, as well as sending out a pair of
nerves at each of the 24 levels, is the spinal cord. Stability of the
column is dependent on the bony anatomy, multiple ligaments, the
“stiffness” of the gel discs, as well as the many muscles that connect
these bones.
There are 2 major groups of muscles that are responsible for holding
your back together. The first group consisting of a column of 3 muscles
lies adjacent to and travels along the entire length of the spine. The
other group, comprised of multiple little muscles that run at a variety
of angles, connects the bones at each individual level. Additional
secondary muscles help to stabilize the spine and are involved with
functions such as flexing the hips.
Why is back pain such a big deal to runners? The answer is related to
the role that all of the muscles along the spinal column play in
protecting the spinal cord, as well as keeping the brain from
experiencing too much shock from each step. Just as the repetitive
nature of running can lead to injury within an athlete's major leg
muscles, the spine can experience the same problems.
Treatment of lumbar strains is determined by the presence or absence
of radiating, or radicular, pains, along with any loss of nerve function
in the legs. Worth noting, nerve loss can exhibit itself in the form of
numbness/ tingling, muscle weakness, or absence of reflexes. In the most
severe cases, patients can lose control of their bowel and bladder
functions making this condition a true surgical emergency. If a patient
is exhibiting any neurological compromise, I strongly rely on additional
work-ups, specifically, x-rays or an MRI.
When pain is isolated to the lumbar spine area, treatment is based on
controlling the acute symptoms, along with preventing future
reoccurrences. I generally recommend a gentle stretching program and the
use of a heating pad to try to loosen up the tightened muscles. To
assist with this, I'll often prescribe physical therapy accompanied by
deep tissue massage. Anti-inflammatories, muscle relaxants, and pain
relievers may also prove to be beneficial.
Here's the key: To help prevent an initial injury or a reoccurrence
of back pain, a core strengthening and stretching program is vital. The
focus of your program should be on stretching and strengthening the
muscles of the low back, abdomen (“6 pack”) and hips. There are many
ways to strengthen these muscles. The easiest is to concentrate on
sitting, standing and walking with good posture.
It is important to note that several very serious conditions can
cause back pain, including pancreatitis, aortic dissections/aneurysms
and kidney stones. If you experience back pain that is out of the
ordinary, don't ignore it! Seek medical care from your physician or at
the nearest emergency room.
Dr. Michael Gordon, of the Milwaukee Orthopaedic Group, Ltd. is an
orthopedic surgeon with a fellowship in sports medicine. For questions,
you can reach Dr. Gordon at 414-276-6000.
|
