| Low Back PainContrary to what you may think, don't just rest. Recent studies have shown that prolonged rest may cause certain kinds of low back pain to worsen because your muscles will weaken with lack of movement or exercise. You can limit your activity, but do not stop it completely. Some Physical Medicine & Rehabilitation physicians have reported seeing more patients for low back pain in the winter, which they sometimes attribute to our tendency to be "couch potatoes" when cold weather sets in. But remember, don't ignore your back pain. If it persists, consult with a PM&R physician. TreatmentA variety of nonoperative treatment measures may help physicians manage lumbar complaints and athletes, including medications, physical modalities, and selective injection; several other approaches are available for physical therapist and other providers. Although most back injuries can be managed nonoperatively, surgery is more appropriate for certain conditions, such as lumbar disc herniations associated with cauda equina involvement or progressive neurological defects, substantial loss of functional capacity, and intractable pain. Rehabilitation Appropriate rehabilitation is necessary to return full activity safely. The central concept and rehabilitation of athletes of low back pain are dynamic core stabilization, treatment of the full kinetic chain, and sport specific training. Return to play criteria include restoration of full, pain-free range of motion, appropriate aerobic conditioning, normal strength, adequate spinal awareness, and it demonstrated ability to perform sports related skills without pain. Low back pain is a common complaint among athletes that can be associated with significant structural abnormalities in the spine. Athletes are risk for a variety of spinal injuries related to sports participation. Physicians treating athletes who have low back pain need to be aware of issues related to specific sports injuries, the essential aspects of initial assessment and treatment, and a full functional rehabilitation of these athletes. A successful treatment program requires early an accurate identification of injured structures and sport specific training to prepare an athlete for turn to sports participation. Initial treatment of patients who have low back pain may begin with bed rest. Relative rest that restricts all occupational and avocational activities may be indicated for up to two days following an acute episode to ease initial pain symptoms. Rest for longer periods has not been shown to be beneficial. In addition, it can resultant deconditioning, loss of bone density, decreased intradiskal nutrition, loss of muscle strength and flexibility, and increased segmental stiffness.
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