Kaohsiung Armed Forces General Hospital

Pingtung Branch of Kaohsiung Armed Forces General Hospital

Patient Guide for Low Back Pain

I.Definition

Pain, muscle tightness, or stiffness occurring from the lower rib area to the lower buttocks, which restricts movement and functionality. This condition requires medication for symptom relief for at least one week within the past six months.

II.Causes

1. Injuries to ligaments and the spine due to occupational activities, sports, or accidents.
2. Overstretching of muscles, such as from being overweight, repeated heavy lifting, or poor posture. When being overweight, the body’s center of gravity shifts forward, increasing strain on the back muscles and spine.
3. Medical conditions, such as: Herniated disc、Spinal trauma、Degenerative arthritis of the spine、Compression fractures、Osteomyelitis、Hip or knee disorders.
4. During pregnancy: Hormonal changes cause loosening of the pelvic joints, leading to relaxed connective tissues, ligaments, and uterine muscles. Additionally, the weight of the fetus shifts the mother’s center of gravity forward, increasing stress on the lumbar spine, resulting in low back pain.

III. Symptoms

1. Pain that radiates to the legs or even the feet, known as sciatica.
2. Numbness, burning, cold sensation, or stiffness in the lower limbs.
3. In severe cases: leg weakness, limping, foot drop, or difficulty with urination and bowel movements.

IV.Precautions

1. When walking, point your toes forward and keep your weight centered on the middle of the soles, not on the inner or outer edges. Female patients should avoid wearing high heels.
2. Maintain correct standing posture: keep your head up, chest out, stomach in, and spine upright. Avoid excessive back curvature.
3. For jobs requiring prolonged standing, rest one foot alternately on a low stool. Change posture at least every 10 minutes.
4. Sit with proper posture: engage the abdomen, lean your back against the chair, sit fully, bend the knees, and keep both feet flat on the floor.
5. Sit down before tying shoelaces or picking up things from the floor.
6. A mattress that is too soft or too hard can stress the lumbar spine. An ideal mattress allows the lower back to sink about 3 cm when lying down. The best pillow is soft, resilient, and about 6–9 cm in height.
7. When lying on your back, place a pillow under your knees to help the back fully relax.
8. When lying on your side, bend both legs and place a pillow between the knees.
9. Avoid sleeping on your stomach, as it can compress the spine and nerves, leading to pain.
10. Do not bend your back when lifting heavy objects. Instead, squat with both knees and keep the object close to your body. Avoid lifting items that are too heavy or bulky.
11. Do not stand on tiptoe directly under shelves when reaching for high objects. Use a chair or ladder and extend your arms diagonally upward.
12. Maintain a healthy body weight: Men(Height in cm – 80) × 0.7、Women: (Height in cm – 70) × 0.6
13. After back pain subsides, begin abdominal and back muscle exercises to maintain flexibility and strengthen muscles and ligaments.
14. If the pain worsens or you experience numbness or weakness in the lower limbs, seek medical attention immediately.
15. Avoid prolonged sitting. When necessary, use a lumbar cushion and a high-backed chair.
16. Do not sleep face down, as this posture increases tension in the back muscles, cartilage, and nerves, making lower back pain more likely. Sleeping on your side or back is acceptable.
17. If pain occurs after exercising, stop immediately and consult your physical therapist for help.