DiseasesLower back pain — do painkillers treat it, or just mask the problem?
Sources: 13 · Article: 17 206 characters
Jan Jaśkowski points out that pain can result from an injury or overuse, but it does not always correspond to damage to the spine.
- Pain can also be affected by muscles, joint mobility, stress, sleep, activity, and other aspects of life.
- Staying active and choosing activity suited to your abilities can help, especially exercises performed sitting or standing.
- Jan Jaśkowski also recommends taking lifestyle and overall health into account, rather than focusing on just one treatment method.
- Massage can relax the muscles for a short time, but it does not remove the cause of the problem.
What the authors write
Jan Jaśkowski
Pain may be linked to an injury or overuse, but it is also affected by physical, psychological, health-related, lifestyle, and social factors.
„Physical factors (protecting the back, avoiding certain movements), psychological factors (fear of injury or not getting better, depression, stress), health (being constantly tired), lifestyle (sleep problems, little physical activity, excess weight), and social factors (poor relationships at work or in the family, dissatisfaction with work, family tragedies such as the illness or death of a loved one).”Czynnikami fizycznymi (chronienie pleców, unikanie pewnych ruchów), psychologicznymi (strach przed uszkodzeniem, brakiem poprawy, depresja, stres) stanem zdrowia (bycie ciągle zmęczonym), stylem życia (problemy ze snem, niewielka aktywność fizyczna, nadwaga) i czynnikami społecznymi (złe relacje w pracy lub rodzinie, niezadowolenie z pracy, tragedie rodzinne – choroba lub śmierć bliskiej osoby).
Jan Jaśkowski
Pain severity does not always depend on the extent of changes in the spine.
„The development of pain, including back pain, is a very complicated process and is often independent of the degree of damage to an anatomical structure (for example, an intervertebral disc). You can read more about how pain develops here.
As scientific studies show (not only those by American scientists), 20% of people in their twenties and as many as 40% of people in their eighties have a protruding intervertebral disc and do not experience back pain.”Powstawanie bólu, w tym bólu kręgosłupa to bardzo skomplikowany proces i często jest niezależny od stopnia uszkodzenia struktury anatomicznej (np. dysku międzykręgowego). Więcej o powstawaniu bólu możesz przeczytać tutaj.
Jak pokazują badania naukowe ( nie tylko amerykańskich naukowców ), 20% dwudziestolatków i aż 40% osiemdziesięciolatków ma protruzję dysku międzykręgowego i nie odczuwa dolegliwości bólowych kręgosłupa.
Jan Jaśkowski
Changes in the discs or vertebrae can also occur in people who do not feel pain.
„As scientific studies show (not only those by American scientists), 20% of people in their twenties and as many as 40% of people in their eighties have a protruding intervertebral disc and do not experience back pain. Nearly 50% of people in their twenties and 96% of people in their eighties have degenerative changes in the spine and do not experience pain! We can therefore conclude that a structural change by itself is not the cause of pain.”Jak pokazują badania naukowe ( nie tylko amerykańskich naukowców ), 20% dwudziestolatków i aż 40% osiemdziesięciolatków ma protruzję dysku międzykręgowego i nie odczuwa dolegliwości bólowych kręgosłupa. Blisko 50% dwudziestolatków i 96% osiemdziesięciolatków ma zmiany zwyrodnieniowe kręgosłupa i nie odczuwa dolegliwości bólowych! Można zatem wywnioskować, że sama zmiana strukturalna nie jest przyczyną powstawania bólu.
Jan Jaśkowski
Differences in hip muscle strength and endurance, as well as weak gluteal muscles, may contribute to pain.
„Muscle imbalances
Scientific studies confirm a link between mechanical factors and back pain. In 2002, researchers Nourbakhsh and Arab showed that imbalances in the length, strength, and endurance of the hip flexor muscles play an important role in the development of back pain.”Dysproporcje mięśniowe
Badania naukowe potwierdzają istnienie zależności pomiędzy czynnikami mechanicznymi a bólem kręgosłupa. W 2002 roku naukowcy Nourbakhsh i Arab wykazali, że dysproporcje w długości, sile i wytrzymałości mięśni zginaczy biodra odgrywają istotną rolę w powstawaniu bólu kręgosłupa.
Jan Jaśkowski
Impaired function of the sacroiliac joint can weaken pelvic stability and lead to pain.
„Studies show that if the sacroiliac joint does not function properly, two of the gluteal muscles—the gluteus maximus and gluteus medius—are “switched off,” which destabilizes the pelvis and may lead to back pain. In addition, the latissimus dorsi muscle works with the gluteus maximus to stabilize the sacroiliac joint.”Jak pokazują badania jeśli staw krzyżowo-biodrowy nie funkcjonuje prawidłowo dwa z mięśni pośladkowych: pośladkowy wielki i pośladkowy średni zostają „wyłączone” co destabilizuje miednicę i może prowadzić do bólu kręgosłupa. Dodatkowo, mięsień najszerszy grzbietu razem z mięśniem pośladkowym wielkim stabilizują staw krzyżowo-biodrowy.
Jan Jaśkowski
Sitting in a hunched position can weaken the function of the latissimus dorsi and be linked to problems with the sacroiliac joint.
„Therefore, its proper function depends on spinal mobility, especially in the thoracic spine. Considering that many of us sit hunched over a computer for hours, the latissimus dorsi gets “switched off,” which may lead to dysfunction of the sacroiliac joint.
4. Disorders of the internal abdominal organs.”W związku z tym jego prawidłowe funkcjonowanie jest uzależnione od ruchomości kręgosłupa, zwłaszcza kręgosłupa piersiowego. Biorąc pod uwagę że wielu z nas godzinami siedzi w pozycji pochylonej nad komputerem, mięsień najszerszy grzbietu zostaje „wyłączony” co może prowadzić do powstawania dysfunkcji stawu krzyżowo-biodrowego.
4. Dysfunkcje narządów wewnętrznych brzucha.
Jan Jaśkowski
Jan Jaśkowski also lists impaired muscle coordination, sacroiliac joint problems, and digestive system disorders as possible causes.
„The most commonly mentioned causes are weak muscles, a sedentary lifestyle, excess weight, smoking, poor posture, and psychological factors such as chronic stress or depression. Osteopaths know, however, that four equally important causes are often overlooked: 1. Muscle imbalances, 2. Impaired muscle coordination, 3. Sacroiliac joint dysfunction, 4. Digestive system disorders.”Najczęściej wymienanymi przyczynami są słabe mięśnie, siedzący tryb życia, nadwaga, palenie papierosów, zła postawa oraz czynniki psychologiczne takie jak przewlekły stres czy depresja. Osteopaci wiedzą jednak, że pominięto tutaj cztery równie ważne przyczyny, a mianowicie: 1. Dysproporcje mięśniowe, 2. Zaburzenia koordynacji mięśniowej, 3. Dysfunkcje stawu krzyżowo- biodrowego, 4. Zaburzenia układu pokarmowego.
Jan Jaśkowski
According to Jan Jaśkowski, lack of movement can disrupt signals between the brain and the body, tense the wrong muscles, and overload the joints.
„If the brain does not receive accurate information from the body (for example, because receptors are not working properly due to a lack of movement), it sends incorrect commands to the body. It tenses muscles that should be relaxed and relaxes those that should be tense.”Jeżeli mózg nie otrzymuje prawidłowych informacji z ciała (na przykład ze względu na zaburzenia w pracy receptorów wynikające z braku ruchu), wysyła nieprawidłowe polecenia do ciała. Napina mięśnie, które powinny być rozluźnione i rozluźnia te, które powinny być napięte.
Jan Jaśkowski
Avoiding movement does not help recovery; most people recover relatively quickly.
„However, immobilization does not improve your condition at all. Back pain can be treated without resorting to drastic methods.
Back pain is very common. It can be very painful and cause a lot of worry, but although it occurs extremely often, it is rarely life-threatening.”Jednak unieruchomienie wcale nie poprawia twojego stanu. Ból kręgosłupa może być wyleczony bez uciekania się do drastycznych metod.
Bóle kręgosłupa są bardzo częste. Bóle kręgosłupa mogą być bardzo bolesne i przysparzają sporo zmartwień, są niezwykle często występującą dolegliwością, ale rzadko są niebezpieczne dla życia.
Jan Jaśkowski
Activity, exercise, relaxation, and spending time with loved ones can support treatment, as can changes to lifestyle and overall health.
„Setting personal treatment goals, changing factors that affect pain (lifestyle and overall health), taking part in activities you enjoy, exercising, relaxing, and spending time with family and friends—all of these support treatment and recovery.”Wyznaczenie personalnych celów terapii, zmiana czynników wpływających na ból (styl życia, ogólny stan zdrowia), zaangażowanie w aktywność, którą lubisz, ćwiczenia fizyczne, relaksację, spotkania z rodziną i przyjaciółmi – wszystko to wpływa pozytywnie na leczenie i regenerację.
Jan Jaśkowski
Rehabilitation should focus on exercise, rather than routine surgical treatment.
„Rehabilitation should focus on physical exercise. Whenever possible, these exercises should be done standing or sitting—that is, in the positions we use in everyday life and in which we most often feel pain.”Rehabilitacja powinna być skoncentrowana na ćwiczeniach fizycznych. Ćwiczenia te powinny być wykonywane (kiedy tylko jest to możliwe), w pozycji stojącej i siedzącej – czyli w pozycjach, w których funkcjonujemy na codzień oraz kiedy najczęściej odczuwamy dolegliwości bólowe.
Jan Jaśkowski
It is worth exercising while standing or sitting, because these positions better reflect everyday activities and the loads placed on the body.
„Whenever possible, these exercises should be done standing or sitting—that is, in the positions we use in everyday life and in which we most often feel pain. Our body behaves differently when we stand, when we sit, and when we lie down.”Ćwiczenia te powinny być wykonywane (kiedy tylko jest to możliwe), w pozycji stojącej i siedzącej – czyli w pozycjach, w których funkcjonujemy na codzień oraz kiedy najczęściej odczuwamy dolegliwości bólowe. Nasz organizm inaczej zachowuje się kiedy stoimy, inaczej kiedy siedzimy, a jeszcze inaczej kiedy leżymy.
Jan Jaśkowski
Exercises performed lying down do not prepare you as well for standing or sitting activities, so Jan Jaśkowski recommends replacing them with such exercises when possible.
„First of all, exercises performed lying down will not prepare our bodies for activities performed standing or sitting, and should be replaced as soon as possible with exercises in a sitting or standing position. This is because the load on the joints, muscles, fascia, and intervertebral discs changes in these positions.”Przede wszystkim ćwiczenia wykonywane na leżąco nie przygotują naszego organizmu do aktywności wykonywanych na stojąco czy na siedząco i powinny być jak najszybciej zastępowane ćwiczeniami w pozycji siedzącej lub stojącej. W tych pozycjach zmienia się bowiem obciążenie stawów, mięśni, powięzi i dysków międzykręgowych.
Jan Jaśkowski
Exercises that improve mobility should be repeated often.
„Scientific studies show that one cause of back pain is insufficient mobility in the spine, hip joints, and shoulder joints. We also know that improving range of motion requires exercises that:
Are repeated often.”Z badań naukowych wynika, że jedną z przyczyn powstawania dolegliwości bólowych kręgosłupa jest brak odpowiedniej ruchomości kręgosłupa, stawów biodrowych i ramiennych. Wiemy rownież, że do zwiększenia zakresu ruchomości potrzebne są ćwiczenia, które:
Są często powtarzane.
Jan Jaśkowski
Massage can relax muscles and improve joint mobility, but its effects may be short-lived.
„However, their effectiveness is not always satisfactory. Massages help relax tense muscles and increase joint mobility, but their effects may be short-lived. This is because massages do not remove the cause of muscle tension or restricted mobility.”Jednak ich skuteczność nie zawsze jest zadowalająca. Masaże pomagają rozluźnić napięte mięśnie i zwiększyć ruchomość stawów, ale ich efekt bywa krótkotrwały. Dzieje się tak dlatego, że masaże nie usuwają przyczyny powstawania napiętych mięśni i ograniczeń ruchomości.
Jan Jaśkowski
Massage alone does not remove the cause of muscle tension or limited mobility.
„However, their effectiveness is not always satisfactory. Massages help relax tense muscles and increase joint mobility, but their effects may be short-lived. This is because massages do not remove the cause of muscle tension or restricted mobility.”Jednak ich skuteczność nie zawsze jest zadowalająca. Masaże pomagają rozluźnić napięte mięśnie i zwiększyć ruchomość stawów, ale ich efekt bywa krótkotrwały. Dzieje się tak dlatego, że masaże nie usuwają przyczyny powstawania napiętych mięśni i ograniczeń ruchomości.
Jan Jaśkowski
Jan Jaśkowski recommends basing treatment on proven methods, not on random advice from the internet.
„This is especially true of advice from laypeople, when there has been no proper diagnosis. You can never know with 100% certainty how a patient’s body will react to a particular treatment. That is why you should base your treatment on reliable medical knowledge and scientifically tested methods, not on stories from a neighbor or acquaintances.”A tym bardziej laikom bez odpowiedniej diagnozy. Nigdy na 100% nie wiadomo jak organizm pacjenta zareaguje na dane leczenie. Dlatego należy opierać swoje leczenie na rzetelnej wiedzy medycznej i przebadanych naukowo metodach, a nie na opowieściach sąsiadki czy znajomych.
Jan Jaśkowski
Jan Jaśkowski presents osteopathy as an approach that takes into account exercise, posture, the workplace, diet, and other health factors.
„Osteopaths look at back pain in the context of a patient’s life, and treatment aims to improve many aspects that affect health, such as exercise, posture, the workplace, diet, and more. This comprehensive approach aims not only to reduce current pain, but also to prevent it from returning and to improve the body’s potential and capabilities.”Osteopaci patrzą na bóle kręgosłupa w kontekście życia pacjenta, a leczenie ma na celu usprawnienie wielu apsektów wpływających na zdrowie, takich jak ćwiczenia, postawa, stanowisko pracy, dieta i inne. To wszechstronne podejście ma na celu nie tylko zmniejszenie obecnych dolegliwości bólowych, ale także zapobieganie nawrotom choroby oraz zapewnienie większego potencjału i możliwości organizmu.
Research from PubMed · Europe PMC
We selected 4 studies with the best, positive results. This is a selection, not a full review of all research.
Total number of studies on this topic in PubMed: 10 666.
For spinal stenosis, successful programs more often included stretching, trunk strengthening, fitness improvement, and an approach that took psychological factors into account.
Aim of the study: To analyse the components used in exercise interventions for people with symptoms of neurogenic claudication due to lumbar spinal stenosis and identify components associated with successful interventions.
Results: We found thirteen trials reporting 23 exercise interventions delivered to 1440 participants. These featured 60 different components. Most exercise interventions included supervision and flexion-based exercises. Balance exercises were rarely included. Exercise components featured more frequently in successful interventions included stretches, strength or trunk muscle exercises, fitness exercises, especially cycling, and psychologically informed approaches. Interpretation is limited by low study numbers and heterogeneity. No conclusions could be drawn about exercise supervision or dose.
Money for the studygovernment, public institutions · National Institute for Health Research (NIHR)
Do the authors have ties to companies?not stated
Did a manufacturer help with the study?unknown
Type of studyreview of many studies
“Not stated” does not mean nobody paid — the database does not always record it.
For symptoms of a lumbar disc herniation, physiotherapy may help, and strength training for the back and abdominal muscles has been shown to be effective in the chronic phase.
Aim of the study: Physiotherapy is the treatment of choice in patients with symptoms caused by a lumbar disc herniation. In clinical practice a broad range of physiotherapeutic modalities has been revealed to be helpful.
Results: During the acute stage the efficacy of the McKenzie-concept, mobilisation therapies and traction has been demonstrated in randomized controlled trials with a blind assessor. In addition, pain reducing physical therapies such as cold or electrotherapy and non-steroidal anti-inflammatory drugs, analgesics and/or muscle relaxants are sensible initial accompanying treatments. The effectiveness of active physiotherapies such as training of local strength endurance of back and abdominal muscles has been proven in patients during the chronic stage. The indications for a in-patient rehabilitation programme, for surgery and the danger of developing chronic low back pain are discussed.
Money for the studynot stated
Do the authors have ties to companies?not stated
Did a manufacturer help with the study?unknown
Type of studydiscussion of other studies
“Not stated” does not mean nobody paid — the database does not always record it.
In a six-year study of a professional basketball team, proprioception training was associated with a 77.8% decrease in the incidence of lower back pain.
Aim of the study: Single limb stance instability is a risk factor for lower extremity injuries. Therefore, the development of proprioception may play an important role in injury prevention.
Results: Low back pain showed similar results with a reduction of 77.8% (p < 0.005). The reduction in knee sprains was 64.5% (not significant). Comparing the third biennium with the level of all new entry players, proprioceptive control improved significantly by 72.2% (p < 0.001). These findings indicate that improvements in proprioceptive control in single stance may be a key factor for an effective reduction in ankle sprains, knee sprains, and low back pain.
Money for the studynot stated
Do the authors have ties to companies?not stated
Did a manufacturer help with the study?YES
Type of studyclinical study in people
“Not stated” does not mean nobody paid — the database does not always record it.
The pain was caused by iliopsoas muscle abscesses, and treatment with intravenous vancomycin led to complete resolution of the clinical and radiological findings.
Aim of the study: BACKGROUND Septic abortion is a serious, life-threatening uterine infection that can occur before, during, or after a miscarriage or termination, and when it is associated with an intrauterine fetal death (IUFD), the retained fetal tissue can be a focus for bacterial infection.
Results: Targeted treatment consisting of a 28-day course of intravenous vancomycin resulted in full clinical and radiographic resolution. CONCLUSIONS Iliopsoas abscess is a complex clinical entity whose diagnosis can be challenging, even more in a pregnancy context. Very few cases of psoas abscess during pregnancy have been reported in the literature, and even fewer have been bilateral. Timely diagnosis and broad-spectrum antibiotic coverage are the cornerstones of treatment.
Money for the studynot stated
Do the authors have ties to companies?no — the authors say so
Did a manufacturer help with the study?NO
Type of studyother
“Not stated” does not mean nobody paid — the database does not always record it.
Perspectives and opinion materials
The content below presents the authors’ opinions, interpretations and hypotheses. It is not treated as equal to scientific studies and systematic reviews.
Orthomolecular Medicine News Service Opinion material
„From the IOM perspective, FibroScan gives us real-time feedback on the restoration of biological terrain through: Orthomolecular nutrition and antioxidants Low-carb and ketogenic diets Mitochondrial and detoxification support Intermittent fasting 📊 Supporting Data: AUC of 0.93-1.00 for cirrhosis diagnosis (5-7). Cutoff range: 14.5-18.0 kPa depending on etiology Outperforms biochemical markers like APRI and FIB-4 (6) Especially useful to track reversal and adjust treatment plans 2.”From the IOM perspective, FibroScan gives us real-time feedback on the restoration of biological terrain through: Orthomolecular nutrition and antioxidants Low-carb and ketogenic diets Mitochondrial and detoxification support Intermittent fasting 📊 Supporting Data: AUC of 0.93-1.00 for cirrhosis diagnosis (5-7). Cutoff range: 14.5-18.0 kPa depending on etiology Outperforms biochemical markers like APRI and FIB-4 (6) Especially useful to track reversal and adjust treatment plans 2.
Orthomolecular Medicine News Service Opinion material
„As there are different etiological backgrounds to pneumonia, it is important for physicians to know that vitamin C is very safe and functions positively in the medical treatment of both infections and many other diseases. Also, in acute illness, Klenner emphasized starting vitamin C treatment immediately even if the diagnosis was unclear [7]. To get high concentrations of vitamin C in body tissues it is reasonable to combine different forms of vitamin C in the treatment: conventional oral vitamin C, liposomal vitamin C and, if needed, intravenous vitamin C [8]. [Dr. Bo H.”As there are different etiological backgrounds to pneumonia, it is important for physicians to know that vitamin C is very safe and functions positively in the medical treatment of both infections and many other diseases. Also, in acute illness, Klenner emphasized starting vitamin C treatment immediately even if the diagnosis was unclear [7]. To get high concentrations of vitamin C in body tissues it is reasonable to combine different forms of vitamin C in the treatment: conventional oral vitamin C, liposomal vitamin C and, if needed, intravenous vitamin C [8]. [Dr. Bo H.
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