Back pain

Back pain is one of life’s maladies that affect all of us at one time or another. Many people are hospitalized for back problems. Lower back pain is the mist common kind and can result from a variety of causes. Most doctors refer to back pain as acute (generally severe, but short-lived), sub acute or chronic (long-lasting or occurring often). Acute back pain usually lasts from one to seven days. Pain may be mild or severe and occasionally may be caused by an accident or injury. About 80 percent of all back pain is acute. Sub acute back pain usually lasts from seven days to seven weeks and usually is mild; occasionally it's severe. This pain generally is unrelated to other illnesses you may have. About 10 to 20 percent of all back pain is sub acute. Chronic back pain usually lasts more than three months and maybe mild or severe. It may be related to other illnesses you may have or may have no identifiable cause. About five to 10 percent of all back pain is chronic.

Back pain is a wide-ranging ailment. Some of the more common symptoms are a persistent dull pain usually located in the small of the back, shooting pains which radiate from the small of the back down to the left leg, limited mobility and swiftness characterized by unnatural positions and an inability to completely straighten the spine.

For many people, the key to a healthy back is proper exercise. Some exercises are designed to strengthen your back and stomach muscles, while other exercises are designed to improve your posture. A 30-minute aerobic conditioning program three times a week is ideal for overall fitness. Walking and/or water exercise are highly recommended for most people with back problems. The right kind of exercise program may help keep your back problem under control. It can make it easier for you to continue doing your daily activities. You may need to take a break from vigorous exercise if it makes your back pain worse. The exercises on the following page may help strengthen the back or improve posture. Ask your doctor and physical therapist which exercises you can do to relieve back pain, stay fit, and prevent injuring yourself again. Adopting the right posture also helps prevent any backaches.

Anything that puts pressure on your back muscles or nerves can cause pain. Any illness or damage to your spine also can cause pain. The cause of most acute back pain is unknown, but probably is due to minor strains, sprains and overuse. Emotional stress may add to the pain, especially since it slows the rate of recovery. Other possible causes of back pain are included in the following sections: 

Ruptured Intervertebral Disc:

This may be the most painful, yet easiest condition to identify. A ruptured or herniated disc is one that bulges into the spinal canal, pressing on the nerve roots. This causes the nerve roots to become irritated. A disc can rupture after bending over and lifting, or it may occur for no apparent reason. A ruptured disc may cause back pain and muscle spasms, but a more common symptom is sciatic pain. This is severe pain spreading down one leg and often into the foot. Sometimes it is the only symptom of a ruptured disc. A ruptured disc usually can be detected by a physical examination alone. Sometimes a procedure such as a myelogram, Computerized Axial Tomography (CAT) scan, or Magnetic Resonance Imaging (MRI) is needed to confirm the diagnosis and determine if surgery is necessary. 

Spinal Stenosis:

In spinal stenosis, the spinal canal becomes narrowed. This squeezes the back nerves and puts pressure on them. It is this pressure that causes the back pain. Numbness, pain and weakness in the legs also can occur. The most common symptom of spinal stenosis is pain that worsens when walking and subsides when sitting down. 

Osteoarthritis:

Osteoarthritis is just one form of arthritis that can cause back pain. It breaks down the cartilage (soft, elastic material) that cushions the spinal joints and other joints in the body. Lower back pain can become more intense when osteoarthritis affects the hips or the knees. Osteoarthritis also can directly affect the spine, causing muscles, tendons, or ligaments to become strained, which can lead to back and/or neck pain. 

Ankylosing Spondylitis:

This form of arthritis causes the joints in the spine to become stiff and swollen. In time, stiff joints can fuse (grow together). The most common symptoms are pain and stiffness in the buttocks and lower back (particularly in the morning) that continue for more than three months. 

Injury or Accident:

Have you ever moved a piece of furniture that didn't seem too heavy, only to feel pain in your back the next day? Have you ever stretched for something that was just a little out of your reach and felt a twinge in your back? Many back injuries are caused by an unexpected twist or sudden motion. This usually results in muscle strain. 

With either an injury or accident, severe muscle spasms usually last 48 to 72 hours. They generally are followed by days or weeks of less-severe pain. It usually takes two to four weeks to heal completely from a mild back injury. It could take from six to 12 weeks if there are strained ligaments or if the strain is more severe. Severe back injury from a fall or accident may require hospitalization and a longer recovery period. 

Osteoporosis:

This is a type of bone disorder that causes bones to become thin and weak due to calcium loss. Fragile bones, especially those bones in the spinal column, can break more easily, and there is an increased tendency for this to happen in older women. Osteoporosis also contributes to compression fractures, or spinal fractures in which the vertebrae become flattened. Falls, lifting heavy objects or moving the wrong way can result in a compression fracture. 

Rheumatoid Arthritis:

This form of arthritis causes any joint to become stiff, painful and swollen. It can affect the neck but almost never the joints in the lower back. 

Polymyalgia Rheumatica (PMR):

This rheumatic disorder causes muscle pain, aching and stiffness in the neck and shoulders, lower back, thighs and hips. It can last a few months or many years. Most people experience severe stiffness in the morning. 

Fibromyalgia:

People with fibromyalgia feel pain and stiffness in muscles and tendons, especially in the neck and upper back. The pain can last for weeks, months or years. The symptoms may disappear by themselves. This condition often is related to sleep problems, poor conditioning or an old injury.

It often is difficult for doctors to find the exact cause of back pain, especially since there are so many possible causes. If the cause is unclear, your family doctor may suggest that you see an orthopedist, rheumatologist, neurosurgeon, neurologist, physiatrist or other medical specialist for diagnosis. If your back pain is accompanied by any of the following, see a doctor today: 

Avoid meats and animal protein products if gout is suspected due to the high uric acid content of these foods. Eat a diet, which emphasizes whole grains, fresh fruits and vegetables and foods rich in protein, which are not milk based. Drink at least eight to six glasses of water each day to expedite the removal of muscle acids like lactic and pyruvate. Dehydration can also cause pain.

A programme of exercising can help strengthen the back muscles and is very beneficial. Use an ice pack to help relieve pain but should be applied only for short intervals. Placing a rolled up towel or pillow in the back can also increase comfort. Lots of rest and swimming is also very helpful. Sleeping on a mattress without a pillow also helps at times. Hot oil massages are also effective.

Stress, poor posture, lack of exercise and being overweight all can contribute to the problem. In terms of stress, people react to it in different ways. Some may feel tired, sleep poorly, overeat or feel irritable. Some clench their jaw. Others tighten their neck and shoulders. Still others get a headache or an upset stomach when they are tense. Many people tighten their back muscles when they are worried or tense. This can make existing back problems worse. Take a minute now to think about what happens in your own body when you worry or get tense. Do you think stress is affecting your back? If so, look in the stress management section of this material for some helpful tips.