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Back pain:Symptoms, causes, cure and prevention

Back pain


Introduction

Back pain is a very common reason for frequent doctor visits and absence from work. Although back pain may very uncomfortable and painful, most times it is not usually serious. Back pain has been known to be one of the most common reasons of disability worldwide. To better understand the causes of lower back pain, your back comprises of several parts, including:
Vertebrae (spine bones), nerves, blood vessels
 Muscles, ligaments.

 The lower spine is one of the keys to low back pain. It’s made up of:
The bones of the lower spine, including the lumbar and sacral vertebrae
Muscles and ligaments
Disks of cushioning tissue between the vertebrae
Nerves and your spinal cord

Even though back pain can affect people of any age, it is mostly experienced by adults between 35 and 55 years.

Pain in the lower back can be linked to the bony lumbar spine, discs between the vertebrae, ligaments around the spine and discs, spinal cord and nerves, lower back muscles, abdomen and pelvic internal organs, and the skin around the lumbar area. 

Pain in the upper back of the body may be due to disorders of the aorta, tumors in the chest, and spine inflammation.

Lower back pain, which is also known as lumbago, is not a disorder. It’s a symptom of several different types of medical problems. It usually results from a problem with one or more parts of the lower back, such as Ligaments muscles

According to the American Association of Neurological Surgeons, 75 to 85 percent of Americans have high chances of experiencing back pain in their lifetime. Of those, 50 percent are likely to have more than one episode within a year. In 90 percent of all cases, the pain gets better without surgery.

Most common symptoms of back pain

Low back pain can create a wide variety of symptoms. It can be mild and seriously annoying or it can also be severe. Low back pain may start suddenly, or it could start slowly possibly coming and going and gradually get worse over time.

Depending on the primary cause of the pain, symptoms can be experienced in a variety of ways. For example:
Pain that gets worse after prolonged sitting or standing
Pain that is dull or achy.
Difficulty standing up straight, walking, or going from standing to sitting
Muscle spasms and tightness in the low back, pelvis, and hips
Stinging and burning pain that goes from the low back to the backs of the thighs, sometimes into the lower legs or feet; can include numbness or tingling.

If by chance an individual should experience any of these symptoms such persons should see a doctor immediately:

Weight loss
Persistent back pain - lying down or resting does not help
Pain down the legs
Increased body temperature (fever)
Inflammation (swelling) on the back
Pain reaches below the knees
A recent injury, blow or trauma to your back
Urinary incontinence - you pee unintentionally (even small amounts)
Difficulty urinating - passing urine is hard
Numbness around the genitals, buttocks and anus.
Fecal incontinence - you lose your bowel control (you poo unintentionally)

Main causes of back pain
Risk factors

A risk factor can be said to be something which increases the chances of developing a condition or disease. The following factors are linked to a higher risk of developing low back pain:
Gender - back pain is more common among females than males
Strain related causes which include

Strained muscles
A muscle spasm
Strained ligaments
Doing these can also lead to strains and spasms:
Lifting things improperly
Lifting objects that is too heavy
A sedentary lifestyle
Age - older adults are more likely to suffer from back aches than young adults or children
Strenuous physical exercise
Strenuous physical work.
A mentally stressful job
Pregnancy - pregnant women are much more likely to get back pain
Depression
Anxiety
Obesity and overweight
Smoking

Results of bad sitting, walking, and standing postures.
Structural problems - the following structural problems may also result in back pain:

Ruptured disks - each vertebra in our spine is cushioned by disks. If the disk ruptures there will be more pressure on a nerve, resulting in back pain.

Sciatica - a sharp and shooting pain that travels through the buttock and down the back of the leg, caused by a bulging or herniated disk pressing on a nerve.

Bulging disks –just as ruptured disks occurs, a bulging disk can result in more pressure on a nerve thus resulting to pain.

Abnormal curvature of the spine: if the spine curves in an unusual way the patient is more likely to experience back pain.

 An example is scoliosis, a condition in which the spine curves to the side.
Osteoporosis - bones, including the vertebrae of the spine, become brittle and porous, making compression

Infection of the spine - if the patient has an elevated body temperature (fever) as well as a tender warm area on the back, it could be caused by an infection of the spine.

Cauda equina syndrome - the cauda equine is a bundle of spinal nerve roots that arise from the lower end of the spinal cord. People with cauda equine syndrome feel a dull pain in the lower back and upper buttocks, as well as analgesia (lack of feeling) in the buttocks, genitalia and thigh.

Cancer of the spine - a tumor located on the spine may press against a nerve, resulting in back pain. Everyday activities or poor posture.

Back pain can also be the result of some everyday activity or poor posture. Examples include:
Adopting a very hunched sitting position when using computers can result in increased back and shoulder problems over time.
Bending awkwardly
Pushing something
Pulling something
Lifting something
Carrying something
Standing for long periods
Bending down for long periods
Coughing
Sneezing
Twisting
Over-stretching

Muscle tension Bad mattress - if a mattress does not support specific parts of the body and keep the spine straight, there is a greater risk of developing back pain.

Sleep disorders - individuals who have sleeping disorders are more likely to experience back pain compared to others  who don’t.
Straining the neck forward

Long driving sessions without a break
Other infections include - pelvic inflammatory disease (females), bladder, or kidney infections may also lead to back pain.
Shingles - an infection that affects the nerves may lead to a back pain, depending on the nerves that were affected.

What are the ways a back pain can be diagnosed?

A physiotherapist - a physiotherapist training focuses on diagnosing problems with the joints and soft tissues of the body.
 X-rays can also show the alignment of the bones and whether the patient has arthritis or broken bones.

If the doctor or patient suspects some injury to the back, tests may be ordered. Also, if the doctor suspects the back pain might be due to an underlying cause, or if the pain persists for too long, further tests may be recommended.

Most primary care physicians will be able to diagnose back pain after carrying out a physical examination, and interviewing the patient, but In majority of cases imaging scans are not required.

Suspected disk, nerve, tendon, and other problems - X-rays or some other imaging scan, such as a CT (computerized tomography) or MRI (magnetic resonance imaging) scan may be used to get a better view of the state of the soft tissues in the patient's back.
MRI or CT scans - these are good for revealing herniated disks or problems with tissue, tendons, nerves, ligaments, blood vessels, muscles and bones.

Electromyography or EMG - the electrical impulses produced by nerves in response to muscles is measured. This study can confirm nerve compression which may occur with a herniated disk or spinal stenosis (narrowing of the spinal canal).

Bone scan - a bone scan may be used for detecting bone tumors or compression fractures caused by brittle bones (osteoporosis). The patient receives an injection o a tracer (a radioactive substance) into a vein.

 The trac collects in the bones and helps the doctor detect bone problems with the aid of a special camera.
The doctor may also order a blood test if infection is suspected.
Chiropractic, osteopathy and physical therapy
A chiropractor manipulates and adjusts the back of a patient.
An osteopath - the osteopathic expert diagnoses by touching and a visual inspection. Osteopathy involves slow and rhythmic stretching (mobilization), pressure or indirect techniques and manipulations on joints and muscles.

A chiropractor – A chiropractor will diagnose a patient by touching and inspecting the persons eyes and vision.  Most good chiropractors will want to see imaging scan results, as well as urine and blood tests.


Best common ways to treat and take care of back pains

In the vast majority of cases back pain resolves itself without medical help - just with careful attention and home treatment.
Pain can usually be addressed with over-the-counter (OTC) painkillers. Applying a hot compress or an ice pack to the painful area may also relieve pain.

Resting is helpful, but should not usually last more than a couple of days. Too much rest may actually be counterproductive by allowing muscles to weaken, which can lead to further episodes of back pain in some tricyclic antidepressants, such as amitriptyline, have been shown to alleviate the symptoms of back pain, regardless of whether or not the patient has depression.

Medication - back pain that does not respond well to OTC painkillers may require a prescription NSAID (nonsteroidal anti-inflammatory drug). Codeine or hydrocodone - narcotics - may also be prescribed for short periods; they require close monitoring by the doctor.

Physical therapy - the application of heat, ice, ultrasound and electrical stimulation, as well as some muscle-release techniques to the back muscles and soft tissues may help alleviate pain.

As the pain subsides the physical therapist may introduce some flexibility and strength exercises for the back and abdominal muscles.

 Techniques on improving posture may also help. The patient will be encouraged to practice the techniques regularly, even after the pain has gone, to prevent back pain recurrence.

Cortisone injections - if the above-mentioned therapies are not effective enough, or if the pain reaches down to the patient's legs, cortisone may be injected into the epidural space (space around the spinal cord).

CBT (cognitive behavioral therapy) - CBT can help patients manage chronic back pain. The therapy is based on the principle that the way a person feels is, in part, dependent on the way they think about things.

Injections may also be used to numb areas thought to be causing the pain. Botox (botulism toxin), according to some early studies, are thought to reduce pain by paralyzing sprained muscles in spasm.

 These injections are effective for about 3 to 4 months.
People who can be taught to train themselves to react in a different way to pain may experience less perceived pain. CBT may use relaxation techniques as well as strategies to maintain a positive attitude. Studies have found that patients with CBT tend to become more active and do exercise, resulting in a lower risk of back pain recurrence.

Surgery - 

surgery for back pain is very rare. If a patient has a herniated disk surgery may be an option, especially if there is persistent pain and nerve compression which can lead to muscle weakness.

 Examples of surgical procedures include:

Fusion - two vertebrae are joined together, with a bone graft inserted between them. The vertebrae are splinted together with metal plates, screws or cages. There is a significantly greater risk for arthritis to subsequently develop in the adjoining vertebrae.
Artificial disk - an artificial disk is inserted; it replaces the cushion between two vertebrae.
Diskectomy: a portion of a disk may be removed if it is irritating or pressing against a nerve.

Common best practices on how to prevent back pain

You may be able to avoid back pain or prevent its recurrence by improving your physical condition and learning and practicing proper body mechanics.

To keep your back healthy and strong:
Build muscle strength and flexibility. Abdominal and back muscle exercises (core-strengthening exercises) help condition these muscles so that they work together like a natural corset for your back.

 Flexibility in your hips and upper legs aligns your pelvic bones to improve how your back feels. Your doctor or physical therapist can tell which exercises are right for you.

Exercise-

Regular low-impact aerobic activities those that don't strain or jolt your back can increase strength and endurance in your back and allow your muscles to function better.

 Walking and swimming are good choices. Talk with your doctor about which activities are best for you.

Use proper body mechanics:


Stand smart. Maintain a neutral pelvic position. If you must stand for long periods, place one foot on a low footstool to take some of the load off your lower back. Alternate feet. Good posture can reduce the stress on back muscles.

Body weight - the amount of weight people carry, as well as where they carry it, affects the risk of developing back pain. The difference in back pain risk between obese and normal-weight individuals is considerable. Being overweight do strain the back muscles.

 If you're overweight, trimming down can prevent back pain. People who carry their weight in the abdominal area versus the buttocks and hip area are also at greater risk.

Posture when standing - make sure you have a neutral pelvic position. Stand upright, head facing forward, back straight, and balance your weight evenly on both feet - keep your legs straight and your head in line with your spine. If you regularly use a computer, it is important to ensure that you have a chair with good back support and adopt a good posture and head position.
Lift smart. 

Avoid heavy lifting, if possible, but if you must lift something heavy, let your legs do the work.

 Keep your back straight no twisting and bend only at the knees. Hold the load close to your body. Find a lifting partner if the object is heavy or awkward.

Flexibility - exercises aimed at improving flexibility in your core, including your spine, hips, and upper legs, may help too.

Quit Smoking -

 a significant percentage of smokers have back pain incidences compared to non-smokers of the same age, height and weight. Lighting up doesn’t just damage your lungs; it can also hurt your back.

Exercise -

 regular exercise helps build strength as well as keeping your body weight down. Experts say that low-impact aerobic activities are best; activities that do not strain or jerk the back. Before starting any exercise program, talk to a health care professional.

Sitting posture: 

 Choose a good seat with good lower back support, armrests and a swivel base. You should consider placing a pillow or rolled towel in the small of your back to maintain its normal curve. Keep your knees and hips level.

 Change your sitting position more frequently, at least every half-hour a good seat should have good back support, arm rests and a swivel base (for working).

 When sitting try to keep your knees and hips level and keep your feet flat on the floor - if you can't, use a footstool. You should ideally be able to sit upright with support in the small of your back. If you are using a keyboard, make sure your elbows are at right-angles and that your forearms are horizontal.

Keeping your back as straight as you possible, keeping your feet apart with one leg slightly forward so you can maintain balance. Bend only at the knees, hold the weight close to your body, and straighten the legs while changing the position of your back as little as possible.

Bending your back at the first instance can be unavoidable, but when you bend your back try your best  not to stoop or squat, and be sure to tighten your stomach muscles so that your pelvis is pulled in. Most important, do not straighten your legs before lifting; otherwise you will be using your back for most of the work which can subsequently induce pain.

Do not lift and twist at the same time. If something is particularly heavy, see if you can lift it with someone else. While you are lifting keep looking straight ahead, not up nor down, so that the back of your neck is like a continuous straight line from your spine.
Shoes –putting on flat shoes actually places less strain on your back.

Driving - it is very very important you have a proper support for your back. Make sure the wing mirrors are properly positioned so you do not need to twist your body.

 Improve Flexibility
Too much tension and tightness can cause back pain. "Our goal in increasing flexibility is to put an equal load throughout the body from the feet all the way up to the head,” Davis says. “One good exercise is to sit on the edge of the bed with one leg extended and the other one on the floor. Give your hamstrings a stretch by leaning forward while keeping your back in a neutral position.”

 Apply Ice and Heat

Heating pads and cold packs can help comfort tender trunks. Most doctors recommend using ice for the first 48 hours after an injury particularly if there is swelling and then switching to heat.

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