What is Back Pain?
Pain in the lower back or low back pain is a common concern. Low back pain is not a specific disease but rather, a symptom that may occur from a variety of different processes. In some cases, people with low back pain despite a thorough medical examination, no specific cause of the pain can be identified.
Low back pain is second only to the common cold as a cause of lost days at work. It is also one of the most common reasons to visit a doctor's office or a hospital's emergency department.
For 90% of people, even those with nerve root irritation, their symptoms will improve within 2 months, no matter what treatment is used-even if no treatment is given.
Doctors usually refer to back pain as acute if it has been present for less than a month and chronic if it lasts for a longer period of time.
What Causes Back Pain?
Back pain is only a symptom of an actual problem. Pain arising from other organs may be felt in the back. This is called referred pain. Many intra-abdominal disorders-such as appendicitis, aneurysms, kidney diseases, bladder infections, pelvic infections, and ovarian disorders, etc. can cause pain referred to the back. Your doctor will have this in mind when evaluating your pain.
Back pain may be caused by injury, mechanical or inflammatory conditions of the spine. The mechanical or inflammatory problem must be fixed before the pain will go away for good. Nerve root syndromes are those that produce symptoms of nerve impingement (a nerve is touched/compressed), often due to a hernia (or bulging) of the disc between the spinal bones. Sciatica is an example of nerve root impingement. Impingement pain tends to be sharp, in one spot, and associated with numbness in the area of the leg that the affected nerve supplies.
Musculoskeletal pain syndromes that produce low back pain include myofascial pain syndromes and fibromyalgia. Other skeletal causes of low back pain include osteomyelitis or sacroiliitis (infections of the bones of the spine). This pain is usually worse at night and is worse when sitting or standing for a long time. Tumors, possibly cancerous, can be a source of skeletal pain
What are the Common Symptoms of Back Pain?
- Pain in the lumbosacral area (lower part of the back) is the primary symptom of low back pain.
- The pain may radiate down the front, side, or back of your leg, or it may be confined to the low back.
- The pain may become worse with activity or change of posture.
- Occasionally, the pain may be worse at night or with prolonged sitting such as on a long car trip.
- You may have numbness or weakness in the part of the leg that receives its nerve supply from a compressed nerve.
Self-Care at Home
General recommendations are to resume normal, or near normal, activity as soon as possible. The best immediate care of a back injury is rest in order to allow the back to heal. However bed rest must be limited to a few days only to allow for the injury and inflammation enough time to heal. Two/three days of bed rest can be effective but can also produce severe weakness, stiffness and poor circulation to back structures. Muscles become weak and lose flexibility. Joints get stiff and become over-sensitive. Discs become starved of oxygen and nutrients. Prolonged bed rest can also produce emotional problems. These changes can prevent recovery. However, stretching or activities that place additional strain on the back are discouraged.
Medication can reduce pain, inflammation and muscle spasm. They can speed recovery and help you tolerate return to activities. Like bed rest, medication reduces symptoms only. They do not restore spinal function.
Heat, ice, ultrasound and electrical stimulation can improve circulation and reduce pain. These modalities stimulate nerves that assist in decreasing pain, open blood vessels and relax muscle tension. However, they do not restore spinal function.
Massage can be very healthy for muscles and connective tissue. It can reduce spasm and improve circulation but, does not restore strength.
Mobilization is when a physiotherapist moves the joints of the spine with their hands. This is usually a gentle procedure. A more intense, sudden force referred to as a manipulation can also be used. The purpose of manipulation is to restore mobility to the joints and to stimulate their nerves in ways that can reduce pain and spasm. Manipulation is usually accompanied by exercises that build strength and flexibility.
Surgery does not fix a “bad” back. It may help some people with certain severe back problems and it should be viewed as an option of last resort.
One of the most important parts of surgery is the rehabilitation post operatively.
Physiotherapy is a physical, mechanical and educational approach to correcting the causes of back problem. Specially trained medical professionals i.e. physiotherapists use a combination of treatment strategies including:
Physical modalities to control pain and inflammation
Massage to reduce pain and restore tissue mobility
Traction and joint mobilization
Exercises to build flexibility, strength and endurance
Education to make people aware of their back problem, to stay in shape and avoid re-injury.
Exercise is a key to recovery. Movement must be started as soon as pain will allow some activity. Movement, strength and flexibility are necessary to restore circulation; healing and back function for long - term recovery. Certain exercise may also help damaged discs improve their circulation and reduce disc bulging.
Taking care of your back problem
For a new/ new re-injury:
Stop, rest and apply ice. Immediately rest your injured back. A good rest position is to lie on your back on a hard surface such as the floor. Place your legs on a chair, so that your hips and knees are bent at right angles. Support your lower back with a rolled towel.
Place ice rather than heat for 10-15 min at a time. Pain should improve significantly in a day or two. You should start activity as soon as you can tolerate it e.g. walking, back exercises etc. Do not quit exercises when the pain goes away. You need to do preventative exercises for life, to avoid re-injury.
Two things determine how much work your back does on the job: THE DESIGN of your job and your WORK HABITS. Following the rules of proper lifting is vital to protecting your back from fatigue and injury. The design of your job, however, is also important.
Hold the load close to your body. Keep your chin tucked and lower back slightly arched. Try to stand an inch taller than usual as you carry the load.
Think before you lift
Analyze the work task to decide how best to do it. Lift properly. Do not try to lift too heavy a load. Get help. Use equipment. DO not do something unsafe to your back.
Healthy or hurt, it’s your back for life!