Beating that back pain
If a bad back has ever kept you home from work, you’re not the only one. Back pain is common (affecting 8 out of 10 people at some point during their lives) though how people experience it can vary widely. For some, it may last only hours or days, for others it is a chronic, recurring issue that interferes significantly with their lives. This month, we speak with Chartered Physiotherapist, Gopi Kitnasamy about what causes back pain, the different kinds that can be diagnosed and what treatments are available. Here are 7 things you need to know about back pain…
1: Why do we have back pain?Experts say that back pain is related to the way parts of our body work together, in this case, specifically the interactions between our bones, muscles and ligaments in our backs. The underlying causes of back pain vary in severity, but pain in the lower back may 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. Problems with any of these components can lead to back pain.
2: What are the common causes of back pain? While it is most commonly felt in the lower back, back pain can appear anywhere along your spine, from your neck down to your hips. Neck pain though a common problem is generally nothing to worry about. It often can come from sleeping awkwardly or even during a period of anxiety and stress. Caused by the sudden movement of the head backwards or sideways, whiplash occurs often during road accidents and presents a more serious injury to the neck. The full symptoms may take 6 – 12 hours to develop. It can also be caused by problems in the discs in the neck region which can lead to chronic issues.
Back pain is sometimes linked with pains in the leg which are called sciatica. It affects the sciatic nerve that runs from the spine to the leg. The pain is felt anywhere from the buttock to the big toe. Other symptoms include numbness and tingling in the legs and feet. Sciatica is caused by the compression or irritation of the sciatic nerve- the longest nerve in your body running from the back of your pelvis, through your buttocks, and all the way down both legs, ending at your feet.There’s nothing wrong with the leg itself. If you notice weakness of the muscles in your leg, especially if you can’t pull your foot up towards you or if you lose bladder or bowel control, see your doctor urgently. Other causes of back pain include arthritis, osteoporosis, abnormal curvatures of the spine like Scoliosis and Kyphosis and cancer or infection of the spine.
3:Are some people more at risk? Yes, though your risk factors may surprise you: for instance, a job that involves a lot of mental stress can trigger back pain. Other known risk factors for back pain include a sedentary lifestyle, anxiety, depression, obesity or weight issues as well as poorly managed exercise, strenuous physical work or poor posture. The last includes activities like bending awkwardly, carrying something too heavy or at an odd angle, standing for long periods or sitting in a hunched position. Some drivers, even if they’ve sat up straight, experience back pain after a few hours on the road. People have also known to develop a back pain suddenly, after a bad bout of sneezing, coughing or twisting. Unsurprisingly, pregnant women are also at risk.
4:What are the symptoms? You’d be forgiven for thinking that the symptom of back pain, is well, back pain. The truth though is that an episode can be associated with multiple other issues. Aside from an ache or pain anywhere on the back, back pain can also spread all the way down to the buttocks and legs. However, if these symptoms accompany your back pain you should consider seeking medical advice: Weight loss or fever can indicate a more serious underlying issue as does inflammation or swelling of the lower back, urinary or fecal incontinence or numbness around the genitals, anus or buttocks. If you have had a recent injury, blow or trauma to your back or if the pain is persistent and doesn’t lessen when you lie down, you should seek medical advice as soon as possible.
5:How do you diagnose back pain? Usually back pain is categorised into two types: acute or chronic. Acute back pain comes on suddenly and persists for a maximum of three months, while chronic back pain develops gradually over a longer period, lasts for over three months and is associated with long-term problems.
Your doctor will be able to diagnose back pain after carrying out a physical examination and interviewing you. In some cases, no further testing is required. However, if your doctor suspects that there is an injury or a more serious underlying cause or the pain persists for too long, further tests such as x-rays, bone scans or MRIs, EMGs may be ordered.
6:How do you treat back pain? Most back pain goes away on its own, though it may take a while. Taking over-the-counter pain relievers and resting can help. However, don’t stay in bed for more than a day or two or you risk making it worse. Your doctor may recommend you take painkillers or muscle relaxant medication. Depending on the cause, surgery may have to be considered.
A Physiotherapist will be able to do an assessment and suggest some appropriate treatments with electrotherapy,manipulation and exercise therapy to provide you pain relief and prevent recurrence. Many patients find exercises very helpful. These include stretching techniques initially and then later strength and stability exercises. Your physiotherapist will help you with improving your posture as well. Even after your pain has gone, continue to do your exercise regularly and work on maintaining your good posture – it will help prevent another episode of back pain.
7:How do you prevent back pain? Being aware of the risk factors can help you prevent back pain. Regular exercise is recommended as a way of building your strength and also of managing your weight. (Overweight people are significantly more likely to experience back pain.) Choose an activity that emphasizes flexibility and core strength but doesn’t include straining or sudden jerks. Be watchful of your posture when standing and sitting. When lifting things, lift with your legs and not your back – this means you should not straighten your legs before lifting something heavy, which leaves your back to do most of the work.
It’s generally a good idea not to lift and twist at the same time and when you’re moving things, pushing is always better than pulling for your back. If you’re driving long distance, take plenty of breaks and ensure your back is supported. At home, choose a mattress that maintains your spinal curvature and avoid a pillow that forces your neck into a steep angle. And finally, advice that applies to your overall general health as well is to quit smoking and binge drinking. Smokers are significantly more like to experience back pain when compared to non-smokers of the same age, height and weight.