Nasty back pain

ABOUT  80 percent of us, 8 out of 10 of us, will develop some form of back pain sometime in our lifetime.

Obviously, our erect posture puts a lot of load on our spine, especially the lumbo-sacral (low back) spines. A significant number of low back pains are self-induced, resulting from our bad habits and poor lifting technique. The pains could also affect the back of the neck, cervical spine pains.

What is back pain?

Back pain could be acute of chronic. Acute low back pain usually lasts for a few days and are mostly due to trauma (sports injury, lifting, gardening, direct jolt or impact, improper sitting) or joint conditions, like arthritis. The symptoms are usually muscle aches, or stabbing to shooting pain in the back, limited range of motion, or inability to stand up straight. The chronic type lingers for more than 3 months, and progressive. The feeling of constant tiredness in the back, lingering nagging lower back pains and sometimes muscle spasms and stiffness of the back. Low back pains must be differentiated from passing kidney stones.

Is sitting up straight good?

While slouching is bad for our back, sitting up straight for a prolonged period can be a strain on the back. A good strategy is this: lean back with feet on the floor and slight curve in the back. Better than that is getting up and stretching your back often from a sitting position, while reading, sewing, doing computer-work, etc.

Is bed rest good for our back?

For acute back pain, back strain and back injury, bed rest will help some, and your body will let you know. If your body does not tell you to stay in bed, do not do so. Bed rest, even for a day or two can make back pain worse.

Is lifting bad for the back?

Lifting anything too heavy for oneself is obviously bad, but lifting ordinary items daily, and regular mild to moderate weight lifting exercises as tolerated by personal condition and limitation, is healthy. It is usually not how much tolerable weight one lifts but how one does it that matters more. The prudent technique in lifting is for one to squat close to the item, with the back straight and head up. When getting up, lift the load by using the legs and not the back, without bending or twisting the body. For those with acute pain, lifting even a glass of water away from the body hurts. It is best to always carry objects near the body to lessen strain on the back, even for those with non-aching back.

Does obesity strain the back?

Yes, most definitely. Any excess body weight will pose extra burden on the back. Our individual bone, ligament, tendon, and muscle structures are built to withstand a weight that is normal for us. Anything beyond what is supposed to be normal for us will be added trauma to our musculo-skeletal system, especially of the back. Those who are overweight are more prone to back pains.

Does exercise reduce the risk?

Yes, those who are do daily exercise and are fit have lower risk of developing back pain. The so-called weekend warriors, who do weight-lifting or strenuous activities during weekends may be out of shape from being couch-potatoes the rest of the week, are more prone to develop chronic back pains for life.

Does acupuncture help?

In some cases, acupuncture might help, and so with massage therapy, but they are resorted to for

intractable back pains, resistant to the standard

therapy. The mainstay of management remains: daily exercise for the back and proper weight lifting technique. Regular pain pills and muscle relaxants could also be beneficial. Yoga, meditation, relaxation, and cognitive behavioral treatment have also been recommended for resistant chronic back pains.

Which mattress is better?

The conventional thinking that firm mattresses are better for people with back pains may not be true for all people. In a study, medium-firm mattresses have been related to lesser back pain in some people.  So, this varies because individuals have different sleep habits. Whichever is more comfortable for your back is the right mattress for you.

What preventive measures can be taken?

While preventive measures may not guarantee freedom from back pain forever, they are worth doing. Only about 20 percent will succeed but the discomfort and aggravation of this type of chronic pain justifies trying. Stressors, like lifting, repetitive motions, vibration, and wrong posture are the usual causes of work-related injuries to the back, which can also aggravate the condition. Learning how to lift objects properly helps ward off back pain. Nowadays manufacturers design furniture and other items using the principles of ergonomics to protect the body from harm and injury over the long run at home or at the work place, like computer desks and chairs. Some of the injuries are to vision, hands (carpal tunnel), neck and to the lower back (arthritis and pinched nerves). One of measures to lower the risk for back pain is to live a healthy lifestyle that includes daily physical exercise.

What is the management for back pain?

Majority of low back pain does not require surgery. NSAID (Non-steroidal Anti-Inflammatory Drugs, like Celebrex, Ibuprofen, etc., are used to reduce pain and inflammation. More resistant form of back pain may need a combination of drugs, some of them anti-spasm pills or anti-depressant medication, prescribed by the physician. Chronic back pain will benefit from regular back exercises. For acute back pain, on top of pain pills, the use of warm compress may be soothing for some people. In this situation, bed rest should not be more than 2 days. Being up and about helps in the recovery. If the back pain persists or becomes severe, orthopedic consultation is recommended for definitive diagnosis, especially for those with numbness and pains radiating to either leg from a pinched spinal nerve.

What is the outlook?

Unless there is a serious disease involved, back pain is not a deadly condition.  Acute back pain due to trauma usually recovers after a few days, with treatment and behavioral modification. Chronic back pain usually lasts for a lifetime, coming on and off, and one usually learns to accept it. If, at any point, the pain becomes worse or unbearable, a consultation with the family physician is recommended for a more definitive diagnosis, and to make sure the pain is due to a more serious organic problem. Other causes of back pain will also have to be ruled out.

*Please visit xlibris.com and amazon.com, and search for the book, Let’s Stop “Killing” Our Children, which contains a compilation of articles from this column. Email: [email protected]