Lower back pain

MILLIONS of people around the world suffer from back problems. Some are totally disabled, permanently or temporarily. Because the spine is a complex collection interlocking prices, back pain can arise from a variety of reasons. Sometimes the root of the pain is found in degenerative or hereditary disease. Other times, the pain involves bio mechanical stresses caused by obesity, improper lifting, poor postures, injury, age or sedentary lifestyle.

Back pain can also be caused by disease.  Here are the most common organic causes of back trouble:

• Herniated disk — The spinal disks are located

between the vertebrae and act as the body’s shock absorbers. The soft core of each disk is covered by a layer of fibers. A disk becomes herniated when the core ruptures through this layer. The result is a shooting pain down the leg accompanied by back pain.

• Anklosing spondylitis—This disease is a form of inflammatory arthritis that most commonly affect males (5 to 1) between the ages of 25 and 35 with a family history of this problem. The early symptoms come and go unnoticed, but over the years the spine becomes increasingly rigid.

• Spondylothisthesis—This condition is caused by a defect in the spinal arch that results in the sliding forward of mone vertebra onto the one below it.

• Metastatic disease—This term refers to a disease that spreads from an affected point to the other parts of the body especially the back. The back pain is really a secondary symptoms of disease somewhere else.

• Degenerative disk disease—This disease which is not completely understood is caused by the aging process and causes pain and disability.

Biomechanical stresses

Less than  10 percent of lower back pain has an organic origin. Instead, most of the pain is caused by conditions called biomechanical stresses which overload the spinal structure. Motion ultraviolet film shows in glowing detail that all the pressure of the body falls on the lower back. With proper posture and care the back adapts well to this burden. However, when posture is poor or the vertebrae are twisted or strained , back pressure pushes on nerves causes unbalanced hip structure, and twists disk. Vertebrae with 65-75 percent of the population walking around with poor upper spinal posture, it’s no wonder most lower back problem are so common.

In addition to the natural pull of gravity and poor posture the following biomechanical stresses frequently causes lower back back pain:

• Compressive forces from improperly lifting a heavy weight.

• Tension on ligaments and muscles from bending forward in an extreme position.

• Twisting forces from exposure to abnormal  positions over a long period of time.

• Trauma from a fall.

• Weakening or atrophying of muscles and pressures on disks from a lifetime of poor posture.

• Static muscle strain from long periods in uncomfortable positions (sedentary workers are specially prone to this)

• Muscle spasm from injury.

• Tense painful muscles from distressed emotional state.

• Tight short muscles from heavy manual labor.

• Improperly fitted shoes (especially high heels)

Conventional medicines

Back Pain is an extremely common complaint in doctors offices. Whether you take your pain to a family practitioner or an orthopedist your treatment regimen will probably begin with a series of diagnostic test. Test typically described includes:

• X-rays are used to eliminate way probability of disease, inflammation abscesses or other bone disorders.

• Myclography is used to find muscle spasm and soft tissues damage such as swelling.

• Computerized Axial Tomography (CAT) scan is a type of X-ray scanning procedures that enables the doctor to see more closely and in greater detail any soft tissue may damage.

•    Magnetic Resonance Imaging (MRI) once the cause of your back pain is determined, the physician has a variety of treatment procedures to choose from.

Drug therapy

Over the counter analgesics and non-steroidal anti-inflammatory are usually the first line of treatment. Although they do ease the perception of pain, muscle relaxants are also prescribed to relieve the muscle tension in the lower back. In the acute stages of back pain where there is a recurrence of spasms and  mobility is severely affected,  anti-inflammatory drugs, analgesics and muscle relaxant are  helpful in managing the pain. However in the case of chronic back pain, drug therapy should be considered a dangerous treatment approach.

Surgery

Back surgery is an option for those suffering from back pain in only two situations: if there is a tumor or ruptured disk placing pressure on the major nerve root or the spinal cord or of there is spinal cord or nerve root compressions from a fractured or other major instability such as traumatic injury. But there is a growing consensus in the medical community that only a fraction of these people actually need surgery or will benefit from it.

These are several  types of a surgery commonly performed in treating these conditions:

• Dickectomy removes a ruptured or herniated disk. The success rate is only 40-80 percent and subsequent disk surgeries are significantly less successful.

• Spinal fusions are performed to stabilized the spine or straighten the abnormal curves caused by scoliosis. Vertebrae are “welded” together by bone grafts which will heal as a single piece.

• In a Tarnisectomy, the surgeon cuts through a part of the bony ring  to remove a herniated disk, Tarnisectomy is listed as one of the top  unnecessary operations. In 200,000 such surgeries performed each year in US, experts estimate  up to 40 percent or 80,000 operations are unnecessary and up to 70 percent of patients with a herniated disk will improve without surgery. According to follow-up studies done up to 10 years after the back pain was diagnosed, patients who had surgery fared no better than these treated medically. (To be continued)

Calixto S. Paquiao, A.B; B.S.E;P.E was the national coach of the Philippine weightlifting team from 1977 to 1985, based in Rizal Memorial Stadium and Sports Complex, Metro Manila. He is a Certified Coach of International Coaching and Refereeing Course and a U.S certified Fitness Trainer by Nautilus U.S.A specializing in personal fitness training, sports nutrition and weight management. He was enshrined in the Cebu Sports Hall of Fame in 2002. He was trained and certified by The PUM Netherlands Senior Experts based in Hague on  International Therapeutic Massage and Pain Control.

He specializes in natural therapy: chronic and acute back, shoulder, knee, sciatic nerve pain, sports injuries (no fracture), migraine. He is currentlyfitness director of Coach Pacquiao Fitness and Wellness Center.