Check-up : Treating back pains
Gillian, 54, works from her home in Kingston and spends a lot of time seated around a computer. Her problem is 'back pain'.
She says that after a couple hours sitting in front of the computer, she begins to feel pain in her waist. Her back gets sore and she is stiff when she tries to get up, and finds that she moves slowly for a while.
Sometimes when she fixes a meal in her kitchen, she also finds that her back pains her and her right leg can feel "tingly and even numb".
Her doctor tells her she has back muscle spasm at times and perhaps even a pinched nerve. He prescribed some Voltaren which helps sometimes, but not always.
Gillian asks about the possible causes of her back pain and what treatment is available short of surgery!
Low back pain has a multiplicity of causes, including irritation or injury to any part of the spinal muscles, bones, nerves, discs or tendons which make up the lower back area. Low back pain is a common disorder which, however, can vary a lot in the intensity of pain being experienced.
Most low back pain does not require urgent attention, but if it is the result of trauma or a motor vehicle accident, then a doctor needs to be seen immediately if there is accompanying leg weakness, or bowel or bladder incontinence.
Lower back strain or a degenerating vertebral disc can both result in mild or severe back pain. In many cases, mild to moderate low back pain can resolve eventually even without treatment.
Symptoms of low back pain can differ significantly. Back pain can be a dull aching sensation or severe shooting pain. If back pain does not resolve within three days, a doctor should be visited.
Back pain that occurs after working out with weights or lifting heavy furniture is usually caused by a muscle strain.
When injury occurs to the spinal vertebral bones with intervertebral disc injury, the bulging disc can compress a nerve root which runs from the buttock down the leg. This is called sciatica (sciatic nerve pain).
Several common causes of back pain include:
• A job which requires a lot of physical lifting or twisting of the spine.
• Sitting for long periods of time at a desk, especially if the chair is not comfortable.
• Wearing a heavy handbag over one shoulder. Even when worn correctly - across both shoulders to equalise the weight being carried - the weight bearing itself can be a problem as heavy additional weight can strain the lower back, especially in students who carry this extra weight daily to school or college. It is better to wheel the weight around than to carry it on your back!
• Excessive gym workout. Overdoing the training programme at the gym is a very common cause of back pain and even back injury.
• Poor posture can cause back pain. Slumping in the chair, slouching the shoulders and not sitting up properly is another common cause of back pain. Sit with shoulders back and feet even on a low stool.
• Spinal stenosis, spondylitis, fibromyalgia are all causes of chronic back pain.
• Inactive lifestyle.
Most people first complain of an episode of back pain by their late 20s to early 30s and the incidence only increases after this.
Mostly we rest when we feel back pain, but with muscle strain inactivity may not help resolve the condition. There is a need to avoid the causative action, such as stop carrying a heavy school bag every day. Studies show that more than a few days of rest can reduce muscle tone and actually lead to worsening of back pain.
As a 'home' relief, yoga and a back massage can help relieve chronic back pain (pain present for more than three months). Back-strengthening exercises also help to lessen back pain. These are back flexion and extension exercises. Take over-the-counter paracetamol or ibuprofen. Alternately, apply hot and cold packs to lessen pain and relax muscles.
Acupuncture, medications, local steroidal injections, physical therapy and surgery are the range of treatment available from the medical team which works on back pain. Sometimes it even becomes necessary to visit a pain clinic.
To prevent back pain:
• Control your weight.
• Exercise regularly.
• Lift with your legs and not your back.
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