Back Pain

Four in five Americans are affected by backache at some point of time in their life. Backache can occur in several forms, including lower back pain, middle or upper back pain, and lower back pain with sciatica.

Back pain that comes on suddenly and lasts no more than six weeks (acute) can be caused by a fall or heavy lifting. Back pain that lasts more than three months (chronic) is less common than acute pain.

Some of the common causes of backache include:

  • Problems of Muscles and Nerves.
  • Arthritis and Degenerative Disc Disease.

Causes:

 

Inter-vertebral disc degeneration

is the most common mechanical cause of backache. This condition means that the discs located between the spinal vertebrae are disintegrating with age. As the cushioning ability of these discs goes down, the back pain grows. Wear and tear of facet joints is another cause of backache. Facet joints are large joints with which the vertebrae are connected. Ruptured discs, muscle tension and spasms are other mechanical causes of  backache.

 

Spinal Injury:

Injuries to the spine such as a sprain or a fracture can cause temporary or chronic pain.

  • sprain occurs when one or more of the ligaments supporting the spine are torn.
  • Osteoporosis can cause fractured vertebrae.
  • Accident and falls are other causes of spinal injuries.

 

Symptoms

Signs and symptoms of back pain can include:

  •  
  • Muscle ache
  • Shooting or stabbing pain
  • Pain that radiates down your leg
  • Pain that worsens with bending, lifting, standing or walking
  • Pain that improves with reclining

Seek immediate care if your back pain:

  • Causes new bowel or bladder problems
  • Is accompanied by fever
  • Follows a fall, blow to your back or other injury

Contact a doctor if your back pain:

  • Is severe and doesn’t improve with rest
  • Spreads down one or both legs, especially if the pain extends below the knee
  • Causes weakness, numbness or tingling in one or both legs
  • Is accompanied by unexplained weight loss
  • I you start having back pain for the first time after age 50
  • If you have a history of cancer, osteoporosis, steroid use, or excessive drug or alcohol use.

Risk factors

Anyone can develop back pain, even children and teens. These factors might put you at greater risk of developing back pain:

  • Age. Back pain is more common as you get older, starting around age 30 or 40.
  • Lack of exercise. Weak, unused muscles in your back and abdomen might lead to back pain.
  • Excess weight. Excess body weight puts extra stress on your back.
  • Diseases. Some types of arthritis and cancer can contribute to back pain.
  • Improper lifting. Using your back instead of your legs can lead to back pain.
  • Psychological conditions. People prone to depression and anxiety appear to have a greater risk of back pain.
  • Smoking. This reduces blood flow to the lower spine, which can keep your body from delivering enough nutrients to the disks in your back. Smoking also slows healing.

Prevention

You might avoid back pain or prevent its recurrence by improving your physical condition and learning and practicing proper body mechanics. To keep your back healthy and strong:

  • Exercise. Regular low-impact aerobic activities — those that don’t strain or jolt your back — can increase strength and endurance in your back and allow your muscles to function better. Walking and swimming are good choices. Talk with your doctor about which activities you might try.
  • Build muscle strength and flexibility. Abdominal and back muscle exercises, which strengthen your core, help condition these muscles so that they work together like a natural corset for your back. Flexibility in your hips and upper legs aligns your pelvic bones to improve how your back feels. Your doctor or physical therapist can tell you which exercises are right for you.
  • Maintain a healthy weight. Being overweight strains back muscles. If you’re overweight, trimming down can prevent back pain.
  • Quit smoking. Talk to your doctor about ways to quit. Avoid movements that twist or strain your back.

 

Diseases or medical conditions:

  • Scoliosis, which causes the spine to curve.
  • Spondylolisthesis
  • Different forms of Arthritis: such as Ankylosing spondylitis, Rheumatoid arthritis, Osteoarthritis
  • Spinal stenosis.
  • Osteoporosis Other causes of backache
  • kidney stones
  • kidney infections
  • Pregnancy
  • Fibromyalgia
  • Endometriosis.

 Use your body properly:

  • Stand smart. Don’t slouch. Maintain a neutral pelvic position. If you must stand for long periods, place one foot on a low footstool to take some of the load off your lower back. Alternate feet. Good posture can reduce the stress on back muscles.
  • it smart. Choose a seat with good lower back support, armrests and a swivel base. Placing a pillow or rolled towel in the small of your back can maintain its normal curve. Keep your knees and hips level. Change your position frequently, at least every half-hour.
  • Lift smart. Avoid heavy lifting, if possible, but if you must lift something heavy, let your legs do the work. Keep your back straight — no twisting — and bend only at the knees. Hold the load close to your body. Find a lifting partner if the object is heavy or awkward.

Diagnosis

Your doctor will ask about your symptoms and your medical history. He or she will examine your back muscles and spine and will move you certain ways to check for pain, muscle tenderness or weakness, stiffness, numbness or abnormal reflexes. For example, if you have a disk problem, you may have pain in your lower back when the doctor raises your straightened leg.

Your symptoms and the physical examination may give your doctor enough information to diagnose the problem. However, with back pain, your doctor may only be able to tell you that the problem is not serious. If your doctor determines that your back pain is caused by muscle strain, obesity, pregnancy or another cause that is not urgent, you may not need any additional tests.

However, if he or she suspects a more serious problem involving your vertebrae or spinal nerves, especially if your back pain has lasted longer than 12 weeks, you may need one or more of the following tests:

  • X-rays of your back
  • Blood test
  • Urine tests
  • Spinal magnetic resonance imaging (MRI)
  • Computed tomography (CT) scan
  • Nerve conduction studies and Electromyography to determine whether nerves, muscles injured.
  • Bone scan, especially if you have a previous history of cancer

Treatment

  • Pain relieving medications can provide relief from backache in many cases.

Most episodes of back pain are not serious and may be treated with:

Some medications are formulated to ease the pain, while some others induce sleep to make the patient comfortable. However, it may not always be a prudent idea to go for over the counter drugs because they are not meant for long term use. If the backache is recurring, it is important to consult a doctor. Over the counter

    • NSAIDs such as aspirin can help reduce pain and swelling temporarily.
    • acetaminophens such as Tylenol may also be used, but not for long term use.
    • pain medications and sleep drugs
    • Muscle relaxants or prescription pain relievers, if necessary, for a short period
  • Physiotherapy, yoga, and other mild exercises may also be used to relieve backache. However, such remedies or physiotherapies must be performed only under professional supervision to ensure that the problem is brought under control safely and does not worsen.
  • Limited bed rest (no more than two days)
  • Hot or cold compresses

People with back pain are encouraged to return to their normal activities gradually, and to temporarily avoid heavy lifting, prolonged sitting, or sudden bending or twisting.

 

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