Back pain affects nearly 80 percent of Americans, and the most common form is low back pain. Because it involved your back in almost every movement, it is vulnerable to injury. Back pain can even be disabling. It is one of the most common problems that leads to a visit to the doctor and time off work. In fact, it is the second leading cause of disability for people under 45.
Although people complain of back pain, it is not a diagnosis but a symptom of an underlying condition. There are two types of back pain, acute and chronic. Acute back pain is pain of recent onset.
It occurs suddenly, usually following an injury.
It is the most common type of back pain.
It usually resolves in less than a month, but does not last longer than six weeks.
Chronic pain is pain that may have a quick or slow onset, but persists for long periods of time. Although it may last three months or more, some people suffer from chronic back pain for their entire lives. Chronic pain is the least common type of pain.
What causes back pain?
To understand the causes of back pain, we need to understand the spine. The back comprises 33 vertebrae or bones. We divide it into 5 groups: cervical, thoracic, lumbar, sacrum, and coccyx.
The cervical spine (upper back or neck) comprises 7 vertebrae.
The thoracic spine (middle back) has 12 vertebrae, and the lumbar spine (lower back) has 5 vertebrae.
The sacrum comprises 5 fused vertebrae, and the coccyx (tail bone) of 4 fused vertebrae.
Ligaments and muscles hold together the vertebrae, with discs between the vertebrae. We filled the discs with a gelatinous center, which allows them to act as a shock absorber. We connect the vertebrae to each other for stability and support. They protect the spinal cord and the spinal nerves that pass through the spinal canal.
Because the neurological system is complex, it is difficult to determine the exact cause of back pain. We divided the causes of back pain into the following categories: Mechanical, Injury, Acquired Disorders or Diseases, Infections or Tumors.
Mechanical causes: These are problems related to the functioning of the spine. For example, spondylolisthesis (deterioration of the disc: one vertebra slides forward over another, causing the vertebrae to rub against each other and therefore causing pain). Other mechanical problems include fractures, herniated discs, spinal stenosis, spinal degeneration and sciatica.
Injuries - This category includes common forms of back pain because of injury to the spine or the ligaments and muscles involved in the spine. Sprains, for example, result from pulling or tearing a ligament that supports the spine because of improper lifting or body mechanics or even twisting. Severe injuries can result from an accident or a fall.
Gained disorders - These are medical problems you may have been born with, such as scoliosis (abnormal curvature of the spine), or other problems you have gained, such as arthritis (osteoarthritis and rheumatoid arthritis) that can lead to fractures, musculoskeletal pain syndromes such as fibromyalgia, spinal stenosis (narrowing of the spinal canal putting pressure on the spine or nerves), and even pregnancy.
Infection/Tumor - An infection, although uncommon, can cause pain if it affects the vertebrae. Osteomyelitis (infection and inflammation of the vertebrae) and discitis (infection of the discs) are two examples. They can be benign or cancerous, but usually result from a tumor that has spread from another area of the body.
How is back pain diagnosed?
In order for your doctor to discuss the treatment for your back pain, he or she will need to take a thorough history and physical examination. You will need to give a clear and concise description of your pain. Your doctor will need to know how the pain started, what you were doing when it started, how severe it is, whether it comes and goes or is constant, and what makes the pain better or worse. You will need to have diagnostic tests. The most common tests to diagnose back pain are X-rays, bone scans and MRIs. These can diagnose problems due to bone or soft tissue injuries. Your doctor may order blood and urine tests to look for infection. If your doctor thinks a nerve problem may cause the pain, he or she will give you an EMG (electromyography) or nerve study. An EMG is an evaluation of the electrical impulses of the nerves and the response of the muscles.
How is back pain treated?
The common goals of treatment are to relieve back pain and restore mobility. Treatment varies depending on the severity and type of injury. The most common and basic treatment used for strains or minor injuries is rest. Heat can promote circulation in the area and relieve spasm. Cold compresses can reduce swelling in the affected back area. Over-the-counter medications such as aspirin, Motrin, Tylenol and Aleve are prescribed to relieve pain and inflammation.
Long-term bed rest is not recommended, as it can slow healing and lead to other problems. The doctor will ask you to gradually return to your normal activities after 24 to 72 hours of rest. He or she may put you on a physical therapy program that includes heat, massage, ultrasound, and a personalized exercise program. If the pain does not subside and interferes with your normal daily activities, your doctor may prescribe painkillers such as Darvocet, Vicodin or Percocet, as well as anti-inflammatory drugs to relieve muscle spasms.
If your pain becomes chronic and all other treatments have failed, your doctor may refer you to a back or pain specialist. Because the back is a complex entity, specialists are more familiar with new advances in the treatment of back pain. Treatment options include epidural nerve blocks (injection of an anesthetic, anti-inflammatory or steroid into the epidural space of the back for long-term pain relief) and trigger point injections (injection of steroids and an anesthetic into the muscle that triggers the pain). Other medications, such as antidepressants and anticonvulsants, have been effective in relieving the pain caused by nerve damage.
Other types of treatment include:
Using a TENS (transcutaneous electrical nerve stimulation) unit. Electrodes are placed on two or three painful areas of the back and connected to a unit that provides a mild electrical stimulus to the area to relieve pain.
Chiropractic back adjustments.
Acupressure or acupuncture treatments.
Relaxation and breathing techniques and stress management instruction.
Massage and basic stretching exercises to promote mobility and relieve spasms.
Yoga and Pilates - These can help relieve pain and stress. Certain yoga postures can help relieve low back pain and improve strength, flexibility and balance. Yoga is good for reducing stress and can help manage the psychological aspects of pain.
Aquatic or water therapy - This can be very beneficial in relieving pain and improving mobility for people with chronic low back pain. There is no resistance to movement in the water, and the water is soothing, comforting, and relaxing to the body.
How can I prevent back pain?
While some people say it’s impossible to avoid back injuries, most doctors agree that we can prevent the common causes of back pain by following a few lifestyle changes:
Exercise: You’ll need to consult your doctor before starting an exercise program, as some exercises, such as high-affected aerobics and weight lifting, can make back pain worse. Other exercises, such as swimming, walking and cycling, can improve overall health and strengthen the back. We should not avoid exercise as it helps to improve overall health.
Lumbar support belts: it required Some people whose jobs involve heavy lifting daily to wear lumbar support belts and attend back training at work to learn how to prevent lifting injuries.
Do not wear high heels.
Keep your head up and your stomach in when you stand. If you stand for long periods, place one foot on a stool and alternate your weight frequently.
Sit in a chair with good lumbar support. Maintain good posture, sit up straight, and keep both feet flat on the floor. Make a lumbar roll with a rolled towel and place it behind your lower back when driving or sitting for long periods of time.
Use good posture when lifting. Keep objects close to your body. Keep your back straight, your head up and your stomach in. Do not lift objects that are too heavy. Ask for help when lifting bulky objects. Do not bend forward to pick up an object, but bend your knees and lift directly from your knees.
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In conclusion, back pain can be difficult to treat, but there are many options for you. Experts are discovering new research every day. You can take care of your back by changing your lifestyle and eliminating or reducing the amount of stress in your life. By maintaining good posture, using proper lifting techniques and educating yourself on how to avoid back pain, you can prevent further back injuries.
