Low back pain is extremely common. In fact, most adults have experienced low back pain at some point in their lives. It is a common cause of days off from work and can have a severe economic effect on a small island economy likeAnguilla.
What Is Low Back Pain?
The lower back, which starts below the ribcage, is called the lumbar region.
The back is an intricate structure composed of bones, muscles, ligaments, tendons and disks. Disks are the cartilage-like pads that act as cushions between the segments of the spine. Back pain can arise from problems with any of these component parts. In some people, no specific cause for their back pain can be found.Low back pain can vary from one individual to another. It can vary in intensity. In some individuals it can be very intense and is one of the top reasons for of missing work.
What are the symptoms of Low Back Pain?
Symptoms range from a dull ache to a stabbing or shooting sensation. The pain may make it hard to move or stand up straight. Acute back pain comes on suddenly, often after an injury from sports or heavy lifting. Pain that lasts more than three months is considered chronic. If your pain is not better within 72 hours, you should consult a doctor.
When should you see your doctor as soon as possible?
Severe back pain after a fall or injury should be checked out by a health care professional as soon as possible. Other warning signs include a loss of bowel or bladder control, leg weakness, fever, and pain when coughing or urinating. If you have any of these symptoms along with your back pain, contact your doctor.
Low back pain might also be associated with other serious conditions like prostate cancer in men and various gyaecological disorders in women.
Muscle Strain or Sciatica?
The kind of back pain that follows heavy lifting or exercising too hard is often caused by muscle strain, but sometimes back pain can be related to a disc that bulges or ruptures. If a bulging or ruptured disc presses on the sciatic nerve, pain may run from the buttock down one leg. This is called sciatica. This affects some adults here inAnguilla, especially those over the age of 50.
Factors are associated with Low Back Pain
Several factors are associated with low back pain. These include your posture, what you do at work, carrying heavy bags on your shoulder, what exercises you do at the gym, anxiety, depression, sedentary lifestyle and strenuous activities.
Back Pain and Chronic Conditions
Several chronic conditions can lead to low back pain. These include the following:
• Spinal stenosis is a narrowing of the space around the spinal cord, which can put pressure on the spinal nerves.
• Spondylitis refers to chronic back pain and stiffness due to severe inflammation of the spinal joints.
• Fibromyalgia causes widespread muscle aches, including back pain.
Who gets Low Back Pain?
Almost anyone over the age of 20 can develop low back pain. Most individuals will get low back pain by the age of 25 and the frequency increases with age. Low back pain is common in the elderly.
Other factors can increase your chances of getting low back pain. They include:
• Being overweight
• Inactive lifestyle
• Jobs that require heavy lifting
• Smoking
Preventing Low Back Pain
There is no sure way to prevent back pain – as you age – but there are steps you can take to lower your risk:
• Stay at a healthy weight.
• Exercise regularly.
• Lift with your legs, not your back.
• Make sure your work station position is not contributing to your pain.
• Sit smart. Choose a seat with good lower back support, arm rests and a swivel base. Consider placing a pillow or rolled towel in the small of your back to maintain its normal curve. Keep your knees and hips level.
• Stand smart. Maintain a neutral pelvic position. If you must stand for long periods of time, alternate placing your feet on a low footstool to take some of the load off your lower back.
Diagnosis
Making the diagnosis is often based on the medical history and physical examination. Other tests might be needed to determine the cause of low back pain. Your doctor may order X-rays, CT or MRI scans to look for damaged bones or discs, or other injuries to the spine. In the vast majority of cases all of these tests are not required, while in some cases no cause can be found for the back pain!
Treatment
Fortunately, low back pain often gets better on its own. When it does not, there are effective treatments.
Back pain due to muscle strain will usually get better on its own, but you can take steps to make yourself more comfortable. A heating pad or warm baths may provide temporary pain relief.
When your back hurts, you may not feel like getting out of bed. If the pain is due to muscle strain, doctors recommend returning to your normal activities as soon as possible. Studies suggest that any more than a day or two of bed rest can actually make the pain worse and may reduce muscle tone and flexibility.
Medications
Mild back pain often feels better with over-the-counter pain relievers such as acetaminophen, ibuprofen or naproxen. Pain-relieving creams may be helpful for muscle aches. For severe pain, or chronic pain, your doctor may recommend prescription medication.
If simpler therapies and medications are not helping, your doctor may recommend injections to the back. One procedure, called a nerve root block, targets irritated nerves. Injections for back pain usually contain steroid medication.
Physical Therapy
If back pain has left you inactive for a long time, a rehabilitation programme can help you strengthen your muscles and get back to your daily activities. A physical therapist can guide you through stretches, strength exercises and low-impact cardio that will help you be fitter without straining your back.
Surgery
If long-lasting back pain is interfering with your daily life, and other treatments have not provided relief, you may be a candidate for surgery. Depending on the cause of your pain, a surgeon may remove a herniated disc, widen the space around the spinal cord, and/or fuse two spinal vertebrae together. Surgery is rarely needed to treat back pain.
Alternative measures
A number of alternative treatments are available that may help ease symptoms of back pain. Always discuss the benefits and risks with your doctor before starting any new alternative therapy.
Herbal treatments
Some herbal supplements with anti-inflammatory properties may ease back pain. Although more research is needed to reliably determine their safety and efficacy, some studies suggest that the following herbs may be helpful:
• Willow bark (Salix alba), taken orally
• Devil’s claw (Harpagophytum procumbens), taken orally
• Capsicum (Capsicum frutescens), applied as a topical plaster.
Always talk to your doctor prior to using herbal supplements (of any form or type) as some can have severe interactions with other medications. Contrary to what many people believe, not every plant from the earth is safe to use. Natural herbal supplements can also have side effects, especially if taken in wrong or large amounts.
Spinal Manipulation
Chiropractors and some osteopathic doctors use spinal manipulation to treat low back pain by applying pressure with their hands to bones and surrounding tissues. This treatment is not appropriate for everyone.
Acupuncture. Some people with low back pain report that acupuncture helps relieve their symptoms. In acupuncture, the practitioner inserts sterilized stainless steel needles into the skin at specific points on the body. Various studies have produced mixed results on the benefits of acupuncture for low back pain.
Massage. If your back pain is caused by tense or overworked muscles, massage therapy may help loosen knotted muscles and promote relaxation.
Cognitive behavioural therapy. Chronic back pain is commonly associated with emotional stress, and mental health conditions such as depression. In cognitive behavioural therapy, you learn to identify and change negative thought patterns that have a damaging impact on your mental and physical health. Research has found that this type of therapy may significantly relieve chronic low back pain.
Progressive relaxation. This relaxation technique involves systematically tensing and relaxing different muscle groups in your body. Progressive muscle relaxation boosts your ability to recognize and counteract muscle tension as soon as it starts. Evidence suggests this technique helps ease back pain.
Yoga and Low Back Pain
If back pain does not go away in three months, there’s evidence that yoga can help. Make sure your instructor is experienced at teaching people with back pain, and will modify postures for you as needed.
Conclusion
Back pain is one of the most common reasons why people go to the doctor or miss work. There are many factors that contribute to low back pain. The pain can vary in severity and duration but, fortunately, many cases of back pain, require no treatment. When treatment is needed a number of options are available. Talk to your doctor about these treatment options.
Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. Dr Brett Hodge is an Obstetrician/Gynaecologist and Family Doctor who has over twenty eight years in clinical practice. Dr Hodge has a medical practice in theJohnsonBuildingin The Valley.
