Back Pain Ques & Ans
Back pain is very common, with most people experiencing at least one episode during their lifetime. Your back is a complex structure composed of bones, muscles, nerves and joints.
Back pain is caused by a problem of one of these elements. It’s a musculoskeletal disorder that can range from a slight spasm to severe pain or being immobile.
Back pain is most common in the lumbar (lower back) region, although it can be felt anywhere along your spine, from your neck down to your hips. Back pain symptoms include:
- muscle ache and spasms
- tension, soreness and stiffness
- pain that runs down your legs
- limited flexibility or range of motion of your back.
There are some risk factors that can increase your chances of developing back pain. These include:
wear and tear or degenerative disease can lead to a reduction in bone strength, a decrease in muscle elasticity and tone and, a loss of fluid and flexibility of your intervertebral discs.
carrying extra weight puts pressure on your spine.
back pain is less common in people who are physically fit. Fitness helps maintain back and abdomen muscle strength and the integrity of intervertebral discs.
the extra weight you carry when you’re expecting a baby can put strain on your back.
a job that involves heavy lifting can lead to back pain as well as an inactive job where you sit all day with inadequate back support or poor posture.
such as anxiety, stress or depression.
can cause tissue damage in your back. Also, often smokers have an unhealthier lifestyle than non-smokers.
Most often back pain develops for no apparent reason and is known as non-specific back pain. Sometimes it’s due to a disruption to the normal functioning of muscles, ligaments, cartilage or an irritated or pinched nerve.
This can be caused by minor strains and sprains, injuries or muscle overuse. In a few cases, back pain is caused by more serious damage or disease to your spine.
Medical conditions that are often linked to back pain include:
the soft material inside an intervertebral disc can bulge or rupture and press on a nerve when compressed. This is known as sciatica if the sciatic nerve is compressed.
Degenerative disc disease
cageing can cause the intervertebral discs to lose integrity and their cushioning ability.
when a vertebra slips out of place and pinches a nerve.
narrowing of the spinal column that puts pressure on the spinal cord and nerves.
Back pain most often gets better on its own without seeing a doctor. There are some self-help remedies you can try to relieve a back that hurts and speed up your recovery. As a part of first aid for your back, start with applying an ice pack for the first 24 hours. These include:
Relax and remain optimistic
to relieve muscle tension and recover faster.
try to carry on with your daily activities. Exercise strengthens and increases flexibility of your back as well as releasing natural painkillers, called endorphins.
Heat or ice
may loosen tight muscles and lessen pain.
such as paracetamol or ibuprofen if back pain is unbearable. But remember not to take medicines for more than a couple of days. Then be sure to see a medical practitioner.
Most cases of back pain don’t require urgent care, but you should see a doctor immediately if your pain is the result of trauma, or if your pain is accompanied by any of the following symptoms:
- Unexplained recent weight loss
- Pain in your chest
- Swelling or a deformity in your back
- Loss of bladder or bowel control
- Inability to pass urine
- Constant pain that won’t ease
- Worse pain at night
- Numbness around your genitals, buttocks or back passage
- Tingling or numbness in your legs or arms
It’s advisable to make an appointment with your doctor for an evaluation if your back pain has lasted for more than six weeks and it isn’t getting any better with self-help measures or, if it’s actually getting worse.
You should also see your doctor of this is the first time you’ve had backache after reaching 50 years of age, or if you’ve a history of cancer or osteoporosis.
The future for most people with back pain is good and they will recover within a few weeks. However, it depends on the cause of the back pain and how it’s managed.
An acute strain injury will normally heal with minimal treatment but a slipped disc that’s irritating the sciatic nerve may be best treated by surgery.
It’s better to seek treatment early for back pain to allow you to manage it properly, as symptoms of long term back problems are more likely to persist. For example, if you see a physiotherapist quickly, this can speed up your recovery and also prevent the problem happening again.
Your future is also improved by a positive attitude.
Your back has many connected parts including: vertebrae (bones), joints, flexible ligaments and tendons, large muscles and highly sensitive nerves.
Your spine is a flexible column that supports your back. It’s composed of 24 vertebrae with discs between each that act as shock absorbers. On either side of your spine, running from top to bottom, are facet joints that link the vertebrae together and allow flexibility. Muscles, tendons and ligaments offer support and mobility.
Your spinal cord passes through the protective spinal column. It carries nerves from your brain to the rest of your body and these pass between the discs, muscles and ligaments.
Your doctor may request investigative tests to help determine the cause of your back pain. The most common diagnostic tests include:
provides images that show the alignment of your bones and whether you have arthritis, broken or displaced bones or a tumour.
generates detailed and cross section images of the bones in your spine and can reveal herniated discs or problems with bones, muscles, tissue, tendons, nerves, ligaments and blood vessels.
provides detailed images of your vertebrae, intervertebral discs and nerve roots. MRIs are often used to accurately diagnose spinal disorders and to rule out spinal infections or tumours.
Back pain is commonly diagnosed as due to:
Spinal muscle or ligament strain
often caused by repeated heavy lifting or sudden awkward movements.
the inner core of the disc may leak out and irritate a nearby nerve root, known as sciatica if the sciatic nerve is aggravated.
causes nerve compressions and is known as spondylolisthesis.
degeneration such as osteoarthritis can lead to a narrowing of the space around the spinal cord, known as spinal stenosis.
Abnormal spine curves
such as scoliosis where your spine curves to the side.
your vertebrae become porous and brittle and can more easily develop compression fractures.
lower back pain.
also known as a prolapsed or herniated disc. It’s when an intervertebral disc in your spine is bulging or damaged and presses on a nerve.
an irritation or compression of a nerve in your spine that’s often due to: a slipped disc, slippage of a vertebrae where the nerve exits the spine or an overgrowth of the facet joint.
irritation of your sciatic nerve that runs from the back of your pelvis, through your buttocks, and down both legs to your feet.
narrowing of your spinal column that puts pressure on your spinal cord and nerves.
an abnormal twisting and curvature of your spine.
a vertebra slips out of position and presses on a nerve.
a weakening of your bones that makes them fragile and more likely to break.
breaking down of the protective cartilage on the ends of your bones that causing pain, swelling and problems moving the joint. Bony growths can also develop.
Acute pain is an unpleasant sensation triggered in the nervous system to alert you that something’s wrong with your body, and that you need take care of yourself. Sometimes, acute pain becomes chronic and persists for months or even years.
In many instances, this happens because your physiological condition is ongoing and unresolved, for example if you have arthritis. However, often the pain doesn’t appear to be caused by any disease, injury or detectable damage to the nervous system.
There are a number of back surgeries available to treat back pain. Sometimes they are used in combination to have the best outcome for you. Back surgery is performed to relieve pressure on a compressed nerve, to stabilise adjacent vertebrae or to improve a deformity such as scoliosis.
joining of two or more vertebrae using a section of bone to stabilise and strengthen your spine.
removal of herniated/prolapsed disc material that is pressing on your nerve in the spine. Traditionally performed by open surgery but these day a minimally invasive technique called micro-discectomy is commonly used.
removal of a section of bone from one of your vertebrae that’s compressing a nerve in your spine.
Lumbar spinal decompression
surgery to give the nerve root more space. It can be performed by at least one of these procedures: spinal fusion, discectomy and laminectomy.
an alternative to spinal fusion for painful movement between two vertebrae.
Non-surgical treatments for chronic back pain include:
provided by a physiotherapist/another doctor with specialist training and comprises.
to strengthen your muscles and improve your posture, as well as physical activity and stretching exercises.
fine needles are inserted at different points in your body to help reduce lower back pain.
massage or spine mobilisation and manipulation
Pain relieving injections
delivery of steroids and anaesthetic into your joints, ligaments, muscles or around your nerves.
Facet joint injections
local anaesthetic and steroid medication is injected in to your facet joint to relieve the pain and inflammation.
Nerve root blocks
injecting local anaesthetic and an anti-inflammatory steroid medicine into the area around your nerve root to reduce pain of a trapped or inflamed nerve and reduce inflammation.
There are many treatments available for back pain. Your best treatment option will depend on how long you’ve had the pain, it’s cause if it can be diagnosed, how severe it is and, your individual needs and preferences.
- Magnet Therapy (one of the most effective for pains)
- Myofascial release
- Energy Healing
- Reiki/Pranic Healing
- Trigger Point Therapy
- Relaxation Techniques