Causes
The human back is composed of a complex structure of muscles, ligaments, tendons, disks, and bones, which work together to support the body and enable us to move around.
The segments of the spine are cushioned with cartilage-like pads called disks.
Problems with any of these components can lead to back pain. In some cases of back pain, its cause remains unclear.
Damage can result from strain, medical conditions, and poor posture, among others.
Thanks to a combination of activity, core strengthening exercises, and physical therapy, Hayes says her symptoms have improved dramatically over the last year. Here are 12 ways to help alleviate back pain:
1. Limit Bed Rest
Studies show that people with short-term low-back pain who rest feel more pain and have a harder time with daily tasks than those who stay active.
“Patients should avoid more than three days of bed rest,” says Mike Flippin, MD, an orthopaedic surgeon who specializes in back and spine care at San Diego Medical Center. “I encourage my patients to get moving as quickly as possible.”
2. Keep Exercising
Activity is often the best medicine for back pain. “Simple exercises like walking can be very helpful,” Wilmarth says. “It gets people out of a sitting posture and puts the body in a neutral, upright position.”
But remember to move in moderation, Flippin says. “Stay away from strenuous activities like gardening and avoid whatever motion caused the pain in the first place.”
3. Maintain Good Posture
The pain may have started after a long workout at the gym, but the strain that caused it has probably been building for years. Wilmarth says most people have poor posture when going about their daily activities, putting unnecessary strain on their backs.
“Little things add up,” she says. “You can increase the pressure on your back by 50% simply by leaning over the sink incorrectly to brush your teeth. Keeping the right amount of curvature in the back takes pressure off the nerves and will reduce back pain.”
4. See a Specialist
Developing an individualized exercise plan is essential to managing chronic back pain, says D. Scott Davis, PT, MS, EdD, OCS, an orthopaedic physical therapist and associate professor at West Virginia University.
“There is no magic aspirin that addresses lower back pain in everyone,” Davis says. “Some patients need more core strengthening while others benefit mainly from stretching and improving flexibility. Find a physical therapist, exercise physiologist, or chiropractor who specializes in back care. They will match you with the right exercise plan.”
5. Strengthen Your Core
Most people with chronic back pain would benefit from stronger abdominal muscles.
“The torso is a combination of many muscle groups working together,” Frank B. Wyatt, EdD, professor of exercise physiology at Missouri Western State University, tells WebMD in an email. “If the abdominals are weak, other areas must pick up the slack. When we strengthen the abdominals, it often reduces the strain on the lower back.”
6. Improve Flexibility
Too much tension and tightness can cause back pain. "Our goal in increasing flexibility is to put an equal load throughout the body from the feet all the way up to the head,” Davis says. “One good exercise is to sit on the edge of the bed with one leg extended and the other one on the floor. Give your hamstrings a stretch by leaning forward while keeping your back in a neutral position.”
7. Ditch the Brace
It’s tempting to baby your back muscles, but Davis says braces should be used sparingly. “Braces are helpful for strenuous activities, like heavy lifting, but only keep them on for 15 minutes at a time,” he says. If you wear a brace all day, the muscles — which should be providing stability — weaken and you will have less core strength.
8. Apply Ice and Heat
Heating pads and cold packs can comfort tender trunks. Most doctors recommend using ice for the first 48 hours after an injury -- particularly if there is swelling — and then switching to heat.
But "it is difficult to say if ice or heat is more beneficial,” Flippin says. “I recommend that patients use whichever they find comforting as long as their skin is protected.”
9. Sleep the Right Way
The amount of rest you get is important, and so is the position you get it in. “Sleeping in a bad position or on a mattress without support can cause back pain,” Wilmarth says.
Some pointers:
- Back sleepers should put pillows under their knees.
- Side sleepers should place pillows between their knees to keep their spine in a neutral position.
- Stomach sleeping causes the neck and head to twist and can put undue stress on the back.
10. Quit Smoking
Lighting up doesn’t just damage your lungs; it can also hurt your back.
A study recently published in the American Journal of Medicine found that current and former smokers are more likely to have back pain when compared with people who have never smoked.
“Nicotine causes the small blood vessels to constrict and decreases the delivery of blood to the soft tissue,” Flippin says. “I tell all my patients that quitting smoking could help alleviate their back pain.”
11. Try Talk Therapy
Back pain is often seen with issues such as depression and anxiety, says Alex Moroz, MD, associate professor of rehabilitation medicine at NYU Langone Medical Center.
“Your emotional state colors the perception of pain,” Moroz says. “Therapy can be a helpful part of rehabilitation.”
12. Use Relaxation Techniques
Research shows that practices such as meditation, deep breathing, tai chi, and yoga, which help put the mind at rest, can do wonders for the back.
“If you can induce a relaxation response, it will help reduce the perceived pain level," Moroz says.
Strain
Back pain commonly stems from strain, tension, or injury. Frequent causes of back pain are:
- strained muscles or ligaments
- a muscle spasm
- muscle tension
- damaged disks
- injuries, fractures, or falls
Activities that can lead to strains or spasms include:
- lifting something improperly
- lifting something that is too heavy
- making an abrupt and awkward movement
Structural problems
A number of structural problems may also result in back pain.
- Ruptured disks: Each vertebra in the spine is cushioned by disks. If the disk ruptures there will be more pressure on a nerve, resulting in back pain.
- Bulging disks: In much the same way as ruptured disks, a bulging disk can result in more pressure on a nerve.
- Sciatica: A sharp and shooting pain travels through the buttock and down the back of the leg, caused by a bulging or herniated disk pressing on a nerve.
- Arthritis: Osteoarthritis can cause problems with the joints in the hips, lower back, and other places. In some cases, the space around the spinal cord narrows. This is known as spinal stenosis.
- Abnormal curvature of the spine: If the spine curves in an unusual way, back pain can result. An example is scoliosis, in which the spine curves to the side.
- Osteoporosis: Bones, including the vertebrae of the spine, become brittle and porous, making compression fractures more likely.
- Kidney problems: Kidney stones or kidney infection can cause back pain.
Movement and posture
Back pain can also result from some everyday activities or poor posture.
Examples include:
- twisting
- coughing or sneezing
- muscle tension
- over-stretching
- bending awkwardly or for long periods
- pushing, pulling, lifting, or carrying something
- standing or sitting for long periods
- straining the neck forward, such as when driving or using a computer
- long driving sessions without a break, even when not hunched
- sleeping on a mattress that does not support the body and keep the spine straight
Other causes
Some medical conditions can lead to back pain.
- Cauda equina syndrome: The cauda equine is a bundle of spinal nerve roots that arise from the lower end of the spinal cord. Symptoms include a dull pain in the lower back and upper buttocks, as well as numbness in the buttocks, genitalia, and thighs. There are sometimes bowel and bladder function disturbances.
- Cancer of the spine: A tumor on the spine may press against a nerve, resulting in back pain.
- Infection of the spine: A fever and a tender, warm area on the back could be due to an infection of the spine.
- Other infections: Pelvic inflammatory disease, bladder, or kidney infections may also lead to back pain.
- Sleep disorders: Individuals with sleep disorders are more likely to experience back pain, compared with others.
- Shingles: An infection that can affect the nerves may lead to back pain. This depends on which nerves are affected.
Risk factors
The following factors are linked to a higher risk of developing low back pain:
- occupational activities
- pregnancy
- a sedentary lifestyle
- poor physical fitness
- older age
- obesity and excess weight
- smoking
- strenuous physical exercise or work, especially if done incorrectly
- genetic factors
- medical conditions, such as arthritis and cancer
Lower back pain also tends to be more common in women than in men, possibly due to hormonal factors. Stress, anxiety, and mood disorders have also been linked to back pain.
Symptoms
The main symptom of back pain is an ache or pain anywhere in the back, and sometimes all the way down to the buttocks and legs.
Some back issues can cause pain in other parts of the body, depending on the nerves affected.
The pain often goes away without treatment, but if it occurs with any of the following people should see their doctor:
- weight loss
- fever
- inflammation or swelling on the back
- persistent back pain, where lying down or resting does not help
- pain down the legs
- pain that reaches below the knees
- a recent injury, blow or trauma to the back
- urinary incontinence
- difficulty urinating
- fecal incontinence, or loss of control over bowel movements
- numbness around the genitals
- numbness around the anus
- numbness around the buttocks
When to see a doctor
You should seek medical help if you experience any numbness or tingling, or if you have back pain:
- that does not improve with rest
- after an injury or fall
- with numbness in the legs
- with weakness
- with fever
- with unexplained weight loss
Diagnosis
A doctor will usually be able to diagnose back pain after asking about symptoms and carrying out a physical examination.
An imaging scan and other tests may be required if:
- back pain appears to result from an injury
- there may be underlying cause that needs treatment
- the pain persists over a long period
An X-ray, MRI, or CT scan can give information about the state of the soft tissues in the back.
- X-rays can show the alignment of the bones and detect signs of arthritis or broken bones, but they may not reveal damage in the muscles, spinal cord, nerves, or disks.
- MRI or CT scans can reveal herniated disks or problems with tissue, tendons, nerves, ligaments, blood vessels, muscles, and bones.
- Bone scans can detect bone tumors or compression fractures caused by osteoporosis. A radioactive substance or tracer is injected into a vein. The tracer collects in the bones and helps the doctor detect bone problems with the aid of a special camera.
- Electromyography or EMG measures the electrical impulses produced by nerves in response to muscles. This can confirm nerve compression, which may occur with a herniated disk or spinal stenosis.
The doctor may also order a blood test if infection is suspected.
Other types of diagnosis
- A chiropractor will diagnose through touch, or palpation, and a visual examination. Chiropractic is known as a direct approach, with a strong focus on adjusting the spinal joints. A chiropractor may also want to see the results of imaging scans and any blood and urine tests.
- An osteopath also diagnoses through palpation and visual inspection. Osteopathy involves slow and rhythmic stretching, known as mobilization, pressure or indirect techniques, and manipulation of joints and muscles.
- A physical therapist focuses on diagnosing problems in the joints and soft tissues of the body.
Chronic or acute pain?
Back pain is categorized into two types:
- Acute pain starts suddenly and lasts for up to 6 weeks.
- Chronic or long-term pain develops over a longer period, lasts for over 3 months, and causes ongoing problems.
If a person has both occasional bouts of more intense pain and fairly continuous mild back pain, it can be hard for a doctor to determine whether they have acute or chronic back pain.
There are three broad groups of health providers who treat back pain:
- Primary care providers are often the first port of call for patients when back pain strikes, and generally include:
- Primary care physicians (Family practice doctors, Internists, Obstetricians, Gynecologists, Pediatricians)
- Chiropractors
- Doctors of Osteopathic Medicine
- Spine specialists have a more specific area of expertise in certain diagnoses and/or treatments for back pain and spinal conditions, and generally include:
- Surgeons
- Physiatrists
- Anesthesiologists
- Neurologists
- Rheumatologists
- Therapists have expertise in either physical or occupational rehabilitation for back pain or psychological help for chronic pain, and generally include:
- Physical therapists
- Occupational therapists
- Clinical psychologists
No comments:
Post a Comment