Back pain is one of the most common problems affecting a lot of people during their lifetimes and the causes may be different each time, like a simple strain to a muscle or ligament or a more serious fall or injury.
• Poor posture.
• Lack of exercise resulting in stiffening of the spine and weak muscles.
• Muscle strains or sprains.
• Sudden jerky movements or lifting of heavy load.
• Sciatica, a condition where there may be numbness or a tingling feeling in the legs due to a nerve in the spine being pressed on or squeezed.
• Spinal stenosis, which is pain in the legs which starts after you start walking for a few minutes, and then tends to get better very quickly when you sit down.
• Bone problems such as a fracture – often linked to thinning of the bones, which is known as osteoporosis.
• An infection.
• A tumour.
• Inflammation, for example in the condition ankylosing spondylitis.
How to prevent Back pain :
Staying active is very important. Keeping the muscles around the spine strong, will provide more support to the bones and joints and take pressure off them. The more you move, the more your back will keep its natural range of movement. Not moving can make your back more stiff and painful.
Try to maintain good posture when sitting at home, at work or in the car and try to shift positions from periodically. Staying in awkward positions while working, relaxing or driving for a long time, will affect the soft tissues in your back that support your spine, and will cause back pain.
Learning to lift correctly may help to prevent further episodes of back pain. Bend your knees when lifting and allow your spine to move as necessary, without twisting it. When doing tasks like carrying shopping, try and split the load between both hands. Keeping the weight close to your body also helps.
Initially, resting your back, taking over-the-counter pain killers and muscle relaxants and using heat pads/ice packs in the affected area should provide relief from your back pain. Getting a gentle massage also helps relieve back pain. Massage is a manual technique which uses rhythmic strokes, kneading or tapping actions to move the muscles and soft tissue of the body. Massage can reduce anxiety and stress levels, ease muscular tension and fatigue, and improve circulation, which all work to reduce pain levels.
However, too much rest can make back pain worse. Being active and continuing with your everyday activities as soon as possible, and as much as possible, will speed up your recovery.
In most cases your back pain tends to clear up without the need to see a doctor. But if your pain is really bad, lasts for a long time, stops you from working or doing the things you enjoy affects your everyday activities and gets worse, if you have any of the following symptoms:
• Difficulty controlling or passing urine.
• Loss of control of your bowels.
• Numbness around your back passage or your genitals.
• Serious weakness in your legs so you find standing really difficult.
• Severe and ongoing back pain that gets worse over several weeks.
Then you should urgently consult an orthopaedics expert like Dr Arunava Lala for immediate treatment and relief.
Your orthopaedic, after a physical examination and listening to your problems, may suggest
a magnetic resonance imaging (MRI) scan or computerised tomography (CT) scan or an X-ray, though X-rays s are much less commonly used because back pain is often caused by problems with soft tissues, such as ligaments and muscles, which can’t be seen on x-rays. However,
Changes to the spine as a result of spondylosis can show up on x-rays.
Your orthopaedic doctor may suggest physiotherapy for pain relief. Physiotherapy is one of the most effective treatments for back pain. A physiotherapist can help oversee your exercise programme and recommend specific exercises to help.
Manual therapies, which are sometimes called ‘hands-on’ treatments, such as manipulation and mobilisation of the spinal joints, can help to clear up a back pain along with exercises. These manual therapy techniques are usually carried out by osteopaths, chiropractors and physiotherapists and depend on your particular condition. Your orthopaedist will suggest the exact therapy required by you.
If your back pain is causing problems with daily activities such as dressing, washing and driving, you may find it useful to see an occupational therapist. They may suggest different ways of doing things to reduce the strain or recommend aids or gadgets that will help you. However, it’s important that you don’t come to rely on aids or gadgets instead of trying to get back to your daily activities.
Back pain, especially if it lasts for a long time, can affect people’s mood. If you are feeling really low or anxious, it’s important to talk to someone such as a partner, relative, friend or a doctor. ‘Talking therapies’ can be useful.
For example, cognitive behaviour therapy (CBT) can help people with back pain. The aim is to help people to deal with problems in a more positive way, by breaking them down into smaller parts.
Keeping socially and physically active is an important part of helping with low mood and anxiety, and it also helps with pain. Simple things, such as joining a local leisure centre, sports club, walking group, gardening group, or socialising on a regular basis might really help you.
Sometimes your orthopaedist may suggest injections that are useful for back pain or sciatica which is more severe or if the usual treatments like physiotherapy and painkillers aren’t working well enough. For sciatica, these injections are called epidurals, and involve an injection of a steroid, which is a strong anti-inflammatory medicine, and anaesthetic, near the spine or through the tailbone, to try and help with pain from a ‘trapped’ nerve root.
Another type of injection, called radiofrequency denervation, might be used if it is thought that the back pain comes from natural changes that happen over time to the small joints in the spine called facet joints.
Urgent surgery may be needed if you lose bladder or bowel control or the use of your legs, but this is extremely rare.
Very few people with back pain need an operation. Sometimes an operation is needed for spinal stenosis or for severe sciatica to free the nerve, although most doctors would recommend trying other measures first, including medication, physiotherapy or injections.