back pains

8/12/2019 Back Pains

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Back Pain

Back pain is ranked second to headaches as the most frequent location of pain. Fourout of five adults will experience at least one bout of back pain at some timein their lives. It is almost next to common colds in the list of common diseases.

The most common site for pain is the lower back because it bears the brunt of ourweight and hence is more prone to get affected.

Structurally backache is a condition that usually is caused when one or more structuresof the back gets affected and these includes muscles, cartilage, bones or spinalcord.

Anatomy of our Back - The back region of our body is made of interconnectingstructures like bones, joints, muscles, ligaments and tendons. The spine of the backitself is made up of 24 small bones (seven cervical, twelve thoracic and five lumbar) andis the major support structure of back. These small bones are called vertebrae and theyare further attached to sacrum and coccyx as we go from top to down. The sacrumattaches itself in front to the bones of the pelvis.


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Our Erect Posture and flexibility of our body-The erect human posture has madeour back adapt to withstand the forces of gravity over our lifetime. It also has made thisregion more easily vulnerable to wear and tear, strains and fractures. To keep usmobile, the flexibility of our back is important. This is determined by various factors suchas joint structure, muscle elasticity and connective tissue fiber material made up ofcollagen, elastin and titin. Disc that are interposed between the vertebra, acts as ashock absorber and gives joints their strength, stability and flexibility but limitsmovement. Vertebrae and discs provide a protective tunnel that allows the spinal cordand its spinal nerves to pass through. These nerves running down the center of thevertebrae, branch off to various parts of the body. The collagen fibers help the discwithstand the tension of the erect posture and our weight. Disc protects the spine andkeeps it stable during strenuous activities that put strong force on the spine, such as

jumping, running, and lifting.

Back ache is more prevalent between the age of 35 and 55. The most frequently cause

of our back pain are:

Heavy physical work,Frequent bending, twisting, lifting,pulling and pushing,Repetitive work,Static postures,

Vibrations.


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Psychosocial risk factors for backache include stress, distress, anxiety, depression,cognitive dysfunction, pain threshold, job dissatisfaction, and mental stress at work.

Back pain may be sudden and sharp or it may be dull and if persistent for more than aweek it might result in tension, soreness or stiffness of back muscles. Pain mayaggravate with slightest of movement or even with coughing and sneezing. It may alsobe accompanied with numbness and tingling in the arms or legs.

The pain if limited to the back can be treated by simple remedies at home but ifradiating to the lower abdomen, groin, leg or foot, needs medical attention.

Back pain is a common reason for seeking disability benefit from governments andinsurance companies. However as pain is subjective and difficult to quantify, the process

for such claims is tedious and not everyone who makes a claim gets the necessarybenefit.

What is the reason for Back Pain?

Posture -Back pain most commonly results from poor posture. Sometimes it is due to

poor body mechanics like standing for extended periods of time or sitting in an incorrect

posture. Back injury, heavy physical work, lifting, bending, twisting, or awkward

positions might act a precursor to triggering back pain.

Injury -A sudden fall, car crash, or sports injury can cause a sprain or strain. When aback injury occurs, muscles, ligaments, and tendons become over-stretched and swollenup, causing pain, tenderness, and stiffness.

The three common causes of back pain include:

Muscle strains:Strained muscles, tendons or ligaments or inflamed joints may causepain along your spine.


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Osteoarthritis:This degenerative joint condition affects nearly everyone past the ageof 60, Old age and injury can slowly lead to deterioation of the cartilage. Cartilage is theprotective tissue that covers the surface of the joints of the vertebrae.

Osteoporosis: One in three women who are older than 50 can be affected byosteoporosis and this can lead to painful vertebral compression fractures.

What are the Triggering factors for Back Pain?

Triggering Factors -The episode of back ache might result either from a strenuousevent or previous history. Even psycho-social risk factors like stress, distress, anxiety,depression, cognitive functioning, job dissatisfaction and mental stress can play a role intriggering back ache. There may be some deep underlying causes of low back pain, fewof which include:

Fracture of vertebral bonesSlipped disc; disc bulges out of vertebral joint and puts pressure on spinal nervesSpinal stenosis; owing to narrowing of spinal space,pressure is induced upon the spinal

nervesSpondylolithesis; when one of the back bones slips forward and out of positionDegenerative disc disease; when the discs in spinal cord gradually gets worn outOsteoarthritis; a wear-and-tear disease of bonesRheumatoid arthritis; an inflammatory condition of jointsCarcinoma or benign tumorsKidney stones

EndometriosisPelvic inflammatory disease in females


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Sometimes a routine activities such as gardening, picking up a child, reaching for anobject or even coughing, can trigger back ache.

Treatment Methods Non-operative for Back Pain

If the back pain is localized to an area, one needs to follow a rigid exercise regimen andwith some precautions. But if the pain is radiating there is a need to visit a physicaltherapist. If, pain still doesnt subside down, there might be some specific underlyingcause which requires immediate medical attention.

Self-help

Stay active and perform all the daily activities normally

Avoid bed rest for extended periods as it might make low back pain worse

Apply hot pack to the affected area if pain is chronic or cold packs if pain is acute.Traction for Back Pain This has been the mainstay of treatment for back pain in thepast. However the current thoughts have been this treatment method outdated. Itsprinciple is that it traction stretches tight spinal muscles that are in spasm and it widensthe inter-vertebral foramen to relieve nerve root compression.

Traction is generally applied to the cervical (neck) region or to the lumbar region. Sometimes a mechanical weight is used that hangs by the pulley which is attached byropes to a harness, with the patient being confined to the bed.

Traction has been condemned by many therapist who believe it causes more harm then


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good.

In a review of 25 randomized clinical trial (2206 patients; 1045 receiving traction). on

this subject the Cochrane review concludes that for patients who had mixed symptompatterns i.e acute, sub-acute and chronic low back pain with and without sciatica theresults was as follows:

Strong evidence of no statistically significant differencein outcomesbetween traction as a single treatment and placebo, sham or no treatment;

Moderate evidence that traction as a single treatment is no more effectivethan other treatments;

Limited evidence of no significant difference in outcomes between a

standard physical therapy program with or without continuous traction.

Electrical Stimulation:

Transcutaneous electrical nerve stimulation (TENS)may help stop pain byblocking nerve signals from reaching your brain. A physical therapist places electrodeson your skin near the area of your pain. TENS may relieve pain in your leg due toinflammation or compression of nerves in your back.

This treatment involves manipulation and massage of your spine and back muscles torelieve mild-to-moderate pain.

Acupuncture:

An acupuncturist inserts hair-thin needles under your skin. The needles usually stay infor 15 to 30 minutes. The insertion causes little or no pain. Expect to have severalsessions. Research suggests pain relief may come from the release of endorphins, yourbody's natural painkillers.

back pains

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