Hurt.com

Guide to Back Pain

What is Back Pain?

·         Back pain is a category for any kind of pain that affects the back.

·         Back pain is generally associated with mechanical problems related to the back. The most common problems are disk breakdown, spasms, tense muscles, and ruptured disks.

·         There are a number of medical conditions that cause back pain:

o    Fibromyalgia

o    Arthritis

o    Scoliosis

o    Spondylolisthesis

o    Spinal stenosis

o    Pregnancy

o    Kidney stones

o    Infections

o    Endometriosis

Who Suffers From Back Pain?

·         YOU ARE NOT ALONE!

·         It is estimated that 80% of Americans suffer from back pain at some point.

·         Back pain is the second most common neurological ailment (with headaches only being more common)

·         Americans spend more than $50 Billion per year on lower back pain.

·         Back pain is the most reason for job-related injury and missed work.

·         Back pain is a HUGE national problem.

Your Back & Back Pain

The back is constantly working (even when you are asleep!) The back stretches from your neck to your tailbone. The back is a complex, integrated of nerves and muscles anchored by the spine. The spine is composed of 24 bony rings called vertebrae. The spine and the vertebrae are designed to protect the spinal column or spinal cord. The spinal cord communicates with the brain while managing the interaction of the bones, ligaments, and muscles for the entire body, arms, and legs.

Below are some good links with additional information on the anatomy of the back:

·         Wikipedia: http://en.wikipedia.org/wiki/Human_back

·         Back.com from Medtronic http://www.back.com/anatomy.html

Causes of Back Pain:

Back pain general starts in one of three areas:

• The Vertebrae: The bones that compose the spine

• The Muscles: The muscles, tendons and ligaments that compose the back

• The Nerves: The nerves that compose the spinal column that control the majority of the movement and sensation in the body. Nerves can be pressed or pinched resulting in pain. Sometimes, the nerves can become inflamed causing pain.

How to Prevent Back Pain

Nearly all of us will be afflicted with back pain at some point in our lives. The best things that can be done to prevent back pain are:

·         Maintain a healthy diet with enough calcium and Vitamin D to keep bones strong

·         Lose weight. Maintaining a healthy weight will reduce stress on back and reduce the likelihood of future injury.

·         Exercise: Regular exercise will increase your back strength.

·         Yoga & Stretching: A regimen of stretching like light yoga can help keep your back flexible.

·         Posture & desk alignment: Maintain a proper posture by standing straight. If you work at a desk for a large portion of the day, make sure your computer, desk and chair are adjusted properly to minimize stress on your back.

·         Avoid lifting heavy objects: This may sound obvious, but avoid lifting heavy objects. If you must lift a heavy object, use a back support and lift with your legs while keeping your back straight.

How to Diagnose Back Pain?

Diagnosing back pain is very difficult. Minor back strains will generally not require you to see a doctor. Most other back pain will likely require a professionally diagnosis. For any back pain that lasts for a prolonged period or has significant effect on your lifestyle, you will want to see a primary care physician as your first stop on developing a treatment plan for your back pain. See your primary care doctor if you have:

·         Numbness or tingling

·         Severe pain that does not improve with rest

·         Pain after a fall or an injury

·         Pain plus any of these problems:

·         Trouble urinating

·         Weakness

·         Numbness in your legs

·         Fever

·         Weight loss when not on a diet.

How Do Doctors Diagnose Back Pain?

To diagnose back pain, your doctor will take your medical history and do a physical exam. Your doctor may order other tests, such as:

·         X rays

·         Magnetic resonance imaging (MRI)

·         Computed tomography (CT) scan

·         Blood tests.

·         Medical tests may not show the cause of your back pain. Many times, the cause of back pain is never known. Back pain can get better even if you do not know the cause.

Treatment for Back Pain:

Acute Back Pain Treatments:

Acute back pain can get better without treatment. Over-the-counter analgesic pain killers like acetaminophen, aspirin, or ibuprofen will help alleviate the pain.

Chronic Back Pain Treatments:

·         Hot or Cold Packs (or Both): Heat reduces muscle spasms and pain. Cold helps reduce swelling and numbs deep pain. Using hot or cold packs may relieve pain, but this treatment does not fix the cause of chronic back pain.

·         Exercise: Proper exercise can help ease chronic pain but should not be used for acute back pain. Your doctor or physical therapist can tell you the best types of exercise to do.

·         Medications:

•Analgesic medications are over-the-counter drugs such as acetaminophen and aspirin or prescription pain medications.

•Topical analgesics are creams, ointments, and salves rubbed onto the skin over the site of pain.

•Nonsteroidal anti-inflammatory drugs (NSAIDs) are drugs that reduce both pain and swelling. NSAIDs include over-the-counter drugs such as ibuprofen, ketoprofen, and naproxen sodium. Your doctor may prescribe stronger NSAIDs.

•Muscle relaxants and some antidepressants may be prescribed for some types of chronic back pain, but these do not work for every type of back pain.

·         Behavior Changes: You can learn to lift, push, and pull with less stress on your back. Changing how you exercise, relax, and sleep can help lessen back pain. Eating a healthy diet and not smoking also help.

·         Injections: Your doctor may suggest steroid or numbing shots to lessen your pain.

Complementary and Alternative Medical Treatments

·         Chiropractics / Manipulation: Chiropractors adjust or massage the spine or nearby tissue using their hands.

·         Electrical Stimulation: A small electrical box ends mild electrical pulses to nerves in the affected area.

·         Acupuncture: Use of thin needles to relieve pain and restore health. Acupuncture may be effective when used as a part of a comprehensive treatment plan for low back pain.

·         Acupressure: Application of pressure to certain places in the body to relieve pain.

Surgery:

Most people with chronic back pain do not need surgery. Surgery may be applicable if you suffer from:

o    Herniated disk. When one or more of the disks that cushion the bones of the spine are damaged, the jelly-like center of the disk leaks, causing pain.

o    Spinal stenosis. This condition causes the spinal canal to become narrow.

o    Spondylolisthesis. This occurs when one or more bones of the spine slip out of place.

o    Vertebral fractures. A fracture can be caused by a blow to the spine or by crumbling of the bone due to osteoporosis.

o    Degenerative disk disease. As people age, some have disks that break down and cause severe pain.

o    Cancer, an infection, or a nerve root problem called cauda equina syndrome

Specific Conditions:

Muscle Injury: Inflammation and swelling of the soft tissue can be caused by injury or impact. Often muscle injury places pressure on nearby nerves. Rest, mild stretching, ice and/or heat will resolve most

muscle strains and sprains.

Arthritis: The back is subject to significant wear and tear. Exercise helps strengthen and heal a back because exercise promotes blood flow to the spine. Conditions due to general wear and tear include arthritis of the spine or spondylosis and spinal stenosis which is the narrowing of the space within the spinal canal.

Osteoporosis: As we age, bones become more brittle, especially in women pst menopause. Thinner vertebrae weaken the strength of the spine, and may fracture.

Herniated Disc: Discogenic back pain occurs when the cushioning, shock-absorbing discs between the vertebrae malfunction or break. When discs slip out of position, spinal nerves can be pinched resulting in pain.

Spondylolisthesis: When one vertebra in the spinal column slips forward over another, the integrity of the spine can be compromised and destabilized. This causes vertebrae to pull on muscles, ligaments and other discs, compressing nerves and causing pain.

Sciatica: The collection of spinal nerves joined together at the lower part of the spine is called the Sciatic Nerve. When any one nerve in this group gets irritated or compressed, it sends pain signals to all of the other nerves, and this pain can extend all the way down the leg.

References:

1.     National Institute of Arthritis & Musculoskeletal and Skin Diseases, What is Back Pain?, September 2009.

2.     Medline Plus, National Institutes of Health, 2011.

3.     Zacharoff et al., Your Guide to Pain Management, Inflexxion, Inc. 2009.