Pain in the back anywhere below the ribs and up
to the hips is called low back pain. It is a condition
that affects over 90% of the population at one time
or the other. Next to common cold, it remains the
most common reason why people seek medical help.
Many people who experience low back
pain do not meet up with a doctor since it usually
resolves on its own. They may suffer from any dull
aches to sharp pains or even numbness. The pain
characteristically lingers on for a day or two before
it gradually subsides. In many, the pains keep recurring
in varying intensities.
Studies have shown that back pain
is the single most reason cited by employees for
taking maximum number of 'sick leaves'. Stresses
and strains of daily living and overuse and misuse
of the muscles of the back are the commonest causes
of backache.
Why is back
pain so common?
The curvature of the normal spine
is such that, the bony column is weakest at two
points. The cervical spine (the nape of the neck)
and the dorsal spine are the weakest points. The
lower back bears at least one half of the body weight.
Hence, these points bear the brunt of repeated stresses
and strains.
Every joint has an optimum position
of function, departures from which increase the
likelihood of strains and pains. Over time muscle
strains lead to an overall imbalance in the muscle
structure. There is constant strain on the muscles,
bones, tendons, discs etc. The most common cause
of back pain is poor posture. The real pain might
be triggered by sudden lifting of weights, a sudden
turn or a wrench, a fall on the back, sitting in
a cramped position for a long time, horse-riding,
riding a tractor etc. Occasionally, it won't be
one event alone which triggers your backache. You
may have been doing things improperly for a long
time » standing, sitting or walking, until
suddenly one simple movement might trigger your
pains.
These so-called last straws
to the already overburdened back are some of the
following:
* Trauma: acute or chronic » unusual lifting,
sudden wrenches, fall etc.
* Psychic factors like depression ' can cause lowered
(poor) muscle tone and cause backache
* Any acute illnesses » can cause poor muscle
tone
* Fatigue
* Pregnancy
* Obesity » causes increased lordosis
* General poor health
* Localized, focal infections
* Faulty structure of feet.
What makes backache worse is that once the pain
starts, in order to avoid stressing the painful
parts, we tend to perform actions ( walk, stand,
lift etc.) with the use of other muscles which are
not used to moving in that pattern. This further
increases the stress on the muscles
Causes of
backache
Apart from the above mentioned triggers,
backache can be caused by a number of other conditions.
? Osteoarthritis (OA): with increasing age, the
joints of the backbones undergo degeneration. OA
of the joints that link one vertebra to its neighboring
ones (called the facet joints) causes back pains.
* Herniated Discs
(disc prolapse): > any heavy
strain or increased pressure in the back can displace
the round, resilient discs which act as shock absorbers
for the back bones. They cushion every impact on
the back such as when jogging, weight lifting, horse-riding
etc. injuries, normal wear and tear, and diseases
that affect the backbones can cause minor tears
on the disc surfaces as well as make them bulge
out from their places. Displaced discs can press
on surrounding nerves and cause pain, tingling &
numbness in the legs.
* Injuries and fractures
of the vertebrae (backbone): conditions
that cause nerve, bone and tissue injury can cause
back pain ' vehicular accidents, fall from a bike,
fall on the back compressing the structures in the
back.
* Compression of the
spinal cord itself (Spinal stenosis):
the spinal cord travels through a narrow, hollow
shaped bony canal called the 'spinal canal'. With
aging, the lumen of this canal tends to become narrow,
compressing the contents within it. Back pain is
a common symptom of spinal stenosis.
* Deformities:
often the backbone curvature is damaged secondary
to other diseases. The alignment which is usually
straight tends to deviate either to the sides (scoliosis)
or appear bent forwards (kyphosis). Long-term mal-alignment
of the vertebral column can cause tremendous stress
and strain on the supportive muscles that surround
it. This usually gives rise to backache.
* Occupational:
many occupations can take a toll on your back. If
your work requires long hours of standing, lifting
of heavy weights or sitting in an uncomfortable
position, your back will possibly suffer.
* Athletes are very prone to low back aches.
Back pain might also originate from the nerves,
spine and muscles of the back. Conditions affecting
structures present in the abdomen and pelvis - (kidneys,
ovaries, intestines, prostate etc.) can cause a
backache. In general backache is never really serious.
It is self-resolving and lasts only for some days.
70% of persons approaching a GP
are better in 3 weeks while 90 % are better in 6
weeks time, irrespective of the treatment received.
The
less common causes of back pains include:
* Infections:
tuberculosis and osteomyelitis are conditions that
cause back pains. But, fever, body ache and other
symptoms generally accompany back pains in these
conditions.
Bacteria and viruses can enter the spine either
through direct trauma, through surgical procedures,
injection treatments or spread through the blood
stream.
* Ankylosing spondylitis:
a condition which causes inflammation of the joints
in the spine.
* Pagets disease:
a disorder which affects the bones of spine, chest,
skull, pelvis and legs due to abnormal bone growth.
* Pelvic inflammatory
disease: any inflammation of the
uterus, ovaries or the fallopian tubes can present
with low back pains. Generally the pains are accompanied
by uneasiness and fever.
* Pancreatitis:
the pancreas when inflamed can cause sudden, severe
pains in the abdomen accompanied by nausea, vomiting
and fever. Occasionally, the pains radiate to the
lower back also.
* Aortic aneurysm:
the aorta is the largest artery carrying blood away
from the heart. In some conditions, the walls of
the aorta can become very thinned out due to overstretching.
This can cause pain in the back especially if the
thinned out wall ruptures.
* Kidney stones or
urinary tract infections: Stones
in the kidneys or anywhere within the urinary tract
cause obstruction to normal flow of urine as well
as braise the walls of the ureters (two structures
which carry urine produced within the kidneys to
the bladder where they are stored before being excreted),
and can also cause back pains.
* Tumors:
any abnormal growth of tissues especially in the
back region.
When to see my doctor?
Your back pains definitely
deserve medical attention in the following situations:
* Your pains are accompanied by persistent fever.
* You suddenly lose control over your bowel and
bladder movements.
* There are additional symptoms of numbness in the
feet, nausea vomiting etc.
* You have had a violent accident involving the
back.
* There is redness of the skin overlying the backbones.
* Pain is elicited even with slight application
of pressure.
* You have developed weakness in the legs along
with or after onset of the back pains.
* The pains radiate below the hips to the legs.
* Even the slightest movement in intolerable.
* You have been on steroid treatment for other conditions.
* You have a positive medical history of a tumor
in the past.
* You are HIV positive or have an addiction to drugs.
* You have lost weight in the recent past.
* You are above 50 years of age.
* You are less than 20 years and feel this is the
worst back ache of your life.
* You have had back aches in the past, but this
episode is clearly different.
* Your low grade pains persist for more than two
weeks.
* In spite of resting your back, the pains do not
improve significantly in one or two day's time.
How do I prevent backaches?
Some simple measures can help keep
back pain at bay!
* Learn to bend and lift objects properly.
* Avoid standing for long periods at a stretch.
If you must stand for a long time, make sure your
ears, shoulders, hips and knees are in the same
straight line.
* If you have long hours of sitting, like a long
car drive, try taking stops every one hour and walk
around a bit.
* When sitting for long, make sure your chair has
a high back and supports your back (especially the
region between the ribs and hip-bones) curvature
properly. You may need the help of a pillow for
the same.
* Your chair should not be too high or too low either.
Again, when sitting on a chair, make sure that both
your feet touch ground completely. Your knees should
extend beyond the seating provided and they should
also be higher than your hips.
* Don't slouch when sitting.
* While sleeping, make sure your bed provides adequate
support to your back. Very soft beds can strain
your back muscles. If you are prone to back pains,
then sleep on your back with your legs straight.
Bending the legs at the hips increases stress on
your back muscles.
* Exercise daily. A good exercise will improve your
posture.
* A complete workout session should include walking/swimming
aerobic activity + riding a stationary bike.
* Never skip your warm-up exercises, even if you
do regular workouts.
* Manage your weight. Try maintaining your body
weight within the range optimal for your age, sex,
and daily routines.
* Have foods rich in calcium, Vitamin D, phosphorus
and proteins. They both help in building and repairing
bones and muscles.
* Wear low-heeled shoes. Avoid wearing stilettos
for long periods.
* Quit smoking. Smoking contributes to osteoporosis.
It hardens the arteries supplying blood to our bones
and reduces the blood supply to other vital structures
that form your backbone.
* Relax. Avoid stress from getting at you. Stress
causes the supportive muscles of the back to go
into an abnormally contracted state. Try yoga, tai
chi and massages which are known to help.
Treatment of Low Backache
Conventional
treatment
Painkillers and correction of structural
deformities is the mainstay of conventional approach
to back pains.
* Pain killers: Non-Steroidal Anti-inflammatory
Drugs (NSAIDs) given for two weeks usually reduce
the pains.
* Physiotherapy: physical treatment
through appropriate exercises for improving posture
and muscle tone provide lasting relief.
Homeopathy For Low Backache
Homeopathic medicines offer excellent
relief from low back pains. Homeopathic medications
can relieve the spasms of the back muscles and provide
effective pain relief without any side effects.
Homeopathy is strongly recommended.
