Q & A – Back pain

Back pain is no laughing matter. In fact, nearly everyone in their lifetime will suffer with some type of back pain. Because back and neck pain are such common complaints, it’s no surprise that people have a lot of unanswered questions on the topic.

So…what exactly causes back pain?

Oh, my aching back! We’ve all said it at some point in our lives. As painful as it can be, the exact source of back pain is often difficult to identify or pinpoint. In fact, there are numerous possible pain producers including muscles, soft connective tissue, ligaments, joint capsules, cartilage, discs and nerves. Through everyday activities e.g. exercise, lifting, playing a sport, etc. These areas may be pulled, strained, stretched or sprained. Sometimes, small tears that occur in the outer layer of a spinal disc can result in severe pain. Many people experience pain from an abnormal disc that may be degenerating, bulging or even herniated. Even if the actual tissue damage is considered minor and likely to repair on its own, the intensity of the pain might be quite severe.

There is often a chain reaction which contributes to a person’s pain experience. In the body, numerous chemical substances are released in response to tissue irritation or injury. These substances “stimulate” the surrounding pain-sensitive nerve fibers, resulting in the sensation of pain. Some of these chemicals trigger the process of inflammation, or swelling, which also contributes to pain. The chemicals associated with this inflammatory process feed back more signals which perpetuate the process of swelling. The inflammation from this cycle of events may persist for days to weeks.

How long does an episode of back pain typically last?

No matter how long it lasts, back pain isn’t fun when it’s happening to you or someone you love. Unfortunately, the duration and severity of a single episode cannot be predicted based on the onset, location of pain, or even the initial severity. There are three general categories of pain – acute, chronic and recurrent acute.

The good news is that even if the exact source of pain is not determined, usually acute pain subsides over a month or less as the back’s irritated tissue heals. In general, nearly 80% of first time low back pain episodes resolve by 6 weeks.

Chronic pain is generally described as pain that lasts for months at a time and is often less correlated to tissue damage or injury and may be the result of a more long-term spine condition or other related factors such as muscle weakness, body weight, and certain life stressors. Recurrent acute pain is intermittent, it comes and goes or “flares up” from time to time.

Should I ice or heat a sore low back?

This is probably one of the most commonly asked questions about treatment of back pain. Both ice and heat can help in alleviating pain, but it’s important to know when to use them.

Ice reduces inflammation or swelling by decreasing blood flow from constricted blood vessels. Placing an ice pack on the area shortly after the pain begins (within 48 hours) can help with pain relief. Apply an ice pack to the affected area for up to 20 minutes every 2 hours, but remember to protect your skin from frostbite by using a thin sheet or towel.

Local application of heat or ice can temporarily reduce back pain and heat may facilitate stretching. Heat also is good for soothing sore back muscles, especially after the initial 48 hours has passed. Either dry heat (such as an electric heating pad) or moist heat (such as a hot bath or steamed towels) can be used.

It is important to keep in mind, however, that ice and heat do not necessarily speed up long- term recovery.

If I have chronic back pain, would it be better to have surgery?

There is no simple answer to this. Chronic back pain will vary depending on the source of the back pain. If a treatable found, then the underlying process can be addressed. When the underlying cause is either not specifically identifiable or not amenable to treatment, then the symptoms are treated. The goals of the treatment are to reduce quality of life and increase function.

There are several different general categories of treatment recommended for chronic back pain. They include physical therapy, medications, coping skills, procedures and alternative medicine treatments. Your treating physician should tailor a program involving a combination of these options to address your needs.

Does my weight matter much in relation to my back pain?

Your personal fitness will contribute to the overall health of your spine and weight control is an important component to maintaining a healthy back. Keeping on additional weight, especially in the mid-section or stomach, shifts your entire centre of gravity forward and puts additional unneeded strain on your back muscles and surrounding tissues. We recommend keeping within 5kgs of your ideal weight to avoid experiencing unnecessary back pain or related issues. However, it is also possible to be too thin. Extreme thinness can be accompanied by low bone mass, putting you at risk for osteoporosis. The best advice is to eat a well-balanced diet in moderate quantities and exercise regularly to keep your weight in check.

Does my sleeping position and mattress choice matter in avoiding back pain?

Many people don’t realise that sleeping on your back puts 25kgs of pressure on your spine, but simply placing a couple of pillows under your knees cuts the pressure in half. Lying on your side with a pillow between your knees also reduces the pressure on your lower back.

What is the best type of exercise to alleviate and prevent back pain?

Exercise is one of the most important treatments that your doctor will recommend to reduce back pain. Regular strengthening (core strengthening and resistance or weight training), flexibility (stretching) and aerobic exercise (three to five times per week) will improve your overall fitness and reduce further likelihood of back injury.

Many doctors and specialists provide their patients with proper exercise techniques to alleviate symptoms and prevent further back pain episodes from occurring.

When exercising, follow these simple rules:

  • Do each exercise slowly.
  • Start with five repetitions of each exercise, and work up to 10 repetitions.
  • Always remember to begin and end your exercise sessions with stretching.
Reference: www.spine.org

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