BACK PAIN

Back pain is a common reason for absence from work and doctor visits. Although back pain may be painful and uncomfortable, it is not usually serious.

Even though back pain can affect people of any age, it is significantly more common among adults aged between 35 and 55 years. Experts say that back pain is associated with the way our bones, muscles and ligaments in our backs work and connect together.

Pain in the lower back may be linked to the bony lumbar spine, discs between the vertebrae, ligaments around the spine and discs, spinal cord and nerves, lower back muscles, abdomen and pelvic internal organs, and the skin around the lumbar area. Pain in the upper back may be due to disorders of the aorta, tumors in the chest, and spine inflammation.

Causes of back pain

The human back is composed of a complex structure of muscles, ligaments, tendons, disks and bones – the segments of our spine are cushioned with cartilage-like pads called disks. Problems with any of these components can lead to back pain. In some cases of back pain, its cause is never found.

Problems with the spine such as osteoporosis can lead to back pain.
Strain – the most common causes of back pain are:

• Strained muscles
• Strained ligaments
• A muscle spasm
Things that can lead to strains or spasms include:
• Lifting something improperly
• Lifting something that is too heavy
• The result of an abrupt and awkward movement

Signs and symptoms

A symptom is something that the patient feels and reports, while a sign is something other people, such as the doctor detect. For example, pain may be a symptom while a rash may be a sign.

The main symptom of back pain is, as the name suggests, an ache or pain anywhere on the back, and sometimes all the way down to the buttocks and legs. Some back issues can cause pain in other parts of the body, depending on the nerves affected.

In most cases, signs and symptoms clear up on their own within a short period.

If any of the following signs or symptoms accompanies a back pain, people should see their doctor:
• Weight loss
• Elevated body temperature (fever)
• Inflammation (swelling) on the back
• Persistent back pain – lying down or resting does not help
• Pain down the legs
• Pain reaches below the knees
• A recent injury, blow or trauma to your back
• Urinary incontinence – you pee unintentionally (even small amounts)
• Difficulty urinating – passing urine is hard
• Fecal incontinence – you lose your bowel control (you poo unintentionally)
• Numbness around the genitals
• Numbness around the anus
• Numbness around the buttocks

Preventing back pain

Steps to lower the risk of developing back pain consist mainly of addressing some of the risk factors.

Exercise – regular exercise helps build strength as well as keeping your body weight down. Experts say that low-impact aerobic activities are best; activities that do not strain or jerk the back. Before starting any exercise program, talk to a health care professional.

There are two main types of exercise that people can do to reduce the risk of back pain:
• Core-strengthening exercises- exercises that work the abdominal and back muscles, helping to strengthen muscles that protect the back.
• Flexibility – exercises aimed at improving flexibility in your core, including your spine, hips, and upper legs, may help too.

Smoking – a significantly higher percentage of smokers have back pain incidences compared to non-smokers of the same age, height and weight.
Body weight – the amount of weight people carry, as well as where they carry it, affects the risk of developing back pain. The difference in back pain risk between obese and normal-weight individuals is considerable. People who carry their weight in the abdominal area versus the buttocks and hip area are also at greater risk.

Posture when standing – make sure you have a neutral pelvic position. Stand upright, head facing forward, back straight, and balance your weight evenly on both feet – keep your legs straight and your head in line with your spine.

Posture when sitting – a good seat should have good back support, arm rests and a swivel base (for working). When sitting try to keep your knees and hips level and keep your feet flat on the floor – if you can't, use a footstool. You should ideally be able to sit upright with support in the small of your back. If you are using a keyboard, make sure your elbows are at right-angles and that your forearms are horizontal.
Lifting things – the secret for protecting your back when lifting things is to think "legs not back". In other words, use your legs to do the lifting, more than your back.

Keep your back as straight as you can, keeping your feet apart with one leg slightly forward so you can maintain balance. Bend only at the knees, hold the weight close to your body, and straighten the legs while changing the position of your back as little as possible.

Bending your back initially is unavoidable, but when you bend your back try not to stoop or squat, and be sure to tighten your stomach muscles so that your pelvis is pulled in. Most important, do not straighten your legs before lifting; otherwise you will be using your back for most of the work.

Do not lift and twist at the same time. If something is particularly heavy, see if you can lift it with someone else. While you are lifting keep looking straight ahead, not up nor down, so that the back of your neck is like a continuous straight line from your spine.

Moving things – remember that it is better for your back to push things across the floor, using your leg strength, rather than pulling them.
Shoes – flat shoes place less of a strain on the back.

Driving – it is important to have proper support for your back. Make sure the wing mirrors are properly positioned so you do not need to twist. The pedals should be squarely in front of your feet. If you are on a long journey, have plenty of breaks – get out of the car and walk around.

Your bed – you should have a mattress that keeps you spine straight, while at the same time supporting the weight of your shoulders and buttocks. Use a pillow, but not one that forces your neck into a steep angle.