Backpain|know your back by Dr Syed Arif Hussain
Back pain is a very common complaint. approximately 80% of all humans will have low back pain at least once in their lives. Back pain is a common reason for absence from work, or visiting the doctor’s.
Even though back pain can affect people of any age. Back pain is associated with the way our bones, muscles and ligaments in our backs work together.
What Is Back Pain?
Back pain can range from a dull, constant ache to a sudden, sharp pain that makes it hard to move. It can start quickly if you fall or lift something too heavy, or it can get worse slowly.
What Is the Difference Between Acute and Chronic Pain?
Acute pain starts quickly and lasts less than 6 weeks. It is the most common type of back pain. Acute pain may be caused by things like falling, being tackled in football, or lifting something heavy. Chronic pain lasts for more than 3 months and is much less common than acute pain.
Who Gets Back Pain?
Anyone can have back pain, but some things that increase your risk are:
• Getting older. Back pain is more common the older you get. You may first have back pain when you are 30 to 40 years old.
• Poor physical fitness. Back pain is more common in people who are not fit.
• Being overweight. A diet high in calories and fat can make you gain weight. Too much weight can stress the back and cause pain.
• Heredity. Some causes of back pain, such as ankylosing spondylitis, a form of arthritis that affects the spine, can have a genetic component.
• Other diseases. Some types of arthritis and cancer can cause back pain.
• Your job. If you have to lift, push, or pull while twisting your spine, you may get back pain. If you work at a desk all day and do not sit up straight, you may also get back pain.
• Smoking. Your body may not be able to get enough nutrients to the disks in your back if you smoke. Smoker’s cough may also cause back pain. People who smoke are slow to heal, so back pain may last longer.
What Are the Causes of Back Pain?
There are many causes of back pain. Mechanical problems with the back itself can cause pain. Examples are:
• Disk breakdown
• Tense muscles
• Ruptured disks
Injuries from sprains, fractures, accidents, and falls can result in back pain.
Back pain can also occur with some conditions and diseases, such as:
• Spinal stenosis
• Kidney stones
Other possible causes of back pain are infections, tumors, or stress.
Can Back Pain Be Prevented?
The best things you can do to prevent back pain are:
• Exercise often and keep your back muscles strong.
• Maintain a healthy weight or lose weight if you weigh too much. To have strong bones, you need to get enough calcium and vitamin D every day.
Try to stand up straight and avoid heavy lifting when you can. If you do lift something heavy, bend your legs and keep your back straight.
What are the signs and symptoms of back pain?
A symptom is something the patient feels and reports, while a sign is something the doctor detects.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 buttocks and legs. In most cases signs and symptoms clear up on their own within a short period.
• When Should I See a Doctor for Pain?
You should see a 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:
o Trouble urinating
o Numbness in your legs
o Weight loss when not on a diet.
How Is Back Pain Diagnosed?
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.
Q>How Is Back Pain Treated?
A>Treatment for back pain depends on what kind of pain you have. Acute back pain usually gets better without any treatment, but you may want to take acetaminophen, aspirin, or ibuprofen to help ease the pain. Exercise and surgery are not usually used to treat acute back pain.
Following are some types of treatments for chronic back pain.
Hot or Cold Packs (or Both)
Hot or cold packs can soothe sore, stiff backs. 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.
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.
The following are the main types of medications used for back pain:
• 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. 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.
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(interventional pain procedure)
Your doctor may suggest steroid or numbing shots to lessen your pain. Common types of injections for back pain relief include:
• Epidural steroid injection.
• Selective nerve root block (Tranaforaminal nerve root block)
• Facet joint block
• Sacroiliac joint block
Complementary and Alternative Medical Treatments
some people try complementary and alternative treatments. The most common of these treatments are:
• Transcutaneous electrical nerve stimulation .
• Acupressure. .
Most people with chronic back pain do not need surgery. It is usually used for chronic back pain if other treatments do not work. You may need surgery if you have:
• 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.
• Spinal stenosis. This condition causes the spinal canal to become narrow.
• Spondylolisthesis. This occurs when one or more bones of the spine slip out of place.
• Vertebral fractures. A fracture can be caused by a blow to the spine or by crumbling of the bone due to osteoporosis.
• Degenerative disk disease. As people age, some have disks that break down and cause severe pain.
Rarely, when back pain is caused by a tumor, an infection, or a nerve root problem called cauda equina syndrome, surgery is needed right away to ease the pain and prevent more problems.
Don’t fall for these tall tales
When it comes to the back pain , let’s separate fact from fiction…
(1) You should stay in bed(2) The firmer your mattress the better. (3) Your posture doesn’t matter-(4) All lifting is bad for your back(5) Skinny people don’t suffer(6) Surgery is the only real cure.
• DR SYED ARIF HUSSAIN
• CONSULTING ANESTHETIST& PAIN SPECIALIST
FELLOWSHIP IN PAIN MANAGEMENT(KOLKATA)
MEMBER INDIAN SOCIETY FOR STUDY OF PAIN
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