BACK PAIN

Although one and a half million people in this country are suffering from some degree of back pain at any one time, the majority do get better with no more complicated treatment than bed rest and/or painkilling drugs. In many cases, the pain isn’t even bad enough to merit a visit to the doctor, but if you are suffering your first attack of back pain, or if the pain is severe, see your GP before trying any self-medication – the back is a large, complicated area with tens of thousands of nerve-endings, many of which, for different reasons, can cause pain.

When people suddenly develop back pain, they tend to think that they must have ‘slipped a disc’, imagining the disc to be something like a tap washer. In fact, these intervertebral discs, as they are called, are firmly attached to the side of each vertebra – the interlinked bones that make up the spine – and it is impossible for them to’slip’. They are spongy and act as a kind of ball-bearing and shock-absorber whenever the spine moves. When a disc causes trouble it is because a split has developed in its outer layers, allowing some of the soft inner pulp to prolapse – fall – through. This can then press on nearby ligaments or nerves and cause pain which may be severe. A disc (usually in the lumbar – lower back – region) tends to prolapse following some unusual, prolonged and perhaps unaccustomed physical activity. The disc walls are weakened, the back may feel stiff for a few days, and it might then be something quite minor, like a cough or a sneeze, that ruptures the wall.

However, only a tiny proportion – less than 5% – of back pain is caused by disc problems. At some time in their lives, most people will suffer from back pain which could have been prevented. There are many possible causes, the most common being a strain or sprain of one of the ligaments which help to hold the spine together or one of the muscles responsible for its movement.

Sitting or standing for long periods in unsuitable posi-tions can often be blamed. Repetitive work, such as digging or weeding, carried on for too long, is one cause; lifting things incorrectly – while bending at the waist and twisting at the same time, for example – is another. Hours bent over a desk or at a typewriter, especially if the chair does not provide the right back support and the desk is not the correct height, throws a great strain on the back.

It is best to change position frequently, or get up and walk around from time to time, so that the muscles and ligaments get a little exercise – they were not designed to hold the same position for long. Likewise, make sure you give yourself regular breaks from the digging and the weeding!

Sales reps and others who spend hours driving can often benefit from a specially designed car seat with extra back support. Lifting should always be done by bending at the knees like a fork-lift truck, not from the waist like a crane! And combined lifting and twisting movements should be avoided, as these are very likely to strain the back.

Various forms of arthritis also commonly cause back pain. X-rays of people’s backs show that osteoarthritis – general wear and tear of the joints – affects nearly everyone over 50 and this may result in pain. Rheumatoid arthritis can sometimes be a cause of inflammation and pain in the back and young men in particular may develop another form of arthritis involving the back – ankylosing spondylitis.

Women are prone to osteoporosis – a thinning of the bones – after the menopause. This may cause one or more of the vertebrae – especially those in the neck – to crumble slightly, resulting in nerve pressure and pain.

One of the reasons for consulting your doctor when you first experience back pain is to exclude less common causes – it often helps just to be assured that there is nothing seriously wrong. But it may still be difficult to pinpoint the exact problem. Relieving the symptoms will then be a question of trial and error, but fortunately most back pain will get better of its own accord within a month – often less.

Bed rest for a few days – longer with disc problems – will help any inflammation to subside. A firm mattress, perhaps placed on the floor or with a large, person-sized board under it, is best. Corsets and collars can provide helpful temporary support, but do not wear a corset for longer than three to four weeks, unless otherwise advised by your doctor, or joints can stiffen up. Heat or ice packs will often relieve pain, but be sure to protect the skin.

Aspirin or other anti-inflammatory and pain-relieving medicines like ibuprofen are most effective, and will also help to relax the tenseness in the muscles which adds to the pain. They need to be taken regularly, as recommended, so that a constant level of pain relief is maintained in the blood and the pain is not allowed to surface. Paracetamol can also ease back pain, although it does not reduce inflammation .

None of these medicines should be taken for more than a few days except under a doctor’s advice.

Massage (with or without a liniment, or muscle rub) or a vibrator applied to the painful area can also relax the muscles and be very soothing. A form of physical therapy called the Alexander Technique aims to relax muscles and improve posture by undoing bad sitting and standing habits developed over the years – it will often relieve back ache in the process. Some people find that manipulation of the back by a registered osteopath, chiropractor or physiotherapist will bring relief, but this treatment is best begun within a few days of the onset of the pain. Acupuncture can also be effective when practised by skilled hands.

Exercise, especially swimming, walking and cycling, plays an important part in keeping the muscles and ligaments in good tone. Special exercises designed for the individual by a physiotherapist, especially once the acute pain has subsided, will usually speed recovery and help prevent a relapse.

If the pain is severe – as with lumbago, which afflicts the lower back and is often so agonising that the sufferer is stuck in a stooping position, or especially with sciatica, when the pain is radiating down the leg – stay in bed and call your doctor. If a prolapsed disc is diagnosed or suspected, specialist treatment may be needed.

What’s Available

Algipan Rub and Spray, Deep Heat Range, Doan’s Tablets, Ibuleve, Massage Balm, Menthol and Wintergreen Heat Rub, PR Freeze Spray

Recommendeds

Deep Heat Range, Algipan and PR Freeze Spray Homoeopathic Remedies

Aconite, Arnica, Bryonia, Calc. Fluor., Nux. Vom., Rheumasol, Rhus. Tox.,

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