Back pain is an all-too-familiar trouble that can range from a dull, never-ending ache to a sudden, piercing pain that leaves you disabled. It can come on suddenly – from an accident, a fall, or lifting something too heavy – or it can develop slowly, perhaps as the result of
age-related changes in the spine. Regardless of how it happens or how it feels, you know it when you have it. In addition, chances are, if you don't have it now, you will eventually.
The pain is usually located in the lower lumbar region, where the spine curves inwards just before it reaches the buttocks. This lower back supports most of the body’s weight, and as a result, is susceptible to pain caused by injury or other problems.
It is often difficult to nail the root of low back pain, though poor muscle tone, joint problems, and torn muscles or ligaments (a sheet or band of tough fibrous tissue connecting bones or cartilages or supporting muscles or organs) are common causes. A herniated or slipped disc may also cause low back pain as well as
sciatica, a condition where pain travels down one or both buttocks and/or legs.
Standing or sitting for extended periods, wearing high heels, and being sedentary increase the risk of developing low back pain, as do obesity and back strain due to improper lifting. Up to half of pregnant women experience some low back pain.
Long hours spent driving a car may contribute to a herniated disc. This is possibly due to the vibration caused by the car.
While low back pain is rarely life threatening, it is still important to have chronic or recurring back pain assessed by a healthcare professional. Potentially serious causes include spinal tumor, infection, fracture, nerve damage, osteoporosis, arthritis, or pain caused by conditions found in internal organs such as the kidneys. Low back problems affect the spine's flexibility, stability, and strength, which can cause pain, discomfort, and stiffness.
Aids in naturally supporting the healing ability of the body.
Difference between Acute and Chronic Pain
Pain that hits you suddenly – after falling from a ladder, being tackled on the football field, or lifting a load that is just too heavy, for example – is acute pain. It is basically a kind, you usually experience from doing something you shouldn’t be doing or from doing it in the wrong way. Acute pain comes on quickly and often leaves just as quickly. To be classified as acute, pain should last no longer than 6 weeks. Acute pain is the most common type of back pain.
Chronic pain, on the other hand, may come on either quickly or slowly, and it lingers a long time. In general, pain that lasts more than 3 months is considered chronic. Chronic pain is much less common than acute pain.
Difficulty standing erect or standing in one position for a long time
Discomfort while sitting
Weakness and leg fatigue while walking
Low back pain may be a steady ache or a sharp, acute pain that is worse with movement.
Diagnosing the cause of back pain requires a medical history and a physical exam. If necessary, your doctor may also order medical tests, which may include x rays, strength testing on a treadmill, blood tests, a magnetic resonance imaging (MRI) scan, and computed tomography (CT) scan.
During the medical history, your doctor will ask questions about the nature of your pain and about any health problems you and close family members have or have had. Questions might include the following:
While osteoarthritis is a disease of the joints, its effects are not just physical. In many people with osteoarthritis, lifestyle and finances also decline.
Have you fallen or injured your back recently?
Does your back feel better – or hurt worse – when you lie down?
Are there any activities or positions that ease or aggravate pain?
Is your pain worse or better at a certain time of day?
Do you or any family members have arthritis or other diseases that might affect the spine?
Have you had back surgery or back pain before?
Do you have pain, numbness and/or tingling down one or both legs?
During the physical exam, your doctor may
watch you stand and walk
check your reflexes to look for slowed or heightened reflexes, either of which might suggest nerve problems
check for fibromyalgia by examining your back for tender points, which are points on the body that are painful when pressure is applied to them
check for muscle strength and sensation
check for signs of nerve root irritation.
Only with a medical history and exam - and sometimes, medical tests - can a doctor diagnose the cause of back pain. Many times, the precise cause of back pain is never known. In these cases, it may be comforting to know that most back pain gets better whether or not you find out what is causing it.
Mechanical problems: A mechanical problem is a problem with the way your spine moves or the way you feel when you move your spine in certain ways. Perhaps the most common mechanical cause of back pain is a condition called intervertebral disc degeneration, which simply means that the discs located between the vertebrae of the spine are breaking down with age. Discs are the strong, spongy, gel-filled cushions that lie between each vertebra, and compression fractures of the bones in the spine. As they deteriorate, they lose their cushioning ability. This problem can lead to pain if the back is stressed. Other mechanical causes of back pain include spasms, muscle tension, and ruptured discs, which are also called herniated discs.
Injuries: Low back pain is usually caused by strain from lifting, twisting, or bending. Spine injuries such as sprains and fractures can cause either short-lived or chronic pain. Sprains are tears in the ligaments that support the spine, and they can occur from twisting or lifting improperly. Fractured vertebrae are often the result of osteoporosis, a condition that causes weak, porous bones. Less commonly, back pain may be caused by more severe injuries that result from accidents and falls.
Acquired conditions and diseases: Many medical problems can cause or contribute to back pain. They include scoliosis, which causes curvature of the spine and does not usually cause pain until mid-life; spondylolisthesis; various forms of arthritis, including osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis; and spinal stenosis, a narrowing of the spinal column that puts pressure on the spinal cord and nerves. While osteoporosis itself is not painful, it can lead to painful fractures of the vertebrae. Other causes of back pain include pregnancy; kidney stones or infections; endometriosis, which is the buildup of uterine tissue in places outside the uterus; and fibromyalgia, which causes fatigue and widespread muscle pain.
Infections and tumors: Although they are not common causes of back pain, infections can cause pain when they involve the vertebrae, a condition called osteomyelitis, or when they involve the discs that cushion the vertebrae, which is called discitis. Tumors, too, are relatively rare causes of back pain. Occasionally, tumors begin in the back, but more often they appear in the back as a result of cancer that has spread from elsewhere in the body.
What Are the Risk Factors for Back Pain?
Although anyone can have back pain, a number of factors increase your risk. They include:
Age: The first attack of low back pain typically occurs between the ages of 30 and 40. Back pain becomes more common with age.
Fitness level: Back pain is more common among people who are not physically fit. Weak back and abdominal muscles may not properly support the spine. "Weekend warriors" – people who go out and exercise a lot after being inactive all week – are more likely to suffer painful back injuries than people who make moderate physical activity a daily habit. Studies show that low-impact aerobic exercise is good for the discs that cushion the vertebrae, the individual bones that make up the spine.
Diet: A diet high in calories and fat, combined with an inactive lifestyle, can lead to obesity, which can put stress on the back.
Heredity: Some causes of back pain, including disc disease, may have a genetic component.
Race: Race can be a factor in back problems. African American women, for example, are two to three times more likely than white women to develop spondylolisthesis, a condition in which a vertebra of the lower spine – also called the lumbar spine – slips out of place.
The presence of other diseases: Many diseases can cause or contribute to back pain. These include various forms of arthritis, such as osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis, and cancers elsewhere in the body that may spread to the spine.
Occupational risk factors: Having a job that requires heavy lifting, pushing, or pulling, particularly when this involves twisting or vibrating the spine, can lead to injury and back pain. An inactive job or a desk job may also lead to or contribute to pain, especially if you have poor posture or sit all day in an uncomfortable chair.
Cigarette smoking: Although smoking may not directly cause back pain, it increases your risk of developing low back pain and low back pain with sciatica. (Sciatica is back pain that radiates to the hip and/or leg due to pressure on a nerve) For example, smoking may lead to pain by blocking your body's ability to deliver nutrients to the discs of the lower back. Repeated coughing due to heavy smoking may also cause back pain. It is also possible that smokers are just less physically fit or less healthy than nonsmokers are which increases the likelihood that they will develop back pain. Furthermore, smoking can slow healing, prolonging pain for people who have had back injuries, back surgery, or broken bones.
Others: Pregnancy, a bad sitting posture, a bed which does not support your body correctly or suddenly taking up a new sporting activity may all lead to backaches.
Lower back pain can very easily be treated at home, particularly if symptoms are mild. To relieve pain and discomfort, use over-the–counter medications such as ibuprofen or paracetamol or apply a heating pad to the affected area. In more severe cases, your physician will prescribe NSAIDs, muscle relaxants or trigger point and ligament injection.
Natural treatments such as herbal and homeopathic remedies are a safer, gentler alternative to relieve back pain and discomfort and have been used for thousands of years to treat the pain and discomfort of backache.
Treatments such as herbal and homeopathic remedies are safe and gentle to use without the unwanted side effects of prescription medicine.
These herbs do not only provide symptomatic relief but are also effective for your overall health and wellbeing.
Herbs such as Harpagophytum procumbens (Devil’s Claw) boasts powerful properties that help to promote healthy joints and acts as a digestive tonic while Glucosamine sulphate repairs joints and cartilages. Boswellia serata is another excellent herb that promotes joint and muscle comfort and benefits digestion.
Harpagophytum procumbens ('Sengaparile,' 'Devil's Claw' or 'Duiwelsklou') is known for the claw-like shape of its fruit. For thousands of years, the Khoisan people of the Kalahari Desert (in Southern Africa) have used Devil's Claw to support healthy joints as well as for a digestive tonic. Clinical studies have demonstrated the effectiveness of Devil's Claw in supporting joint, cartilage and back (especially lower back) health.
Magnesium phosphoricum D6 is a biochemic tissue salt found naturally occurring in the body. It is known as the 'homeopathic aspirin' due to its unique pain killing and curative properties and is also an effective muscle relaxant, preventing and treating spasms and cramps and promoting relaxation.
Peppermint Essential Oil: Peppermint has many therapeutic uses and is used for musculo-skeletal pain. Used in massage, peppermint has strong anti-inflammatory and analgesic properties and even assists in promoting blood flow to the affected areas. On the emotional level, the aroma of peppermint oil will relax and refresh the mind as well as the body, helping to uplift the spirits and restore courage and mental focus.
Glucosamine is naturally manufactured in the body and scientists know that this simple substance is found in relatively high concentrations in the joints and connective tissues, where its function is to repair cartilage and maintain joint mobility. Although we know that the body can manufacture small amounts of glucosamine, this is not generally sufficient to sustain joint health, which makes supplementation very important. As a supplement, Glucosamine sulphate is derived from the shells of shellfish, crabs and oysters where it is found in high concentrations.
Boswellia serrata is an extract of resin from a tall tree found in India. Boswellia has been used for thousands of years in traditional Ayurvedic (Indian) medicine. Modern science has verified its excellent benefits for joint health. With regular use, blood supply to the joints is also maintained, keeping soft tissue nourished and viable.
Arnica D6: is a highly respected ingredient in homeopathic medicine and has powerful anti-inflammatory and tissue healing properties. It is used extensively to treat shock, injury and for post-operative care and it even helps to control bleeding.
Filipendula almaria, also known as Meadowsweet, is an herb which has been used for centuries by herbalists to treat fever and pain. This herb contains salicylates - a natural chemical similar to the pharmaceutical aspirin. Unlike, aspirin, however, Meadowsweet has pain relieving and anti-inflammatory properties without side effects such as stomach ulcers and the risk of Raynaud's Disease, associated with the use of pharmaceutical aspirin.
Matricaria recutita C6 is known for its soothing, anti-inflammatory and pain relieving properties.
Ginger Essential Oil: Obtained from the root of the ginger plant, ginger, like peppermint, is a highly versatile medicinal plant with thousands of years of therapeutic history. The oil is warming and toning and has particular application to all musculo-skeletal conditions, soothing pains and aches and also helping to reduce fever. Inhalation of ginger also helps to boost tired spirits and strengthen resolve.
By ensuring that your diet contains all the nutrients needed for healthy bones and muscles you can reduce the risk of developing back problems. Protein helps to build up the strong muscle tissue that your back needs, while B vitamins, particularly niacin, strengthen and nourish nerve tissues. Calcium is off course needed in developing and maintaining healthy bones and nerves while vitamin D aids the body’s absorption of calcium. Essential fatty acids help in keeping the inflammation under control.Vitamin C is also needed for the development and maintenance of strong bones and a healthy nervous system. Magnesium helps in regulating muscle contraction and easing spasm while bromelain is an excellent anti-inflammatory and is capable of being absorbed from the gastrointestinal tract.
Foods containing the above-recommended vitamins, minerals, and enzymes are:
Vitamin D - Cod liver oil (best source), fatty fish such as salmon, mackerel, tuna, sardines, herring, vitamin D-fortified milk and cereal, eggs, green peppers, citrus fruits and juices, strawberries, tomatoes, broccoli, turnip greens and other leafy greens, sweet and white potatoes.
Vitamin B3 (niacin) - The best food sources of vitamin B3 are peanuts, brewer’s yeast, fish (salmon, swordfish, tuna), and meat (beef liver, beef kidney, pork, turkey, chicken). Some vitamin B3 is also found in whole grains, broccoli, carrots, cheese, corn flour, dandelion greens, dates, eggs, fish, milk, potatoes, tomatoes, sunflower seeds and beets. Herbs that contain niacin include alfalfa, burdock root, catnip, cayenne, chamomile, chickweed, eyebright, fennel seed, hops, licorice, mullein, nettle, oat straw, parsley, peppermint, raspberry leaf, red clover, rose hips, slippery elm, and yellow dock.
Vitamin C - Some rich sources of vitamin C are oranges, green peppers, watermelon, Rose Hips, papaya, parsley, grapefruit, cantaloupe, strawberries, kiwi, mango, broccoli, tomatoes, Brussels sprouts, cauliflower, currants, cabbage, and citrus juices or juices fortified with Vitamin C. Raw and cooked leafy greens (turnip greens, spinach), red and green peppers, canned and fresh tomatoes, sweet and white potatoes, winter squash, Acerola Berries, raspberries, blueberries, cranberries and pineapple are also rich sources of Vitamin C.
Calcium- Good sources of calcium include low-fat dairy products, such as milk, yogurt, cheese, and ice cream; dark green, leafy vegetables, such as broccoli, collard greens, bok choy, and spinach; sardines and salmon with bones; tofu; almonds; and foods fortified with calcium, such as orange juice, cereals, and breads.
Magnesium - For magnesium, eat avocado, banana, cantaloupe, honeydew, lima beans, low-fat milk, nectarine, orange juice, potato, spinach
Bromelain – Pineapples. A supplement of brome lain may be necessary in your case as fresh pineapple, which is rich in brome lain, could be allergic to some people.
Essential Fatty Acids - Some experts believe that dietary and supplemental forms of omega-3 fatty acids, including alpha-linolenic acid (ALA) found in walnuts and flaxseeds, may prove helpful as part of your treatment for COPD. Gamma-linolenic acid is found in evening primrose oil, black currant seed oil, and borage oil; alpha-linolenic acid is found in flaxseed oil and other oils. Try and eat foods rich an omega-3 fatty acids (such as cold-water fish, flaxseeds, and walnuts). Eating foods rich in omega-3 fatty acids and limiting foods with omega-6 fatty acids (found, for example, in egg yolks, meats, and cooking oils including corn, safflower, and cottonseed,) is generally known as a good practice. This is because omega-3 fatty acids tend to decrease inflammation while omega-6 fatty acids (other than GLA) tend to increase inflammation.
One of the best things you can do to prevent back pain is to exercise regularly and keep your back muscles strong. Exercises that increase balance and strength can decrease your risk of falling and injuring your back or breaking bones. Exercises such as Tai Chi and yoga – or any weight-bearing exercise that challenges your balance – are good ones to try.
Practicing good posture, supporting your back properly, and avoiding heavy lifting when you can may all help you prevent injury. If you do lift something heavy, keep your back straight. Don't bend over the item; instead, lift it by putting the stress on your legs and hips.
Treatments when you are suffering
Hot and cold (Ice first, heat later): Hot or cold packs – or sometimes a combination of the two – can be soothing to chronically sore, stiff backs. Heat dilates the blood vessels, improving the supply of oxygen that the blood takes to the back and reducing muscle spasms. Heat also alters the sensation of pain. Cold may reduce inflammation by decreasing the size of blood vessels and the flow of blood to the area. Although cold may feel painful against the skin, it numbs deep pain. Applying heat or cold may relieve pain, but it does not cure the cause of chronic back pain.
Several times a day, place an icepack wrapped in a towel on the painful area for up to 20 minutes. After about 48 hours, switch to moist heat to stimulate blood flow and reduce painful spasms. Dip a towel in very warm water, wring it out, then flatten and fold it. Lie on your stomach with pillows under your hips and ankles. Place the towel across the painful area; cover the towel with plastic wrap, then put a warm, not hot, heating pad on the top of the plastic wrap. Leave it on for 20 minutes. You can repeat this 3-4 times a day for several days.
Exercise: Although exercise is usually not advisable for acute back pain, proper exercise can help ease chronic pain and perhaps reduce its risk of returning. The following four types of exercise are important to general physical fitness and may be helpful for certain specific causes of back pain:
Flexion: The purposes of flexion exercises, which are exercises in which you bend forward, are to 1) widen the spaces between the vertebrae, thereby reducing pressure on the nerves; 2) stretch muscles of the back and hips; and 3) strengthen abdominal and buttock muscles. Many doctors think that strengthening the muscles of the abdomen will reduce the load on the spine. One word of caution: If your back pain is caused by a herniated disc, check with your doctor before performing flexion exercises because they may increase pressure within the discs, making the problem worse
Extension: With extension exercises, you bend backward. They may minimize radiating pain, which is pain you can feel in other parts of the body besides where it originates. Examples of extension exercises are leg lifting while lying prone and raising the trunk while lying prone. The theory behind these exercises is that they open up the spinal canal in places and develop muscles that support the spine.
Stretching: The goal of stretching exercises, as their name suggests, is to stretch and improve the extension of muscles and other soft tissues of the back. This can reduce back stiffness and improve range of motion.
Aerobic: Aerobic exercise is the type that gets your heart pumping faster and keeps your heart rate elevated for a while. For fitness, it is important to get at least 30 minutes of aerobic (also called cardiovascular) exercise three times a week. Aerobic exercises work the large muscles of the body and include brisk walking, jogging, and swimming. For back problems, you should avoid exercise that requires twisting or vigorous forward flexion, such as aerobic dancing and rowing, because these actions may raise pressure in the discs and actually do more harm than good. In addition, avoid high-impact activities if you have disc disease. If back pain or your fitness level makes it impossible to exercise 30 minutes at a time, try three 10-minute sessions to start with and work up to your goal. But first, speak with your doctor or physical therapist about the safest aerobic exercise for you.
Acupuncture: This ancient Chinese practice is based on the theory that a life force called Qi (pronounced chee) flows through the body along certain channels, which if blocked can cause illness. According to the theory, the insertion of thin needles at precise locations along these channels by practitioners can unblock the flow of Qi, relieving pain and restoring health.
Although few Western-trained doctors would agree with the concept of blocked Qi, some believe that inserting and then stimulating needles (by twisting or passing a low-voltage electrical current through them) may foster the production of the body's natural pain-numbing chemicals, such as endorphins, serotonin, and acetylcholine.
The ‘lazy S’ sleeping position: It is extremely difficult to lie down comfortably on your bed in any position for a long time, if you have a bad back. Hence, try out the position called lazy S. Put a pillow under your head and upper neck, keep your back relatively flat on the bed, and then put a pillow under your knees. When you straighten your legs, your hamstring muscles pull and put pressure on your back. Keeping your knees bent puts slack into the hamstrings and takes the pressure off your back.
Rolfing: A type of massage, rolfing involves using strong pressure on deep tissues in the back to relieve tightness of the fascia, a sheath of tissue that covers the muscles, that can cause or contribute to back pain. The theory behind rolfing is that releasing muscles and tissues from the fascia enables the back to properly align itself.
Tai chi: Tai chi is an ancient Chinese discipline of slow, fluid movements, and is supposed to be a great relaxation method that helps the muscles in your back. There are a lot of breathing exercises and stretching activities involved, which foster a harmony within the body. Tai chi takes time and self-discipline to learn, but it is definitely worth it. It goes a long way in helping people with bad backs.
Chiropractic: Spinal manipulation is among the most extensively studied and accepted form of treatment for acute low back pain. Spinal manipulation is judged to both relieve pain and restore function. Spinal manipulation also appears to be effective for chronic low back pain, but the evidence is less conclusive. Individuals with chronic low back pain who were treated with spinal manipulation reported a significant reduction in pain compared to those in a control group who only received pamphlets about exercise and body mechanics. Pain relief continued even after the spinal manipulation treatments were completed.
Aromatherapy: Soak in a hot bath to ease pain. Add Epsom salts to help reduce muscle spasm, plus 3-5 drops of any of the following essential oils: rosemary, to soothe stiffness; lavender, a mild antiseptic; or marjoram, which is warming and relaxing.
Lifestyle changes can often help relieve and prevent low back pain. You can lower your risk of back problems by:
Looking for the posture that puts the least stress on your back. Stand up straight with your weight evenly balanced on both feet. Tilt your pelvis forwards, then back, exaggerating the movement. Then settle into the position most comfortable. Now ‘work your way up’ your back, focusing on one area at a time. First concentrate on the area near your waist, then your chest and finally your neck and shoulders. Try to feel which position to maintain when you are standing, walking and beginning or ending any exercise
When you are sleeping, lie on your back or your side. If you are more comfortable on your back, place a pillow under your knees as well as under your head to relieve pressure on your lower back. If you prefer to sleep on your side, place a pillow between your legs. If you have sciatica, the recommended position is on your stomach
If you like to sit up in bed to read or watch television, buy a large foam wedge that supports your upper body in a comfortable position. For added comfort – and to keep your neck in the proper position – use a foam or inflatable neck support when you are sitting up
When you are sitting on an office chair or at home, keep your feet flat on the floor, with your hips slightly higher than your knees. Use a lumbar support behind your lower back. The lumbar roll is a chair’s-width foam cylinder about 12 cm in diameter, easier to position and usually has straps that attach it to the back of the chair.
You should put a similar foam wedge for extra lumbar support in your car, although long drives must anyway be avoided.
Shift gears – Tilt your alternate foot up by a feet or say while standing at the sink, bus stands, pubs etc.
Roll out of bed – you can minimize the pain of getting out of bed by sliding to the edge of the bed. Once there, keep your back rigid and then let your legs come off the bed first. That motion will act like a springboard, lifting your upper body straight up off the bed.
Proper lifting techniques help prevent low back problems from developing. Proper lifting involves keeping an object close to the body and avoiding bending forwarding, reaching, and twisting while lifting.
Low back pain and disc degeneration are both more likely to develop among sedentary people than those who are physically active. However, long-term participation in some competitive sports may contribute to spinal disc degeneration.
Medical doctors for acute low back pain often recommend supervised bed rest, for two to four days, coupled with appropriate physical therapy and therapeutic exercise. However, reviews of bed rest recommendations have concluded that bed rest is, at best, ineffective and may even delay recovery. It is better to try to stay active and maintain a normal daily schedule as much as possible.