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How to Relieve the Back Pain

It is estimated that 80% of people in westernized world suffer from back pain at some point in their lives. After age 35, the fibrous cushions between the vertebrae called disks start to lose elasticity and backache becomes more common. As a result, many people stop exercising and gain weight, thus contributing to the back’s instability. Moreover, many women in their later years develop osteoporosis, which poses the threat of developing painful fractures in the vertebrae. Therefore, it is not surprising that back pain ranks second as the main reason people see their general practitioner and it happens to be the third most common reason for having surgery.

Diagnosing and treating back pain is a difficult task. An estimated 80% of sufferers cannot be given a definitive diagnosis, despite the variety of modern diagnostic tools available today. This uncertainty creates a great opportunity to sell people suffering from debilitating back pain expensive and risky quack remedies. If you realize that, even with no treatment at all, nine out of ten patients with backache will recover in a month, it is easy to see why this is such a thriving business.

Causes of Back Pain

A variety of factors can cause or contribute to back pain and there is usually no single cause. A problem in one area often causes difficulties in another. Back pain is in most cases a result of a combination of bad habits, other health conditions, heredity and normal wear and tear on the body. The most common factors include accidents, sports injuries, lack of physical activity, bad posture, muscle strain from repetitive motion, excess weight, wearing high-heeled shoes, incorrect lifting, bending and twisting, carrying heavy bags or other objects and health conditions such as osteoporosis and osteoarthritis. The types of back injuries fall into three main categories:

Soft tissue injuries to the muscles, ligaments and tendons attached to the spine. Weakened or overused skeletal muscles can become tight and cramp, ligaments can become sprained and tendons inflamed. In fact, spasms, mostly resulting from muscle injuries, make up three-quarters of all back problems.

Spinal joints injuries. Just like the knee, hip and shoulder joints, spinal joints are subject to wear-and-tear.

Disks injuries can result in increased pressure on nerves and may cause muscle spasms.

In addition to all the above factors, back pain may be caused by health conditions unrelated to the back’s machinery. Problems with the kidneys, ovaries, liver, pancreas or menstrual cramps may all trigger back pain.

When to See a Doctor

The good news is that with the first attack of lower back pain the odds are nine to one the pain will go away by itself within four to six weeks. A short stay in bed for up to 24 hours is fine. But after that try to walk a little every few hours to keep the blood flowing and the muscles toned. First, you may find relief with an icepack applied every two to three hours for up to 20 minutes. Thereafter, apply moist heat for 15 to 20 minutes several times a day as long as the pain lasts. Besides that you can relieve the pain with over-the-counter pain medications containing acetylsalicylic acid, ibuprofen, paracetamol (also known as acetaminophen) or naproxen. If the pain does not respond to any of the above measures or even worsens, you need see a doctor.

Diagnosing Back Pain

The starting point is to see your primary care physician who can help distinguish common back pain from signs of an underlying condition. The doctor will want to rule out disk problems and other disorders that could require immediate surgery as well as conditions not related to the spine. The symptom profile is usually followed by a hands-on examination of the spine and its movement. You will have to go through a range of movements in different positions and describe any changes in the type or degree of pain you may experience.

A wide variety of tools are used to diagnose back pain. They range from simple checking for reflexes and electromyogram (EMG) nerve tests to the high-tech methods, including computerized tomography (CT) and magnetic resonance imaging (MRI) scans. But, no matter how sophisticated today’s diagnostic tests are, these results can be deceptive and can lead to unnecessary surgery. In fact, there is little or no hard evidence of an existing link between disk abnormalities and back pain.

Treatment of Back Pain

Bed rest is no longer considered a good advice for somebody who suffered a muscle spasm, the most frequent cause of back pain. Instead, doctors encourage people to resume light activity, such as walking, as soon as possible.

Pain medications. Over-the-counter analgesics, such as acetylsalicylic acid (Aspirin), ibuprofen (Advil, Motrin), acetaminophen (Tylenol, Panadol) or naproxen (Aleve, Naprosyn), can be used to ease the discomfort. If over-the-counter painkillers do not bring relief, your doctor will prescribe stronger analgesics, such as combination medications of opioid and acetaminophen (Vicodin or Percocet) or muscle relaxers, like diazepam (Valium) or methocarbamol (Robaxin). Injections can be more effective for pain relief than oral medications, hence, your doctor may offer an injection of procaine to relieve a muscle spasm or, if the pain is too severe, a steroid injection to reduce inflammation and relieve the pressure of a disk on a nerve. For long-term chronic back pain, a pain modifying medication, such as the antidepressant duloxetine (Cymbalta), may sometimes be prescribed.

Chiropractic. A large number of back pain sufferers are referred to chiropractors for treatment. Chiropractors use hands-on spinal adjustments to make more room for the nerves exiting the spine, break up adhesions to keep the spine flexible, relax muscles via sudden stretching and move displaced vertebrae back into place. Spinal manipulation is considered a safe, effective treatment for acute low back pain, which does not last longer than six weeks. If adjustment shows promise, a course of ten to twelve sessions over four weeks is usually recommended.

Physical therapies include various techniques ranging from massage, heat and cold applications, ultrasound to rehabilitative exercises. Basic therapy involves alternating heat and cold applications to relieve inflammation combined with gentle back massage. Ultrasound is used for acute lower back pain to warm the area in order to bring blood flow and healing nutrients to the affected region. Rehabilitative exercises, aimed at stretching and strengthening the back and abdominal muscles, not only reduce the risk of future back injuries, but also help to ease current pain.

Acupuncture can be also used to treat chronic back pain. Both, traditional acupuncture and simulated acupuncture bring relief. Studies show that acupuncture stimulates the production of the body’s natural pain killer called endorphin and/or possibly interferes with the perception of pain.

Surgery is a treatment of last resort and should only be recommended to the patient when other non-surgical therapies failed to bring substantial relief from back pain. Many surgeons agree that people with typical back pain do not need surgery. You should know that surgery can make a condition worse. Despite that surgery continues to be a frequently used back pain treatment option, which is probably a result of its powerful placebo effect.

However, surgery cannot be always avoided. For instance, many sciatica patients need surgery in order to prevent serious nerve damage. In some cases operation must be performed on an emergency basis, for example, in patients with loss of bladder or bowel control or with progressive leg weakness, as these symptoms may indicate a presence of a condition called cauda equina syndrome. Surgery is known to have the greatest chance for success if pain extends down the leg, below the knee. Paradoxically, back pain alone without leg pain, though a less serious condition, can have multiple causes that are far less likely to be corrected by surgery.

The most commonly used surgical procedures for back pain include:

  • Percutaneous discectomy is a technique designed to remove damaged portions of the disk using a tiny probe inserted through the skin (percutaneous actually means “through the skin”).
  • Microdiscectomy, also known as microdecompression spine surgery, is typically performed for a herniated lumbar disk with a microscope or magnification loop through an incision about an inch long.
  • Laminectomy or open decompression is used to remove a small portion of the bone over the nerve root and thus relieve pressure on the nerves. Laminectomy surgery differs from a microdiscectomy in that there is more muscle stripping and the incision is longer.
  • Laser discectomy is a minimally invasive procedure performed with a tiny scope and a laser beam to vaporize the affected part of the disk.
  • Spinal fusion. The aim of spinal fusion surgery is to stabilize the spine by joining vertebrae together with a bone graft. Reducing the motion at a painful vertebral segment should decrease pain generated from the joint without significantly limiting the patient’s activity.

Alternative treatments. When all standard medical therapies fail, some chronic back pain sufferers are turning to alternative treatments ranging from hypnosis and yoga to biofeedback and electrical nerve stimulation. The aim of these therapies is to alter the perception of pain and/or to override pain signals.

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