A physiotherapist, Oluwafemi Ijaola, speaks about back pain and how to avoid it with DOLAPO AKITOYE
What is back pain?
Back pain is basically a term used to define or probably describe pain in the back. It is as simple as that but the thing is that your back is divided into three segments – your upper back, your mid back and the low or lower back. For a lot of people, what they usually feel more is what is known as low back pain; that is the most common type. They call it low back pain, LPB for short or lumbago, which is another medical term for it. That simply describes pain in your low back.
As I said, your upper back is your upper thoracic; your mid-back is the mid-thoracic and the lower back is the lumbar area or the lumbosacral. When we talk about low back pain, which is the most common, it simply describes pain in the lumbosacral region.
What are the symptoms of back pain?
Back pain can be categorised into two. We have acute or chronic back pain. Acute is of short duration which is less than three months. Chronic is more than three months; so, the number one symptom is pain. Now, we have different types of pain based on the causes. For some people, it starts like a dull ache. For some people, it’s like a shooting or stabbing pain – something very severe. We can say the number one symptom is pain, which describes the name itself but the pain is now categorised into maybe, dull ache or stabbing pain and sharp pain.
Can back pain signify worse situation in the victim’s body?
Definitely! This is because most back pain is mechanical. It is mechanical in the sense that once you have an affectation, an injury or a diseased state of either the spine, the bones of the spine – which we call vertebrae – or the ligaments of the spine, the nerves of the spine or structures of the spine basically, you begin to feel back pain. However, it is not limited to that. Sometimes, there are medical conditions that once you have them, the pain can now be referred to your back. We have infections of the spine, visceral organs – maybe tumour, things like that. Sometimes, low back pain can be an indication of some other serious underlying pathology.
How can it be diagnosed?
Number one: If somebody comes to you complaining about back pain, the diagnosis actually starts from history taking. You want to ask, ‘what is the outset of the pain?’, because there are several causes of back pain and that can help you to streamline before you start telling the patient to go for a test.
If you report a back pain, I want to ask certain questions like ‘is the outset of the pain related to any activity or any injury?’ Sequel to that, you can now start telling your patient to probably go for X-ray or MRI as the case may be.
What are the ways of preventing it?
For example, certain back pains can be as a result of bad posture. If we take pain caused by bad posture and bad care of the back, we usually tell such patients that they need to take proper care of their back to prevent it. It starts from where you sit; what kind of seat do you use when you sit? We always admonish them that when they sit, they should use a proper chair. It is not every chair that is good for one to sit on. You must be able to conform to the curvature of your spine. While working in an office or in the house, use a proper chair.
Number two is sleeping surface – your mattress. You should be able to use something that is firm – something that doesn’t sag. It doesn’t have to be hard. Another thing is what we call, proper lifting techniques. When you want to lift anything or you want to do activities that will entail you going to the ground, use your knees and not your back.
Those are some of the ways we tell people to prevent back pain due to posture. Also, prevention of back pain can even entail telling people that they should make sure they have a kind of lifestyle that makes them exercise regularly – not just jumping or jogging, but specific exercises tailored towards the back. For example, back extension exercises, flexion exercises and flexibility exercises to the back. Those are some of the ways you prevent back pain.
Can yoga help in preventing it?
Yoga is a form of exercise that people have said helps over the years, but it is not (if I may say), on the medical line. It is something probably outside of medicine but a lot of people have advocated that it helps in the prevention and even in the treatment of back pain.
What kind of daily activities of poor posture can lead to back pain?
For one, sweeping! If you are sweeping using a broom, you would be bending your back. Ironing is also another one that can cause back pain. That is why, when you are ironing, you need to use a proper height ironing board so that, you do not have to bend. Then, it goes beyond that. Even for people that carry back packs, there is a way you carry it that over time, you are stressing your back and that can cause back pain. When lifting things in the house, you go with your knees bent and not with your back bent.
Can a poor sleeping pattern cause back pain?
Yes, it can over time because as I said, you have curvatures of your spine. What happens is, if you don’t maintain a proper posture that will indirectly affect the curvature or the anatomy of the spine while you are sleeping.
By the time you wake up, you probably would have positioned your musculoskeletal structure in a shortened position. While trying to wake up, you need to stretch or elongate them and that comes with a lot of pain for many people.
What is a good sleeping position?
Well, for many people, we advocate side-line – when you sleep on your side – with a pillow in between your legs just to cushion your knee. For many people, lying on the back is not so comfortable or convenient. I don’t know but they even say spiritually, it is not so good but for many, we always advocate side-line.
How can back pain be treated?
Well, two ways basically, depending on the type or the cause — conservative management and surgical management. For conservative management — which is without surgery — it basically starts with bed rest for some. For back pain that is very severe in the acute stage, that you cannot even walk, bed rest is best prescribed. You might probably have to be in the hospital for some days. Doctors will prescribe anti-inflammatory drugs for cases where there is inflammation to reduce the effect of inflammation, then, analgesics.
Most times, when you have back pain, you have lots of muscle spasms. Medical practitioners tend to prescribe muscle relaxants and that is for the medical aspect. Also, there is physiotherapy. We use electrotherapy modalities like heat, cold, electrical stimulation and ultrasound to relieve pain; and exercise therapy to strengthen muscles and increase flexibility.
Basically, that is the conservative or non-surgical method of managing it. Once that fails and in severe cases, you need surgery.
What ages are more prone to back pain?
When we talk about back pain caused by degenerative changes which the lay man call arthritis, we usually call it lumbar spondylosis; it tends to be maybe like 50 and upwards. It is usually caused by wear and tear. Now, it is not like that anymore.
Now, you see people in their late twenties, early thirties and in their forties developing the conditions. This is probably because of occupational hazards. You have people sitting down, without exercising from morning till night which is about eight, nine and 10 hours. Also, lifestyle can be responsible. When you don’t take care of your back properly; poor diet and what you eat. We don’t take lots of anti-oxidants that help to fight degenerative process. It is not like it used to be before that it was streamlined to old age. We have many young people suffering from back pain.
Who are more susceptible to back pain between men and women?
It depends on the cause. For some reasons, maybe due to osteoporosis and all that, women tend to undergo the wear and tear faster because of post-menopausal osteoporosis and all that. However, all in all, that is not the only cause of lower back pain. We can have lower back pain as a result of injuries to the back, which is due to heavy lifting which a lot of men do often.
Most women tend to have back pain when they are pregnant. Is it possible for the pain to persist after they have given birth?
Yes, it is possible because what usually accounts for the back pain in pregnancy is postural imbalance. Now, you have the tummy protruding so you have what we call, exaggerated lordosis. Your low back is pushed inwards the more and that causes stretching and a kind of imbalance in the muscle.
After pregnancy, you need to do some exercises that will help to tone and firm up the muscles so that it can come to its normal shape.
What are the risk factors of back pain?
One of the risk factors – just like a number of other conditions – is obesity. Being overweight is one major one. We are talking about low back pain. You will discover that the heavier you are, the more you load your joints. That can pre-dispose you to developing back pain.
What are common myths of back pain?
I think one myth is that when people have back pain, they tend to associate it with pile but this is a misconception. You probably may be suffering from a postural dysfunction or a degenerative joint disease. I think that is one major myth and before you know it, they start taking all sorts of concoction, thinking it is pile.
Health facts:About back pain
- In only 2 per cent of cases where people have back pain, is surgery necessary. Physiotherapists, chiropractors and doctors can often sort out backaches. Surgery is sometimes necessary when back pain is relentless or the patient is experiencing nerve compression or incontinence.
- The spine consists of 33 bony segments, the vertebrae. The discs lie between these. They are tough and spongy and work as shock absorbers, and give the spine flexibility – the spine can in fact bend far enough to form two-thirds of a circle.
- If your back pain started after a trivial movement, such as picking up a book from the floor, you could have a slipped disc or a joint problem in your spine.
- Nerves from the spinal cord branch out and leave the spine through spaces between the vertebrae at the levels of the discs.
- Backache is second only to headaches as the most common location of pain.
- Many people who often have back pain, either lead inactive sedentary lives, or have inherited a genetic susceptibility to back pain.
- Severe intermittent back pain that goes down to your groin, could indicate that you have kidney stones.
- Vibration often causes back problems, which is why truck drivers often have backache.
- In any two-week period of time, between 25 – 33 per cent of all adults get some form of back pain.
- Cyclists often experience back pain, which can often be rectified by adjusting the angle of the bicycle seat.
- Back pain became a part of life when humans started walking upright, rather than one all fours. The vertebrae were never really designed to deal with walking upright.
- Pain in the middle of your back, which becomes worse after eating, could indicate a stomach ulcer.
- The spine, for all intents and purposes, is like a central scaffolding for the rest of the body. The skull, the ribs, the pelvis and the limbs are attached to it.
Source: Health24.com
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