Dealing with back pain for too long?

What is lower back pain?

Low back provides structural support, movement and protection to body tissues. It supports the upper body while standing, extends at the waist when a person bends, and rotates at the waist upon movement. The lumbar spine and the surrounding muscles in the lower back protect the spinal cord and the nervous tissue, along with the nearby organs of the abdomen and pelvis. Pain in the back, anywhere below the ribs and above the legs (lumbar region) is referred to as low back pain. This region of the back bears most of the body's weight and can be easily hurt as part of routine life while lifting, reaching or twisting. It is counted among one of the most common ailments, and almost everyone experiences low back pain at some point or another.

What are the causes of the disorder?

Low back pain can be caused due to:

1. Injury, strain or overuse
2. Age
3. Nerve irritation
4. Arthritis
5. Bone and joint conditions (congenital, degenerative or arthritis)
6. Illness

What one needs to know about symptoms or signs?

Low back pain can be felt as a dull or sharp pain or muscle spasms, in a small area or over a broad area, and can result in a variety of symptoms depending on the cause. Low back pain can also lead to pain, numbness or tingling feeling in the leg, sometimes extending below the knee if the nerves in the lower spine are affected. An emergency condition, known as cauda equine syndrome that occurs when the nerves of the spine get compressed causes numbness or weakness in the legs and loss of bladder or bowel control. Low back pain can be short-term (acute) that goes away in a few weeks, or can be long-lasting (chronic) if affected by other factors like stress or depression.

What are the screening tests and investigations done to confirm or rule out the disorder?

The doctor will begin examination by asking few questions about the patient's medical history, symptoms, nature of work and physical activity. The cause of pain will be deduced through a detailed understanding of the patient's records and lifestyle and physical examination. Symptomatic relief and rest are able to manage most back pain within four weeks. However, further tests will be done in case pain persists beyond four weeks. Tests for back pain include x-rays, magnetic resonance imaging (MRI) and computed tomography (CT) scan. Bone scan or electromyogram and nerve conduction may also be conducted to look for bone, muscle or nerve problems that could be causing the low back pain.

What treatment modalities are available for management of the disorder?

1. Rest
2. Pain relief medication
3. Exercise
4. Alternate therapy - Massage, spinal manipulation, acupuncture
5. Physical therapy
6. Surgery

What are the dietary and physical activity requirements during the course of the treatment?

Eating a healthy diet with sufficient calcium and vitamin D can help prevent osteoporosis, a condition that can lead to low back pain and compression fractures.

How can the disorder be prevented from happening or recurring?

There is no concrete evidence that low back pain can be prevented, but certain measures can help prevent it from occurring. These include exercise to keep back strong, maintaining proper posture while sitting and standing, lifting weights carefully, sleeping in positions that protect the back, maintaining a healthy body weight, quitting smoking (smoking increases sensitivity to pain and increases risk of osteoporosis), and managing stress.

How can a caregiver give support and help the patient cope with the disorder?

Family members of friends can offer support by providing encouragement to get through treatment, help out with daily tasks, and getting involved in the medical care by going along during doctor visits.

Effects low back pain on life

Pain in the low back is a very common problem and is one of the most frequent reasons why people seek medical help. While there are treatment options available to manage and relieve low back pain, it can affect a person's daily life - from dealing with the pain to managing the various physical, emotional and practical (like loss of productivity at work) consequences that come along with it.

Dealing with chronic back pain

While short-term acute low back pain can be treated with adequate rest, painkillers and ice or heat treatment, those dealing with chronic back pain (lasting over three months) require more intensive, long-term treatment, and often one type of treatment does not stop pain. Some choices include acupuncture, chiropractic treatment (that works on muscles and bones), massage therapy (rubbing the soft tissues of affected area to reduce tension and improve blood flow) or a comprehensive rehabilitation programme.

Managing daily activities

Low back pain can take a toll on daily life and add limitations to a day's routine. Rest is recommended for first couple of days, but gentle movement is encouraged later to keep muscles strong. However, some modifications in movement will be required. These include:

1. Restriction on bending, lifting or reaching to avoid extra stress on back.
2. Modifying sleeping position to keep back supported. Sleeping on the side with a pillow between the knees or lying on the back with a pillow placed under the knees helps.
3. Placing a small pillow or rolled-up towel in the curve of the back while sitting.
4. Taking support while getting dressed (avoiding bending over and instead leaning against a wall and bringing knees while putting clothes on).
5. Keeping a foot on a stool while brushing teeth.

Posture modification

Extra care is needed to support the back while sitting or standing. An affected person must take care while lifting items - should bend the knees and flex from the hips, avoiding any slump in spine. Sitting or standing position must be straight, but should not arch the back too much. Slouching and slumping must be prevented as they cause stress on the back.

Managing stress

Stress is harmful to low back pain, as it causes back muscles to become tense. Aside from worries of home and work, even worrying about an existing back pain can worsen the pain.

Managing weight

Those suffering from low back pain need to maintain a healthy weight, especially around the waist, as extra body weight puts a strain on the back. Physical inactivity also results in weak and inflexible muscles. This necessitates lifestyle changes to manage weight and the back pain. Healthy eating habits must be adopted and physical activity should be added as part of the day with consultation of the doctor.

Quitting smoking

Smoking increases the time of recovery from any injury, including back pain. Also, people who smoke are more susceptible to back pain than those who don't because nicotine and other toxins in the smoke prevent vital nutrients in the bloodstream from reaching the spinal discs, increasing the chances of spinal disc injury. The spinal discs cushion the spine's bones, and injury to them will lead to low back pain. This is why quitting smoking becomes an important lifestyle change requirement to heal back pain.

Effect on emotional health

Low back pain can take a toll on a person's emotional and mental health. Fear, frustration, anger, anxiety and depression are common among those dealing with an ongoing back pain. Not being able to carry out regular tasks, inability to concentrate at work or even asking for support from others can bring a person's confidence and morale down. However, it is possible to seek support from friends and family and work with health professionals to create a plan to return to normal duties, and learn new solutions to carry out same job duties in a different fashion to avoid stress on the back. Image Source: sokoyaka