: Admin : 2022-03-01

 What is back pain?

Physical discomfort occurring anywhere on the spine or back, ranging from mild to disabling is known as back pain. It is very common and may affect most of us at some point in our lives, usually by strain caused on a muscle or ligament. But luckily for us, most of the time it is not serious and can be resolved with everyday activities and basic exercises.

How does our back work?

Our back is the rear surface of the human body from the shoulders to the hips. The back supports the weight of the body, allowing for flexible movement while protecting vital organs and nerve structures.

 The back comprises the spine and spinal nerves, as well as several different muscle groups. The spine itself has three main segments: the cervical spine, the thoracic spine, and the lumbar spine. The cervical is the upper part of the spine, made up of seven vertebrae (bones). The thoracic is the centre portion of the spine, consisting of 12 vertebrae. The lower portion of the spine is called the lumbar spine.  A healthy spine has three natural curves that make an S-shape. These curves absorb shocks to your body and protect your spine from injury. 

What are the different parts of the spine and how do they work?

The different parts making up the spine are:-

• Vertebrae: The spine has 33 stacked vertebrae (small bones) that form the spinal canal. The spinal canal is a tunnel that contains the spinal cord and nerves, protecting them from injury. Most vertebrae move to allow for a range of motion. The lowest vertebrae (sacrum and coccyx) are fused together and don’t move.
• Spinal cord and nerves: This neural structure is a column of nerves that travels through the spinal canal. The cord extends from the skull to the lower back. Thirty-one pairs of nerves branch out through vertebral openings (the neural foramen). These nerves carry messages between the brain and muscles.
• Soft tissues: Ligaments connect the vertebrae to hold the spine in position. Muscles support the back and help you move. Tendons connect muscles to bone and aid movement.
• Intervertebral disks: These flat, round cushions sit between the vertebrae and act as the spine’s shock absorbers. Each disk has a soft, gel-like centre (the nucleus pulposus) surrounded by a flexible outer ring (the annulus). Intervertebral disks are under constant pressure. A herniated disk can tear, allowing some of the nucleus’ gel substance to leak out. Herniated disks (also called bulging, slipped or ruptured disks) can be painful.
• Facet joints: These spinal joints have cartilage (a slippery connective tissue) that allows vertebrae to slide against each other. Facet joints let you twist and turn, and they provide flexibility and stability. These joints can develop arthritis and cause back pain or neck pain.

What are the different spine segments?

The 33 vertebrae make up five distinct spine segments. Starting at the neck and going down toward your buttocks (rear end), these segments include:

• Cervical (neck): The top part of the spine has seven vertebrae (C1 to C7). These neck vertebrae allow you to turn, tilt and nod your head. The cervical spine makes an inward C-shape called a lordotic curve.
• Thoracic (middle back): The chest or thoracic part of the spine has 12 vertebrae (T1 to T12). Your ribs attach to the thoracic spine. This section of the spine bends out slightly to make a backward C-shape called the kyphotic curve.
• Lumbar (lower back): Five vertebrae (L1 to L5) make up the lower part of the spine. Your lumbar spine supports the upper parts of the spine. It connects to the pelvis and bears most of your body’s weight, as well as the stress of lifting and carrying items. Many back problems occur in the lumbar spine. The lumbar spine bends inward to create a C-shaped lordotic curve.
• Sacrum: This triangle-shaped bone connects to the hips. The five sacral vertebrae (S1 to S5) fuse as a baby develops in the womb, which means they don’t move. The sacrum and hip bones form a ring called the pelvic girdle.
• Coccyx (tailbone): Four fused vertebrae make up this small piece of bone found at the bottom of the spine. Pelvic floor muscles and ligaments attach to the coccyx.

What are the common causes of back pain?

Back pain commonly stems from strain, tension, or injury. Frequent causes of back pain are strained muscles or ligaments, a muscle spasm, muscle tension, damaged disks, injuries, fractures, or falls. Activities that can lead to strains or spasms include lifting something improperly, lifting something that is too heavy or making an abrupt and awkward movement.

Back pain can also result from some everyday activities or poor posture. Examples include twisting, coughing or sneezing, muscle tension, over-stretching, bending awkwardly or for long periods, pushing, pulling, lifting, or carrying something, standing or sitting for long periods, straining the neck forward, such as when driving or using a computer, long driving sessions without a break, even when not hunched or sleeping on a mattress that does not support the body and keep the spine straight.

The following factors are linked to developing low back pain-occupational activities, pregnancy, a sedentary lifestyle, poor physical fitness, older age, obesity and excess weight, smoking, strenuous physical exercise or work, especially if done incorrectly, genetic factors, medical conditions, such as arthritis and cancer,

Lower back pain also tends to be more in women than in men, possibly due to hormonal factors. Stress, anxiety, and mood disorders have also been linked to back pain.

A number of structural problems may also result in back pain.

• Ruptured disks: Each vertebra in the spine are cushioned by disks. If the disk ruptures there will be more pressure on a nerve, resulting in back pain.
• Bulging disks: In much the same way as ruptured disks, a bulging disk can result in more pressure on a nerve.
• Sciatica: A sharp and shooting pain travels through the buttock and down the back of the leg, caused by a bulging or herniated disk pressing on a nerve.
• Arthritis: Osteoarthritis can cause problems with the joints in the hips, lower back, and other places. In some cases, the space around the spinal cord narrows. This is known as spinal stenosis.
• Abnormal curvature of the spine: If the spine curves in an unusual way, back pain can result. An example is a scoliosis, in which the spine curves to the side.
• Osteoporosis: Bones, including the vertebrae of the spine, become brittle and porous, making compression fractures more likely.
• Kidney problems: Kidney stones or kidney infections can cause back pain.

What are the symptoms of back pain?

Some back issues can cause pain in other parts of the body, depending on the nerves affected. The pain often goes away without treatment, but if it occurs with any of the following people should see their doctor. These symptoms are weight loss, fever, inflammation or swelling on the back, persistent back pain, where lying down or resting does not help, pain down the legs, pain that reaches below the knees, a recent injury, blow or trauma to the back, urinary incontinence, difficulty urinating faecal incontinence, or loss of control over bowel movements, numbness around the genitals or numbness around the anus or numbness around the buttocks.

What is the medication or treatment for back pain?

The majority of back pain episodes by treatment with non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Motrin, Advil) and naproxen (Aleve). Analgesics, such as acetaminophen (Tylenol), are another category of pain relievers. They are also an option for back pain, though they don’t have anti-inflammatory properties. It is advised to be careful with medications like ibuprofen if you have kidney problems or stomach ulcers. Never take more than the recommended dose of over-the-counter medications without a doctor’s recommendation, as even these medications may have severe side effects if taken incorrectly.

Rubs and ointments are also highly effective for reducing back pain and calming down inflamed muscles in the form of gels, lotions, creams, patches and sprays. Muscle relaxants can be helpful if muscle spasms occur alongside pain.

Physical therapy: Applying heat, ice, ultrasound, and electrical stimulation — as well as some muscle-release techniques to the back muscles and soft tissues — may help alleviate pain. As the pain improves, the physical therapist may introduce some flexibility and strength exercises for the back and abdominal muscles. Techniques for improving posture may also help. The patient will be encouraged to practice the techniques regularly, even after the pain has gone, to prevent back pain recurrence.

Surgery is usually reserved for those with structural abnormalities that haven’t responded to non-surgical treatment with medication and therapy. Surgery may be an option for people with severe, constant pain with identifiable structural abnormalities, nerve compression that causes muscles to become weak and spinal cord compression that limits daily activities.

Complementary therapies may be used alongside conventional therapies or on their own. Chiropractic, osteopathy, shiatsu, and acupuncture may help relieve back pain, as well as encourage the patient to feel relaxed.

• An osteopath specializes in treating the skeleton and muscles.
• A chiropractor treats joint, muscle and bone problems. The main focus is the spine.
• Shiatsu, also known as finger pressure therapy, is a type of massage where pressure is applied along energy lines in the body. The shiatsu therapist applies pressure with the fingers, thumbs and elbows.
• Acupuncture originates from China. It consists of inserting fine needles and specific points in the body. Acupuncture can help the body release its natural painkillers — endorphins — as well as stimulate nerve and muscle tissue.
• Yoga involves specific poses, movements, and breathing exercises. Some may help strengthen the back muscles and improve posture. Care must be taken that exercises do not make back pain worse.

Studies on complementary therapies have given mixed results. Some people have experienced significant benefits, while others have not. It is important when considering alternative therapies, to use a well-qualified and registered therapist

How to prevent back pain?

Exercise: Regular exercise helps build strength and control body weight. Guided, low-impact aerobic activities can boost heart health without straining or jerking the back. Before starting any exercise program, talk to a health care professional. Core-strengthening exercises work the abdominal and back muscles, helping to strengthen muscles that protect the back and Flexibility training aims at improving core flexibility, including the spine, hips, and upper legs are highly effective.

Diet: Make sure your diet includes enough calcium and vitamin D, as these are needed for bone health. A healthful diet also helps control body weight.

Smoking: A significantly higher percentage of smokers have back pain incidences compared to non-smokers of the same age, height, and weight.

Bodyweight: The weight people carry and where they carry it affects the risk of developing back pain. The difference in back pain risk between obese and normal-weight individuals is considerable. People who carry their weight in the abdominal area versus the buttocks and hip area are also at greater risk.

Posture when standing: Make sure you have a neutral pelvic position. Stand upright, head facing forward, back straight, and balance your weight evenly on both feet. Keep your legs straight and your head in line with your spine.

Lifting: When lifting things, use your legs to do the lifting, rather than your back to avoid heavy strain. Keep your back as straight as you can, keeping your feet apart with one leg slightly forward so you can maintain balance. Bend only at the knees, hold the weight close to your body, and straighten the legs while changing the position of your back as little as possible. Bending your back initially is unavoidable, but when you bend your back try not to stoop, and be sure to tighten your stomach muscles so that your pelvis is pulled in. Most important, do not straighten your legs before lifting, or you will be using your back for most of the work.

Do not lift and twist at the same time: If something is particularly heavy, see if you can lift it with someone else. While you are lifting keep looking straight ahead, not up or down, so that the back of your neck is like a continuous straight line from your spine.

Moving things: It is better for your back to push things across the floor, using your leg strength, rather than pulling them.

Shoes: Flat shoes place less of a strain on the back.