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Back Pain

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Conditions

Back Pain

What is Back Pain?
Back pain is one of the most common medical problems experienced by most people at some time in their life. It can be acute, usually lasting from a few days to a few weeks, or chronic, lasting for more than three months. It is really important that we discourage people from being afraid of back pain as it is well understood that, in a lot of people, the emotional and psychological experience of back pain can be a primary factor in prolonging the symptoms and preventing people from returning to happy, healthy, active lives.
Back pain can occur as a dull constant pain or a sudden sharp pain. It may be confined to one area or radiate to other areas such as the arm and hand, upper or lower back, and leg or foot.
Other than pain, some people may experience weakness, numbness or tingling in your arms or legs caused by irritation of the nerves or the spinal cord.
Back pain is a complex problem and although some sports or certain jobs are often associated with back pain, the cause of back pain can be wide and varied, including trauma, too much activity and not enough activity.
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causes, diagnosis & treatments for back pain

Causes of Back Pain

The common causes of back pain in athletes include:

  • Intervertebral disc injuries: the discs that sit between the spinal bones can become inflamed, and sometimes can herniate, or bulge. Some people refer to this as a “slipped disc” but in reality it is almost never the case that the disc actually moves out of position. It is perhaps easier to think of this as either irritated, or not irritated. Statistically, the majority of adults over the age of 35 will have some element of naturally occurring degeneration in their lower lumbar discs which is quite commonly not painful. In sport, lifting injuries are often associated with acute injury of the disc.
  • Musculoligamentous joint strain: a strain of the joints involves over stretching the ligaments and capsule that surround the joint between two bonus surfaces. This is very common injury and in most people this pain will improve in a matter of weeks without ongoing problems.
  • Spondylitis: is an inflammatory condition of the spinal bones. This can occur for a number of reasons with management typically involving strengthening and mobility exercises to reduce pain and keep people functioning.
  • Spondylolysis: is an overloading of the bony segments in the spine, causing a stress response or stress fracture in part of the vertebrae. These typically improve with a period of reduced activity followed by a period of strengthening and a supervised, graduated return to activity.
  • Spondylolisthesis: is a condition of the spine that occurs when one vertebra is displaced or has slipped forward over the other below it.
  • Other causes include inflammatory conditions such as rheumatoid arthritis, Ankylosing Spondylitis, growth-related problems such as scoliosis and Scheuermann's kyphosis.
Your physiotherapist will diagnose back pain by reviewing your history and symptoms and examining your spine. A complete examination includes the examination of the signs of unusual curves of the spine, rib hump, tilted pelvis and tilting of the shoulders, and a test of your sensations. Other diagnostic tests may be needed, and if appropriate your physiotherapist will assist with onward referral for these.
The treatment for back pain is usually non-surgical and includes:
  • Exercises to strengthen your trunk and back muscles.
  • Manual therapy such as joint mobilisations, manipulation, and massage to promote movement and reduce pain
  • Anti-inflammatory medications or NSAIDs can provide relief from the pain and may be recommended by your GP or pharmacist
  • Acupuncture can provide very good pain relief for some people
  • Cold packs or heat packs, or both, may help alleviate much of the discomfort and feeling of stiffness
  • Some rest initially may help in the first few days, but more than a few days of immobility can be associated with longer recovery times and delayed return of function.

These measures help to relieve your back pain and in the vast majority of cases people will improve in a period of 4-12 weeks. In certain circumstances, some people do not improve and a referral to a Consultant is required for further intervention such as spinal injections, and very occasionally, surgery. If this is the case, our physiotherapist will be able to advise you and facilitate onward referral.

Low Back Pain

Low back pain is often a common symptom of many disease conditions and the back pain may range from simple or dull pain to sudden and sharp pain. If the pain persists for a few days, it is acute pain whereas if it continues for more than 3 months, it is considered as chronic pain. In most cases, low back pain may resolve without any treatment, however, if it persists for more than 3 days, medical intervention is necessary.

Low back pain may be a common symptom in various conditions such as appendicitis, aneurysms, kidney diseases, kidney and bladder infections, ovarian disorders, pregnancy, nerve root syndromes such as sciatica, herniated discs, spinal stenosis, musculoskeletal problems, osteomyelitis, spondylitis, tumors, spine injuries, fractures, and many more.

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causes, diagnosis, treatments & prevention for low back pain

Low back pain can be alleviated with rest and RICE (Rest, Ice, Compression, and elevation) treatment, pain relievers, non-steroidal anti-inflammatory drugs, corticosteroids, and physical therapy. However, certain conditions causing severe pain may require surgical treatment. Treating the underlying conditions offers relief from back pain.

Causes of Low Back Pain

One of the common causes of low back pain is a low back strain. Low back strain or lumbar strain occurs when the muscle or the tendon in the lower back gets stretched or torn. It is caused by lifting heavy objects or overload, sitting or standing for a longer time, direct blow over the area, or sports such as basketball, baseball, or golf that involve sudden twisting of the lower back, can also lead to strain.

The risk factors such as excess low back curvature, weak abdominal muscles, and forwardly tilted pelvis can increase the risk of this injury. The common symptoms include low back pain that radiates down to the buttocks; inflammation of the soft tissues that surround the muscles; stiffness in the lower back; restricted movements; inability to maintain correct posture; muscle spasms; and pain which continues for a longer period.

Your doctor will perform a physical examination and take a brief medical history to diagnose your child’s condition. Other additional tests such as X-ray and MRI scan may be required to confirm the injury and provide necessary treatment.

Conservative treatment methods include:

  • Rest: Your child should take complete rest for 1-3 days, as more damage could result from putting pressure on the back. Prolonged bed rest should also be avoided as it leads to loss of muscle strength and makes the muscles stiff which will aggravate pain and discomfort. Hence bed rest should not be continued for more than 48 hours.
  • Ice packs can be applied to the injury which will help to diminish swelling and pain.; Ice should be applied over a towel to the affected area for 15-20 minutes four times a day for several days. Never place ice directly over the skin.
  • Braces or belt might be used to support the back while the healing happens.
  • Medications that may be prescribed include non-steroidal anti-inflammatory drugs to reduce pain and inflammation. Other medicines such as muscle relaxants control muscle spasms. These medicines often cause sedation; therefore, consult your doctor to discuss the type of muscle relaxants for your child.
  • Your doctor may also suggest a rehabilitation program for your child. It consists of stretching and strengthening exercises, pelvic traction, gentle massages, and ice or heat therapy to improve your child’s condition. It helps to control the pain, strengthen the abdominal muscles, and also speeds up the recovery which allows your child to return to the weight-bearing activities.
Some of the preventive measures which can help prevent back strain in children include:
  • Doing warm-up exercises before the start of any physical activity or sports and taking short breaks in between the activity.
  • Ensure that your child uses correct lifting techniques such as squatting to lift a heavy object.
  • Ensure that your child maintains a proper posture while sitting and standing.
  • If your child is overweight or obese, it can strain the back muscles. Hence, it is advised that your child lose some weight and maintain a healthy diet.
  • Encourage your child to exercise every day as it improves spine stability and also prevents extra stress on your child’s back.
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