A pain in the back!

Back pain is one of the most common reasons people go to the doctor or miss work and a leading cause of disability worldwide. Most people have back pain at least once. You can fortunately take measures to prevent or relieve most back pain episodes.

If prevention fails, simple home treatment and proper body mechanics often will heal your back within a few weeks and keep it functional for a long period. Surgery is rarely needed to treat back pain. If self-care does not help within two weeks, see your doctor.

In rare cases, back pain can signal a serious medical problem. Seek immediate care if your back pain:

1. causes new bowel or bladder problems;
2. is accompanied by fever;
3. follows a fall, blow to your back or other injury;
4. is severe and doesn’t improve with rest; v spreads down one or both legs, especially if the pain extends below the knee;
5. causes weakness, numbness or tingling in one or both legs;
6. is accompanied by unexplained weight loss; or
7. if you start having back pain for the first time after age 50, or if you have a history of cancer, osteoporosis, steroid use, or drug or alcohol abuse.

Causes

Back pain can come on suddenly and last less than six weeks (acute), which may be caused by a fall or heavy lifting. Back pain that lasts more than three months (chronic) is less common than acute pain. It often develops without a
specific cause that your doctor  can identify with a test or imaging study. Conditions commonly linked to back pain include:

1. Muscle or ligament strain. Repeated heavy lifting or a sudden awkward movement may strain back muscles and spinal ligaments. If you’re in poor physical condition, constant strain on your back may cause painful muscle spasms.
2. Bulging or ruptured disks. Disks act as cushions between the bones (vertebrae) in yourspine. The soft material inside a disk can bulge or rupture and press on a nerve. However, you can have a bulging or ruptured disk without back pain. Disk disease is often found incidentally  when you undergo X-rays.
3. Arthritis. Osteoarthritis can affect the lower back. In some cases arthritis in the spine can lead to a narrowing of the
space around the spinal cord, a condition called spinal stenosis.
4. Skeletal irregularities. Back pain can occur if your spine curves abnormally. Scoliosis, a condition in which your spine curves to the side, also may lead to pain, but only if the scoliosis is severe.
5. Osteoporosis. Your vertebrae can develop compression fractures if your bones become brittle. Risk factors:
6. Age. Back pain is more common as you get older, starting around age 30 or 40.
7. Lack of exercise. Weak, unused muscles might lead to back pain.
8. Excess weight. Carrying too much weight puts extra stress on your back.
9. Diseases. Some types of arthritis and cancer can contribute.
10. Improper lifting. Using your back instead of your legs.
11. Psychological conditions. People prone to depression and anxiety appear to have a greater risk.
12. Smoking. This can keep your body from delivering enough nutrients to the disks in your back.

Signs and symptoms

1. Muscle ache
2. Shooting or stabbing pain
3. Pain that radiates down your leg
4. Limited flexibility or range of motion of the back

Diagnosis

The doctor will assess your ability to sit, stand, walk and lift your legs. These assessments help determine where the pain comes from, how much you can move before pain forces you to stop and whether you have muscle spasms. They will also help rule out more serious causes of back pain. X-rays show the alignment of your bones and whether you have arthritis or broken bones.

MRI or CT scans can generate images that may reveal herniated disks or problems with bones, muscles, tissue, tendons, nerves, ligaments and blood vessels. Blood tests can help determine whether you have an infection. In rare cases, your doctor may use a bone scan to look for bone tumours or compression fractures caused by osteoporosis.

Treatment

Most back pain gets better with a few weeks of home treatment. Pain relievers and the use of heat or ice might be all you need. Bed rest isn’t recommended.

Medications

1. Muscle relaxants. Muscle relaxants can make you dizzy and sleepy.
2. Topical pain relievers. Use these ointments on the sore spot.
3. Narcotics. Codeine or hydrocodone may be used for a short time.
4. Antidepressants. Low doses of certain antidepressants – particularly the tricyclic variety – have been shown to relieve some aches.

About the author:

Dr Dulcy holds a MBBCH degree from Wits University, a diploma in occupational health, a diploma in HIV management, travel medicine diploma, masters of science in sports medicine, and a masters in business administration degree from GIBS  and is here to help! A social entrepreneur with a passion for providing healthcare and wellness solutions for low and middle-income communities in South Africa. Learn more about Dr Dulcy Rakumakoe here.

*Always consult your pediatrician, gynecologist or health-care provider for all health matters relating to you and your children.

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