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Backache (Lumbago) :- Causes, Symptoms, Prevention, Diagnosis and Home treatment of Backache ( Lumbago )

The back includes the area from below your neck to tail bone. It is composed of the bones of the spine (vertebrae); the joints that guide the direction of movement of the spine; the discs that separate the bones of the spine and absorb shock as you move; and the muscles and ligaments that hold them all together. One or more of these structures can be stressed, causing pain Overuse or a sudden or improper movement can result in irritation of the spinal ligaments, the muscles in the back, or the sacroiliac joints (the joints between the spine and either side of the pelvis). One can damage his or her discs the same way so that they stretch or even rupture.

If the tear is large enough, the jelly­like material inside the disc may leak out and press against a nerve. The nerve may also become irritated due to swelling or inflammation in other parts of the back.

Any of these injuries can result in 2 ' or 3 days of acute pain and swelling in the injured tissue, followed by slow healing and a gradual reduc­tion in pain. The pain may be felt in the low back, in the buttock, or down the leg (this type of pain is called sciatica). The goals of self-care are to relieve pain, promote healing, and avoid re injury.

Symptoms of Backache (Lumbago)

Symptoms of backache differ from one per­son to another. Among the common symptoms are pain together with stiffness, which may de­velop slowly or suddenly. It may be a continu­ous ache or it may occur only in a certain posi­tion. Coughing and sneezing as well as bending and twisting make the pains worse. Sometimes the pain is localized at one spot. Most common sites are-lumbago (pain is centered in the small of the back), coccydynia (localized pain at the very base of the spinal column) and, sciatica (a type of neuralgia with shooting pain through the buttocks). The attack frequently comes on very suddenly. The individual may be moving about freely without any pain and the next mo­ment, when in the act of stooping or rising from a sitting posture, he may have a 'catch in the back.' leading to an attack of backache. It usu­ally lasts eight or ten days, but sometimes it may last for several weeks.

Causes of Backache (Lumbago)

Those who lead a cushioned life, sit and sleep on foamy mattresses are more prone to backaches. Backache may be caused by over­straining, sudden jerk, poor posture, weight lift­ing, prolonged sitting and fatigue. There is strain on the part in such a way that the bones. liga­ments, nerves or muscles of the spine are pressed too tightly together or stretched too far apart. A sudden action using the muscles is likely to cause acute strain. The pain is sharp and persistent following such unusual strain.

Back pain can also be caused by con­ditions that affect the bones and joints of the spine. Arthritis pain may be a steady ache, unlike the sharp, acute pain of strains, sprains, and disc injuries. If you think your back pain may be caused by arthritis, combine the self-care guidelines for back pain with those for arthritis

Osteoporosis weakens the bones of the spine, which can lead to com­pression fractures. Compression fractures cause vertebrae to collapse. This can cause misalignment of the spine, which may put pressure on the discs and spinal nerves and lead to varying degrees of pain.

What is Back Surgery

Doctors recommend back surgery much less often now than in the past. Rest, pain relievers, and exercise can relieve almost all back problems, even disc problems.

Surgical procedures are appropriate for certain conditions that do not improve with time, exer­cise, and pain medication. Getting all the facts and thinking about your own needs and values will help you make a wise decision about treatment. If you do plan to have surgery, the body mechanics guidelines and exercises in this chapter are still important. A strong, flexible back will help you recover more quickly after surgery.

Diagnosis of Backache (Lumbago)

In addition to diagnosing the cause of back pain and evaluating back injuries, a doctor may also:

Help you develop an individual­ized exercise and home care plan or modified work plan if needed.

Prescribe muscle relaxants, anti­ inflammatory drugs, and pain relievers. Note: If you do get a strong painkiller or muscle relaxer, it is especially important to avoid postures and activities that could cause you to reinjure your back.

Suggest physical therapy.

Recommend back surgery.

Prevention of Backache (Lumbago)

The keys to preventing back pain are to use good body mechanics and to practice good health habits, such as getting regular exercise, avoiding tobacco, and maintaining a healthy body weight. The rest will come in handy if you are ever suffering from

Exercises to Avoid Backache (Lumbago)

Many common exercises actually increase the risk of low back pain. Avoid the following:

Straight-leg sit-ups.

Bent-leg sit-ups when you have acute back pain. (These may be safe to do if you make sure to keep your lower back pressed against the floor.)

Leg lifts (lifting both legs while lying on your back).

Lifting heavy weights above the waist (military press, biceps curls while standing).

Any stretching done while sitting with the legs in a V.

Toe touches while standing.

Home Treatment for Backache (Lumbago)

•  Immediately after an injury and for the next few days, the most impor­tant home treatment includes the following:

•  Sit or lie in positions that are most comfortable and reduce your pain especially any leg pain.

•  Do not sit up in bed, and avoid soft couches and twisted position.

•  Avoid sitting for long period of time.

•  Frequent rests, lying down during the day, can help relieve back pain but may not speed healing. Unless you have severe leg pain, 1 to 3 days of frequent rest should relieve pain. More than 3 days of bed rest is not recommended and could actually delay healing.

•  For resting, try one of the following positions.

•  Lie on your back with your knees Dent and supported by large pil­lows, or lie on the floor with your legs on the seat of a sofa or chair.

•  Lie on your side with your knees and hips bent and a, pillow between your legs.

•  If it doesn't increase your pain, lie on your stomach.

•  Relax your muscles.

•  Try putting ice on your lower back.

•  After 2 to 3 days of home treatment:

•  You can apply heat to your sore back 72 hours after injury occurs. Apply heat for 20-minute periods. Moist heat (hot packs, baths, show­ers) works better than dry heat.

•  Some people find comfort in alter­nating between heat and ice packs, or using ice only.

•  Continue daily walks (increase to 5 to 10 minutes, 3 to 4 times a day).

•  Try swimming, which is good for your back. It may be painful immediately after a back injury, but lap swimming or kicking with swim fins often helps prevent back pain from recurring.

•  When your pain has improved, begin easy exercises that do not increase your pain. Start with 5 repetitions 3 to 4 times a day and increase to 10 repetitions, as you are able.

•  Try swimming, which is good for your back. It may be painful immediately after a back injury, but lap swimming or kicking with swim fins often helps prevent back pain from recurring.

•  When your pain has improved, begin easy exercises that do not increase your pain. Start with 5 repetitions 3 to 4 times a day and increase to 10 repetitions, as you are able.

When to Call a Health Professional

•  If you lose bowel or bladder control.

•  If you cannot walk or stand.

•  If you have new numbness in the genital or rectal area.

•  If you have leg weakness that is not solely due to pain. Many people with low back pain say their legs feel weak. However, if leg weakness is so severe that you are unable to bend your foot upward, get up out of a chair, or climb stairs, you should see a doctor.

•  If you develop a new, severe pain in your lower back that does not change with movement and is not related to stress or muscle tension. . If you have new or increased back pain with unexplained fever, pain­ful urination, or other signs of a urinary tract infection.

•  If you have a dramatic increase in your chronic back pain, especially if it is unrelated to a new or changed physical activity.

•  If you have a history of cancer or HIV infection and you develop new or increased back pain.

•  If you have new back pain that does not improve after a few days of home treatment, contact your doctor for advice.

•  If back pain does not improve after 2 weeks of home treatment.

SEEKING HELP FROM PHYSICAL THERAPISTS

After the initial first aid treatments, a physical therapist with training in orthopedic treatment can:

Identify specific muscle or disc problems.

Provide other therapies, such as manual therapy, if you aren't improving.

Develop a customized exercise program for your recovery and long-term protection.

Other Health Professionals

Chiropractors and osteopaths can provide relief from some types of back pain through spinal manipulation. Spinal manipulation usually works best if you have had symp­toms for fewer than 4 weeks. If your symptoms don't improve after 1 month of spinal manipulation treat­ment, stop the treatment and have your pain reevaluated.

Acupuncturists massage therapists, and others can also provide treat­ments that may give short-term relief