Managing Back Pain


The back itself is a column (otherwise known as the spinal column) of 33 bones and tissues from the skull to the pelvis. These bones (also known as the vertebrae) surround and protect nerve tissues known as the spinal cord. Between each of these bones is a disk which acts as a shock absorber for the other bones.

These bones are differentiated as being:

1) Cervical vertebrae which consist of the 7 bones in the upper part of the spine (in the head and neck);

2) Thoracic vertebrae which are the 12 bones between the neck and lower back (the lumbar region);

3) Lumbar vertebrae which are the 5 largest and strongest bones (yet, are most prone to injury); and

4) Sacrum which is formed from 5 bones fused together, along with the Coccyx (more commonly known as the tailbone) which is made up of 4 bones fused together.

Back pain is pain not necessarily in the back (the spinal column) but possibly in the muscles, nerves, joints or anything radiating from or in the spine. The pain can be abrupt, short-lived, or long-term; constant or intermittent; be localized or move to other areas, especially the extremities of the arms, hands, feet and legs; and may include tingling, weakness or numbness.

It’s Common

Back pain is extremely common. After headaches, it is the most common location of pain. Specifically, pain in the lower back is the most common form of back pain because it bears most of our weight. Lower back pain (also called lumbago) is the fifth most common reason for visiting a physician, and accounts for 40% of the missed days of work in the United States, and is the leading cause of disability throughout the world. It is most common in people between the ages of 35 and 55.

Doctors different it by its location: either neck pain, middle back pain, lower back pain or tailbone pain. It can be acute (up to 12 weeks), chronic (more than 12 weeks) or subacute (one lasting 6-12 weeks). It can be nonspecific (and usually associated with muscles, fascia and ligaments) or specific (such as having an infection or cancer).

Virtually all (98%) of back pain patients are those who have nonspecific acute pain which has no other ailments or diseases as causes. You may (or may not) feel severe back pain, but that does not necessarily mean harm or damage to your body. Think of a paper cut: it is small and superficial, causes a great amount of pain but does no harm (it usually seals itself before any infection can arise). However, the 98% does leave 2% of patients as possibly having an infection, cancer or other condition that can also result in back pain.

It can be diagnosed with x-rays, a CT scan or an MRI scan, but because back pain is usually (98%) not associated with a location, these are rarely effective. Thus, the doctor usually prescribes things for the result (the pain) rather than the cause, whatever it may be.

Back Pain Causes

Just as diet and exercise comprise very many of the treatments of very many ailments and diseases, so too are there a few general causes of back pain. Such causes can be described as being:

1) Medical: There are innumerable conditions that can cause back pain. It would be counter-productive to list them here in this article, but they can be found at this webpage. Perhaps the most common ones are spinal disc herniation, degenerative disc disease, osteoarthritis, osteoporosis, kidney stones, lumbar spinal stenosis, trauma (accidents, especially), muscle strains or pulled muscles, cancer, infection, fractures, inflammatory disease, and sciatica.

There is also pregnancy, during which half of all women experience lower back pain. In keeping with the theme of this article (avoidance), it would be easy to suggest not getting pregnant. Of course that, in itself, may not be desirable. Just be aware that if you do become pregnant then there is a very good chance that you will feel back pain.

There are also innumerable medical drugs that have back pain as a possible side effect. These drugs can be found here. If you are prescribed any of these then ask you may want to ask about the likelihood of you getting back pain, and whether or not alternative medicines are warranted. If you are taking these and then develop back pain then do consult your doctor right away. If you already have back pain and are prescribed any of these drugs for other conditions then ask your doctor about the likelihood of your back pain worsening.

2) Psychosocial: This would comprise stress (especially mental stress at work), anxiety, job dissatisfaction, distress, depression, cognitive dysfunction, dysfunctional family relationships, and others

3) Activity such as heavy physical work; repetitive work; frequent bending, twisting, lifting, pushing or pulling; static postures; and vibrations.

Contact your doctor immediately if you experience any of the following: pain that does not lessen, or worsens even when resting; pain which is worse when laying down; severe pain; increasing weakness or numbness in a leg or foot; difficulty in walking, standing or moving; fever, unexplained weight loss, or other signs of illness along with the back pain; numbness in the genital or anal area; loss of bowel of bladder control; a burning feeling or difficulty in urination; if you have had a trauma, such as a fall or impact; or if you or your family has a history of cancer.

LifeStyle Changes to Alleviate Back Pain

To avoid or minimize back pain, regardless of cause (except for medical causes, which often require medicine or surgery) you can do things differently. If you are overweight or obese and now have back pain then lose weight through diet, exercise, surgery or other means. There is no proof yet that obesity can cause back pain, but there is a high correlation between the two. Other suggestions can be grouped around:

Change yourself In my other article about back pain, I suggested trying Tai Chi and other methods of reducing stress. Other methods which reduce stress (and hence reduce the possibility of getting back pain and of minimizing its effects) are meditation, counseling, stress management classes, cognitive behavioral therapy, relaxation techniques and yoga (which I discussed in yet another article about back pain).
Perhaps the best–and certainly the simplest–are breathing exercises. One very easy exercise is to find a comfortable position; focus on breathing, and in doing it slowly and steadily; feel your tension escape as you breathe out; and do this for 10-15 minutes.

Change the things that you do Avoid the activities that can cause back pain. If you have to do them then do them differently and better. For example, if you have to lift heavy things then use your legs more and less of your back in lifting.

Avoid sitting and avoid standing. Of course, these contradict each other; the qualification is that you should avoid doing these for extended periods of time. If you do need to sit for a long period of time then try doing it on an ergonomically designed chair, or try using a standing desk. If you do need to stand for a long period of time then use a small footstool by alternating a leg on it, taking the load off your back. You can use the same footstool while you are sitting, so that your knees are above your hips.

Sit up straight! You mother and teachers told you this, and it is especially helpful now if you have back pain. This is especially relevant for those who have desk or office jobs. When you are at your desk, sit up straight and as far back in your chair as possible, while keeping your feet flat on the ground. When you stand, keep your shoulders back and your weight evenly distributed between both feet. Always be aware of when you may be slouching and then remove that.

People change jobs and even professions for many different reasons. If you have back pain then consider job training for another position within your company.

Sleep well and correctly. Be like Goldilocks and find a bed that is neither too hard nor too soft but one that is just right. It is best to sleep on your side but if you continue to sleep on your back then you can place a pillow under your knees, and if you sleep on your stomach then you can place a pillow under your stomach to counteract the effects.

Exercise and exercise more. In my other article, I suggested strength training, tai chi, pilates and aquatic therapy. You do not have to go to a gym, and you can try things that are even simpler than my suggestions. In 2008, the USDA Physical Activity Guidelines Advisory Committee Report advised just 150 minutes a week of moderate aerobic activity, and two or more days a week of strength training. Children were advised to be physically active for at least one hour each day, and other guidelines can be found here. All of these can be as simple as walking, biking or swimming. Maintain your activity, and gradually increase it to help you recover from back pain sooner.

Change other things Do not wear high-heeled shoes; wear comfortable shoes; and look for shoes with arch support.

Avoid having objects, such as a wallet, in your back pocket while you are sitting.
Make sure that you have a comfortable chair in your car, or add beads to it, especially on long drives.

Your spine, along with the enamel on your teeth, are one of the strongest parts in your body and is, along with the enamel on your teeth, very difficult to damage. Your back can take a lot of wear and tear, although it can break down, but also recovers (usually) just as quickly.

With the correct and complete information, help, support and treatment, you should be able to manage and remove your own back pain.