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Back pain

Many people suffer from back pain at one point in their lives.  In a lot of cases, no exact diagnosis is made because the pain gets better within a few weeks and because analgesic drugs (pain killers) are used before any tests for examples X-rays are carried out.  In such cases doctors may use the term ‘non specific back pain’ to describe the condition.

Causes

Non specific back pain is one of the biggest single causes of working days lost through illness in the UK.  The people most likely to suffer from back pain are those who do labouring jobs, those who do a lot of heavy lifting or carrying and those who spend long periods of time sitting in one position or bending awkwardly.  Overweight people are also prone to back pain because their backs are carrying a much heavier load and they tend to have weaker abdominal muscles, which usually help to provide support to the back.

Non specific back pain is suspected to be caused by mechanical disorder affecting one or more structures in the back.  This could be a ligament strain, damage to a spinal facet joint, muscle tear or disc prolapse (slipped disc).

Also in addition to pain from a damaged structure, spasm of surrounding muscles will cause tenderness and pain over a wider area.  This sometimes results in temporary scoliosis (an abnormal sideways curvature of the spine). 

Abnormalities of a facet joint and prolapsed of an intervertebral disc can both cause sciatica (pain down the back of the leg into the foot and buttock).  This condition is the result of pressure on a sciatic nerve root as it leaves the spinal cord.  Sneezing, coughing or straining increase the pain.  Pressure on the sciatic nerve can also cause a pins and needles sensation in the same leg as well as weakness in muscles activated by the nerve.  Seldom, pain may radiate down the femoral nerve at the front of the thigh.

Osteoarthritis in the joints of the spine can cause constant back pain.  Ankylosing spondylitis (an inflammatory disorder where arthritis affects the spine) causes back pain and stiffness with loss of back mobility.  Coccydynia (tenderness and pain at the base of the spine) can occur after a fall in which the coccyx has hit the ground, during pregnancy, or spontaneously for unknown reasons. 

Pyelonephritis can cause back pain as well as tenderness and pain in the loin, chills, fever and pain when passing urine.  Cancer in the spine can cause persistent back pain that disrupts sleep and cannot be relieved by rest.

Self help

People with back pain and sciatica are often advised to remain as mobile as possible.  Sleeping on a firm mattress and taking analgesic drugs can help to relieve pain.  In a lot of cases, back pain gradually clears up with such self help measures. Many analgesic drugs are opioids and are made from the drug heroin which is a highly addictive drug. So what can happen is that a person can start to take pain killers and the pain keeps coming back because the body is starting to get use to and addicted to the drugs.

Investigation

In many cases tests are not needed.  However, if back pain persists, is severe, is associated with a back injury or with weakness in leg or bladder control problems, immediate medical advice should be sought.  An examination of back pain can show tenderness in specific areas or loss of back mobility.  Loss of sensation or weakness in the legs implies pressure on a nerve route, which needs immediate investigation.

X-rays of the spine can reveal narrowing between the intervertebral discs; osteoporosis; ankylosing spondylitis; osteoarthritis; compression fracture; stress fracture; bone cancer; or spondylolisthesis (displacement of vertebrae).  X-rays do not reveal ligament, muscle, facet joint, or disc damage.  To detect pressure on a nerve route (due to disc prolapse for example), myelography, CT scanning or MRI is performed. 

Treatment

If a precise cause if found for the back pain, treatment will be for that cause.  Research has shown that acute non specific back pain is best treated by staying by active as possible, helped for analgesic drugs if necessary. But remember that theses drugs do have side effects and should not be taken over a long period of time  Bed rest is not recommended for more than two days.  physiotherapy, acupuncture or exercise may also be helpful, these are things that we include in a program at the natural health clinic. We also inc shiatsu and reflexology to help to get you back to outstanding health.

Chronic non specific back pain is usually more difficult to treat.  Treatment can include the use of non steroidal anti inflammatory drugs which only provide temporary relief if that. Spinal injection or muscle relaxant drugs are very dangerous and can permanently damage your back.  Use of a TENS machine may also relieve pain in some people, but remember this is also just temporary relief.  Alternatively, the Alexander technique may be helpful; this teaches how to amend posture and movement in order to relieve muscular tension.  Very rarely, spinal surgery may be necessary to treat chronic back pain, but remember if you allow surgeons to remove pieces of your back it may never be the same again. I am not saying not to do it but be very careful about letting people operate on your body unless you have a full understanding of what they are going to do. A good idea would be to be to try to do it natural in chronic case in an emergency you would obviously need to go to the hospital.


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