Back Pain

Overview
The back is a well-designed structure made up of bones, muscles, nerves and other soft tissues. You rely on your back to be the workhorse of the body — its function is essential for nearly every move you make. Because of this, the back can be particularly vulnerable to injury and back pain can be disabling.

Four out of five adults have at least one bout of back pain sometime during life. In fact, back pain is one of the most common reasons for health care visits and missed work.

On the bright side, you can prevent most back pain. Simple treatments and proper body mechanics will often heal your back within a few weeks and keep it functional for the long haul. Surgery is rarely needed to treat back pain.

Low back pain is often triggered by some combination of overuse, muscle strain, or injury to the muscles and ligaments that support the spine.

Back pain can be:
Acute : lasting from a few days to a few weeks. Pain may be triggered by strenuous lifting that is uncharacteristic – that is, following a previous period of inactivity; or a fall.
Chronic : lasting longer than 3 months.
Recurrent: Occasionally you may have several episodes of acute back pain which settles with simple treatment.

Causes
Your lower back bears most of the weight and stress of your body. Back pain most often occurs from strained back muscles and ligaments, from improper or heavy lifting, or after a sudden awkward movement. Sometimes a muscle spasm can cause back pain. Often, there's an accumulation of stress with one particular event unleashing the pain. In many cases, there may not be an obvious cause.

Most back pain is not caused by damage or degeneration of intervertebral discs or any underlying physical damage. It is often thought to be linked to a relatively inactive lifestyle, with people doing less exercise and less physical activity in their daily work. This is aggravated by being overweight and having poor posture.

Sometimes back pain can be due to specific conditions such as a herniated disk or pinching of nerve roots as a result of the herniated disk. The pain can then be sharp and shooting in quality and radiates down one or both legs. Occasionally, back pain in the elderly can be due to osteoporosis . When there is a definable cause, these conditions have definite treatments. It must be emphasized that in most people, no definite cause of back pain can be found.

Treatment:
Acute back pain is treated by a short period of bed rest and pain medications to relieve pain.

Most back pain gets better with a few weeks of home treatment and careful attention. A regular schedule of pain relievers and hot or cold therapy may be all that you need to improve your pain. A short period of bed rest is okay, but more than a couple of days actually does more harm than good. The pain should settle within a few days and you can then ease back into your routine with gentle movement and simple exercises. If home treatments are not working, your doctor may suggest stronger medications or other forms of therapy.

When to seek medical advice
Most back pain gradually improves with home treatment and self-care. Although it may take several weeks before it completely disappears, you should notice some improvement within the first 72 hours of self-care. If not, see your doctor. In rare cases, back pain can signal a serious medical problem. See a doctor immediately if your back pain:

• Is constant or intense, especially when lying down or at night
• Spreads down one or both legs
• Causes weakness, numbness or tingling in one or both legs
• Causes new bowel or bladder problems
• Is associated with abdominal pain or pulsation (throbbing), or fever
• Follows a fall, blow to your back or other injury
• Is accompanied by unexplained weight loss
• Occurs when you are older than 50 years (1 st episode)

Back pain in people below 20 years of age should also be evaluated by a doctor.

Management of Chronic back pain
The management goals when dealing with chronic back pain are to achieve maximal reduction in pain intensity as rapidly as possible; to restore function; to help the patient cope with residual pain; to assess for side effects of therapy; and to facilitate the patient's passage through the legal and socioeconomic impediments to recovery.

Common methods that are used to treat cronic back pain
Apart from pain medications, chronic back pain is also managed with exercise and self-care.

To lose weight and get back to your ideal body weight if you are overweight. . Your doctor will often set a target weight for you. By losing weight you will put less strain on your back muscles and ligaments.
You may be referred to a physical therapist who will design an exercise program tailored for you. Exercise can strengthen the back muscles and keep them in good shape. If the muscles are strong they will take a lot of the strain away from the joints and ligaments of the spine. A useful set of exercises can be found at the following website: http://www.mayoclinic.com
Injections of cortisone may sometimes be given into some of the joints in the back. Nerves may be blocked to determine the site of pain generation.
Back surgery may be needed if a herniated disk is causing compression of a nerve.
In any case, back pain can limit your life. No matter what caused your back pain, you can help reduce and prevent pain by learning and practicing good posture and body mechanics.