Back aches and pains are a health concern for millions of people. Nearly 12 million Americans annually see their doctors because of backaches and pains. One cause could be spinal stenosis.
What is back pain?
Back pain is a symptom that can arise from many causes. It can range from a dull, annoying ache to absolute agony.
Many cases of back pain are caused by stresses on the muscles and ligaments that support the spine. Sedentary jobs and lifestyles may create a vulnerability to this type of stress or damage.
Work-related back pain is among the most common occupational disorders in the United States, according to the National Institute for Occupational Safety and Health.
Obesity, which increases both the weight on the spine and the pressure on the discs, is another factor.
Strenuous sports such as football and gymnastics can also damage the back.
Acute or chronic?
Back pain comes in two forms, acute and chronic, and is most often felt in the lower back. Acute pain comes on suddenly and intensely, usually from doing something you shouldn't be doing or from doing it in the wrong way. The pain usually lasts a short while. Chronic pain is recurring; any little movement can set it in motion and, for whatever reason, it lingers on and on.
You can sprain the ligaments, strain the muscles, rupture the disks and irritate the joints. While logic would point to injuries from sports or traumatic accidents as the cause of the pain, sometimes the simplest of movements will have painful results.
In addition, arthritis, congenital disorders, poor posture, obesity and psychological problems due to stress can be the source of back pain. Complicating the issue further is the fact that back pain can also directly result from internal problems such as kidney stones, kidney infections, blood clots or bone loss.
Even with modern technology, however, the exact reason or cause of back pain can be found in very few people. For most people, drugs work well, such as over-the-counter or prescription medications, to control pain and discomfort.
How is it treated?
Limited rest combined with appropriate exercise and education is often the primary mode of therapy. Bed rest was once thought to be an effective treatment for back pain, but recently its therapeutic benefit has been questioned.
Exercises which increase flexibility and tone and strengthen muscles can get back pain sufferers up and around by hydrating disks that become painful from loss of fluid. For some people, however, bed rest may be the most comfortable position for the first couple of days.
Nonsteroidal, anti-inflammatory drugs - alone or in combination with steroid injections, analgesics, muscle relaxants, or anti-depressants - may be added to the therapy program.
Acute back pain often goes away by itself in a few days or weeks. An ice bag or hot water bottle applied to the back may also help to alleviate pain. Prolonged bed rest is not beneficial because it weakens muscles.
A physician should be notified immediately if there is no relief from pain after a few days in bed, if pain is severe or recurs, if radiating pain, numbness, tingling, or weakening occurs in the arms or legs, if bowel or bladder dysfunction occurs, if a child or elderly person has back pain, or if fever and/or vomiting occurs with back pain.
Spinal manipulation, or osteopathic manipulative therapy and chiropractic, are therapies commonly practiced for correcting abnormalities that are thought to eventually cause disease and inhibit recovery.
Doctors recommend back surgery much less often now than in the past, and only for certain conditions that do not improve after other treatments have been tried. FDA has approved or cleared medical devices such as the Intervertebral Body Fusion device, Anterior Spinal Implant, and Posterior Spinal Implant to treat degenerative disk disease and stabilize and fuse the spine.
Implantable spinal cord stimulation devices are another aid in the management of chronic pain of the trunk and limbs. These devices electrically stimulate the spinal cord by discharging a one-time or continuous stream of electrical pulses. The implanted portion of the device consists of a pulse generator (which contains an internal power source similar to that used in a cardiac pacemaker) and lead extensions that are connected to electrodes placed in the spinal canal. The nonimplanted components of the system include the programming device and screening pulse generator, which are controlled by the physician or patient.
Read what orthopaedic surgeon, James Stoll, M.D., with Columbia St. Mary's advises regarding chronic back pain and an important new treatment. "Artificial disc surgery is currently undergoing large-scale clinical trials in about twenty centers in this country. It's going to be the next big step in what I do."
How can back pain be prevented?
Recommendations for preventing initial and recurring episodes of back pain include:
Regular exercise
Stretching before participation in sporting activities
Quitting smoking
Losing weight
Maintaining correct posture
Using comfortable, supportive seats while driving
Sleeping on the side with knees drawn up or on the back with a pillow under bent knees
Lifting by bending at the knees rather than the waist
Avoiding standing or working in any one position for too long
Reducing emotional stress that causes muscle tension.
Source: National Institute of Neurological Disorders and Stroke of the National Institutes of Health
