Is Low Back Pain Killing You?

Introduction

Low back pain is a serious health issue, affecting about 85% of the population across the world. Low back pain, with or without radiculopathy (pain that radiates down the leg), is a common problem, that causes disability for the younger people below the age of 45 years.In most of the cases of acute lower back pain, it resolves on its own within a few weeks. Sometimes, it becomes chronic and require proper medical care to get rid of the symptoms.

How low back pain has become common

Causes of lower back pain:

In today’s world, low back pain is the most prevalent medical condition.The causes of low back pain vary between the individual sufferers. According to a research study, published in the Journal of Social Science and Medicine, there are 15 prime factors, which can cause back pain, are:

  • Wear and tear
  • Arthritis
  • Sciatica
  • Disc problem
  • Joint problem
  • Trapped nerve
  • Weak muscle
  • As a result of an injury
  • Lifting and carrying
  • Sitting for too long
  • Standing for too long
  • Walking
  • Driving
  • Lying down
  • Not taking enough rest
  • Specific movement while taking rest
  • Stress
  • Not taking pain medications
  • Herniated disc can cause chronic back pain

    Signs and symptoms of low back pain:

    Low back pain is considered as the second leading cause of work-related inability and disability in adults. It is the commonest medical issue, ranked after the common cold. In a study, published in the Journal of Pain Research, the prevalence of low back pain was discovered as;

  • Qataris (A country of eastern Arabia): 57.9%
  • Women: 53.9%
  • Men: 46.1%
  • Housewives: 40.1%
  • Individual with higher income: 53.9%
  • In the study, the researchers discovered the most frequently reported psychological symptoms in the patients with low back pain, are:

  • Headache
  • Pain in the arms, legs, or joints
  • Depression
  • Anxiety
  • Feeling of suicide or wanting to hurt
  • Feeling afraid
  • Physical signs and symptoms:

  • Muscle pain
  • Shooting or stabbing pain
  • Pain radiating down the leg
  • Limited flexibility or range of motion of the back
  • RISK FACTORS of low back pain:

    Back pain not only occurs in adults, but it can also attack the children and adolescents. There are some trigger factors, which may put you at higher risk for back pain:

    Aging:

    Back pain is more common as we age, between the ages of 30-40 years.

    Lack of exercises:

    Weak, unused muscles in the back can cause backache.

    Over-weight:

    People with excess weight put extra strain on the back, which results in the spine pain.

    Diseases:

    Some types of arthritis and cancer can also contribute to pain in the lumbar spine.

    Improper lifting:

    Using the back instead of the legs, while lifting any heavy object, can cause pain.

    Sudden injury to spine can cause low back spine

    Psychological conditions:

    The patients with psychological disorders, like depression and anxiety, are at increased risk of back pain.

    Smoking:

    This may prevent your body delivering enough nutrients to the discs of the spine, which leads to lower back pain.

    Diagnosis of Low Back Pain:

    Physical Examination:

    Your doctor will examine your back and assesses your ability to sit, stand, walk and the capability of lifting your legs. He may also ask you to rate your pain on a scale from zero to ten, to analyze how your legs are working with the pain.

    X-ray to determine cause of low back pain

    Tests to investigate the underlying cause:

    The tests are advised to rule out the underlying cause, the exact location of the pain, the severity of the condition, and also to evaluate if there is any muscle spasm. They also help to rule out if there is any serious problem. The radiographic images are important to know the alignment of the bones and to find out if you have arthritis or any broken bone. Some of the important tests are:

    MRI or CT Scan:

    MRI or CT scan helps by generating the images that may reveal the herniated disks or problems with bones, muscles, tissues, tendons, nerves, ligaments and blood vessels.

    Blood test:

    Blood tests can help determine if you have an infection or other condition, which may be causing the pain.

    Bone scan:

    The doctors rarely advise a bone scan. However, it is used to detect bone tumors or other diseases related to bone.

    Electromyography or EMG

    This test measures the electrical impulses produced by the nerves and muscle responses. EMG confirms nerve compression caused by herniated disks or narrowing of the spinal canal (spinal stenosis).

    Treatment of the Low Back Pain:

    As mentioned above, the acute back pain gets better within a few weeks, with the help of home treatment. You can also use the over-the-counter pain relievers. The heat or ice also works well to get relief of the symptoms.

    The bed rest is not recommended in the patients with back pain.A research, published in the Journal of Joint Bone Spine, revealed that the patients with lower back pain should limit their bed rest because it increases the possibilities of developing the chronic pain. On the other hand, light activities like to continue in the work, domestic activities, sports, and other activities with the tolerable range are highly effective to improve the symptoms. One mustn’t stop such activities out of the fear of pain. If these home treatments do not reduce the symptoms in several weeks, your doctor may suggest stronger medications or other therapies.

    Medication:

    Depending on the severity of the back pain, your doctor may recommend,

    NSAIDs (non-steroidal anti-inflammatory drugs):

    Such as ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve), can give you relieve of acute back pain.

    Muscle relaxants:

    If the painkillers do not work for mild to moderate pain, your doctor may prescribe a muscle relaxant.

    Topical analgesics:

    Topical analgesics are creams, ointments or sprays that have to be rubbed into the skin at the site of the pain.

    Narcotics:

    Certain medications, such as codeine or hydrocodone, may be used for a short time under the supervision of your doctor.

    Injections:

    If the above-mentioned medications do not relieve the pain, your health care provider may inject cortisone (numbing medicines) into the space around the spinal cord (epidural space). A cortisone shot helps reduce inflammation around the nerve roots. The pain is usually reduced for a couple of months.

    Physiotherapy

  • The patients are advised to use the cervical collar in case of the cervical spine and the lumbar corset (in thelumbar spine).
  • Bed rest (limited).
  • Static cervical and lumbar exercises.
  • Intermittent mechanical traction for 20min daily.
  • Moist heat can relieve pain and muscle spasm.
  • SWD, US, MWD, etc. to relieve chronic inflammation and pain.
  • Interferential therapy in case of acute conditions
  • Transcutaneous electrical nerve stimulator (TENS) can be given to relieve the radicular pains.
  • Gentle mobilization techniques can be used to regain range of motion and to relieve the stiffness.
  • Physiotherapy exercises for low back pain

    Electrical stimulation:

    TENS unit may be issued for the patients for home use. The e-stimulator is also prescribed to stimulate your muscles through variable intensities of electrical current. It helps with muscle spasms, and also acts as your natural painkiller. TENS also drives out the inflammation, providing the healing effect. It relaxes and re- educates the involved muscles.

    Physiotherapy eletrical simulation of low back spine

    Heat therapy:

    The physiotherapists use different heating modalities to improve blood circulation to the target area because an increased blood flow brings more O2 and nutrients to that specific area. Blood is also needed to remove waste created by muscle spasms, and it also assists in decreasing the pain.

    Soft tissue manipulation:

    This technique targets the spasms and chronic muscle tension; and also the pain that is built up through daily life stress. The physiotherapist uses direct pressure and friction to release the tension in your soft tissues (ligaments, tendons, muscles).

    Low back pain relief through massage

    Back education:

  • Environmental changes like proper lifting techniques.
  • Selecting the proper chair when sitting.
  • Proper Workplace modifications and good ergonomics to reduce strenuous neck positions during the work
  • So, low back pain, whether it is acute or chronic, the most important part is that you should not neglect the problem because the majority of the patients get the quicker recovery if they take early treatment. Ignoring the problem, means, you are taking the chance of having extreme pain and disability over time. So, do not delay, and get rid of your back pain at the initial stage itself.