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Low Back Pain

Posted on June 13, 2018 | No Comments on Low Back Pain

Who hasn’t endured low back pain? Every person has or will experience low back pain at some point in their lives. Low back pain is one of the most common conditions seen by orthopedic specialists in their clinics. It affects men and women of all ages, from gradeschoolers to grandfathers; all sizes, from small to stout; and all occupations, from secretaries to seamen.

It may occur while one is doing the most ordinary activities—tying ones shoes, picking up loose change from the floor, or just sitting down for long periods of time, as when one has been surfing the net. It may occur from overexertion—jumping high to spike the volleyball, or lunging too low to chase that shuttlecock.

What Causes Low Back Pain?
There are as many causes of low back pain as there are as many ways by which a person can sustain them. Most cases of low back pain are due to “overstretching” of the muscles of the back.These muscles are found adjacent to our back bone, and some of these extend all the way from the area of our buttocks to the sides of our neck.

If you have ever experienced a sudden, sharp pain in this particular 2 region after having bent over, chances are, you may have overstretched any of these large muscles. Persons who operate heavy machinery, or perform a lot of lifting tasks which require them to bend their backs repetitively and excessively are particularly prone to this type of back pain. Even the performance of the most mundane activities, like sweeping the floor using a broom with a short broom handle or a “walis tingling”, can trigger this type of low back pain. Persons who are sedentary, the “couch potatoes”, as well as those whose job requires them to be seated for the better part of the day (call center operators, bank tellers, cashiers, etc.), and those who stand for long hours (security guards, waiters, traffic enforcers, etc) are also susceptible to developing low back pain. These same muscles are also “postural muscles”. These muscles are literally working behind our backs every second that we are awake, whether we be seated or standing, making sure that our upper body is maintained in a relatively erect position. As with most muscles of the body, these are also vulnerable to developing muscle fatigue.

How “Slipped Discs” Occur
The term “slipped disc” has occasionally been interchanged with the term low back pain. The vast majority of back pains are not due to a slipped disc however. What is a slipped disc? Our backbone, or vertebral column, is actually made up of several ovoid pieces of bone, called vertebrae, which are stacked one on top of the other, from our buttock region all the way up to the back of our head.

The material in between, which serves to anchor one vertebrae to the next, is called the intervertebral disc. The discs are also our body’s shock absorbers, allowing us to go about our usual activities without difficulty. The disc is like a tube of toothpaste, firm on the outside (called the annulus fibrosus), with the soft, gooey stuff inside (the nucleus pulposus).
The discs in our lower back are particularly susceptible to damage, since most of the body’s weight is concentrated in this region. If any part of the disc weakens, the gooey stuff inside can leak out. By itself, that break should not cause any problems, however, if they start to push on nearby structures, like nerves, the person might feel not only pain in the back, but also pain, and even numbness going down the buttocks, thighs and legs. This condition is called a disc herniation, or a “slipped disc”.

Who Are at Risk?
Obese people, those who lack exercise,and smokers are all particularly at risk for developing low back pain. The extra weight places additional strain on their back muscles and their discs, and increases their susceptibility for developing muscle fatigue and disc problems. The lack of exercise also contributes to a relative weakening of these postural muscles, and their decreased flexibility can make these people more susceptible to injury. Smokers are also notoriously prone to disc-related back pain, because of the increased susceptibility of the disc to weakening.

Diabetics can develop low back pain if they do not watch their weight or fail to get enough exercise, for the reasons mentioned above. They are also more likely to develop neuropathies, nerve-related low back pain, which can be quite debilitating.

Tips for the Back
Prevention is always the best defense against developing low back pain. Regular aerobic activities, like swimming, walking, or biking, help improve the blood flow to the back, as well as strengthening the muscles. Sports which involve a lot of bending, twisting and sudden movements like badminton, basketball or soccer, increases a person’s chance of injuring his/her back. Therefore, one must be particularly careful of overexerting oneself when participating in these types of recreational activities.

It is also important how to lift and carry heavy objects. As much as possible, ask for assistance. Never bend at the waist to pick up the object. Always bend at the knees, and use the strength of your legs to lift—never your back. Always keep the object close to your body, never with arms outstretched, as this will place additional strain on your lower back.

In the work place, always maintain the correct posture when seated. Chairs should be adjusted such that your knees and hips are bent to around 90 degrees, with your feet resting flat on the floor. Use the backrest as much as possible, and avoid slouching or bending forward. These will minimize stressing your back.

Take standing or walking breaks, ideally at least 10 minutes for every hour you have been sitting down. This will help re-establish circulation to your back muscles. For women, avoid walking around in high-heeled shoes. The abnormal posture associated with these types of shoes places additional strain on your back muscles, making them prone to fatigue.

Most cases of back pain will get better by themselves over four weeks. Avoid lifting or carrying temporarily, but you may continue your regular exercises if these do not cause you much discomfort. Consult your doctor if the pain seems to be getting worse, or has been present for more than four weeks.

Back pains due to falls or injury are also best seen by a doctor at the soonest possible time. Muscle weakness and numbness may also warrant an early consult. Orthopedic surgeons will not routinely request for an x-ray of the back for most patients consulting for low back pain, especially if the cause of the pain is muscular.

A good, complete examination will usually establish the diagnosis, and the doctor may prescribe medication to control the pain. It is not necessary for patients to be placed on bed rest for back pain. Activity modification, lifestyle changes, diet and exercise may be all that is needed to treat this very common condition.

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