Backache

A backache is generally a gripping pain near the inward curve of the back above the base of the spine. It is one of the most common physical ailments, affecting about 80 percent of the population at some time in their lives.

Causes

Pain results from a variety of causes. Strains are especially common when overworked or underexercised back muscles perform beyond their normal capacity. The muscles will then contract or go into spasm and become a tight mass of tissue. Meanwhile, the body transmits a sharp pain signal as nearby muscles tighten in an effort to protect strained muscles and prevent further damage. A strain can be caused by exercise, sudden jerking motions, or a reflex action, such as sneezing.

Overweight is a leading factor in backache, because it increases the stress on back muscles. Similarly, pregnancy can produce back pain because of the weight or position of the fetus. For some women, menstruation is also associated with back discomfort.

Many people experience back pain as they age and their joint tissues deteriorate or shift. Psychological tension, stress, or anxiety about everyday problems can also lead to backache. In addition, back pain can result from diseases of the kidneys, heart, lungs, intestinal tract, or reproductive organs.

Backaches occasionally stem from a congenital (present from birth) malformation. In such cases, pain generally results from the unusual stresses that the deformity imposes on surrounding muscular structures rather than from the abnormality itself. For example, if one leg is shorter than the other, the muscles in the lower part of the body are forced out of alignment, causing back pain.

Symptoms

Backaches can appear abruptly after physical activity or may develop slowly. The pain may feel like a sharp jab or a dull ache. The pain sometimes becomes so piercing that a person who is bending over may not be able to straighten up. Severe back pain may also be accompanied by pain or numbness radiating down one or both legs. Though most muscular back pains disappear within a week or two of their onset, some can last one to two months. Pain may recur unless preventive measures are taken.

Diagnosis

Prolonged back pain (lasting for more than one or two weeks) should be brought to the attention of a physician, who will check for underlying disorders, such as kidney, bone, or lung problems, that may be causing the backache. Once other medical causes have been ruled out, an orthopedic surgeon (a physician who specializes in bone and muscle conditions) may be able to determine the cause of the discomfort.

During the examination, the physician may ask questions about the type of pain and its location, general health, previous illnesses, and physical activity routines. The patient walks, sits, stands, and performs exercises while being observed. An X-ray study may be used to reveal adverse changes in the spine.

Treatment

If there are no apparent physical causes for the backache, physicians usually recommend an exercise program designed to strengthen weak back muscles. Losing weight can also relieve pressure on the back.

For immediate treatment of symptoms, using a heating pad or ice at the site of the pain will usually reduce soreness. Nonprescription analgesic creams containing methyl salicylate (oil of wintergreen) or a similar ingredient produce a soothing warm sensation when applied to the pain site. Muscle relaxants and/or anti-inflammatory drugs may also be prescribed.

When a backache is the result of some deformity or damage to a disk (the soft material that lies between the bones of the spine), surgery may be necessary to correct the problem. Braces, corsets, or shoe lifts can sometimes improve the condition. Physical therapy may be useful because it strengthens back muscles, which helps to prevent the recurrence of back strain. Your doctor may also prescribe at-home exercises to strengthen affected muscles.

Almost all types of musculoskeletal backaches respond well to rest (although not the extended bed rest once prescribed) and gentle movement, which allows muscles to relax and inflammation to subside. Time is often the best healer of back pain.

Prevention

To prevent back pain, stress to the spine should be avoided. Good posture, when awake and asleep, relieves tension on the spinal column. Wearing properly fitted shoes encourages good posture, as does sleeping on a semifirm bed. Contrary to popular belief, a hard mattress is no better for your back than a soft one: It can distort the alignment of the spine and cause back pain. A semifirm mattress conforms to the arch of the back and helps maintain spinal alignment.

Good posture is also important when performing daily activities. Bending at the knees, rather than from the waist, when lifting large, heavy objects places the stress on the legs, not on the lower back. One should also avoid looking down for long periods of time while seated at a desk.



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