Back pain and its management

Most people will experience back pain at some point in their live mostly between the age of 20-40.

Backpain can range from mild to severe.

Backpain resolves by itself though in about 31%  of the persons may require medical intervention.

Acute low backpain is pain in the back between the level of the breast and gluteal folds(buttocks).

This pain may last between six to twelve weeks and may radiate to one or both legs(sciatica).

One may wake up with the pain or the pain may develop after one bends or lifts a heavy load.

Causes.

  • poor sitting or standing posture,
  • standing or sitting for long periods
  • poor sleeping posture,
  • sleeping on a very soft matress
  • Inflamation of the backbone,
  • Inflamation of the pancreas
  • Stomach ulcers
  • Cancer that is spreading(malignancy)
  • Shingles(herpes zoster)
  • Compression fracture(collapse of the Vertebra(bones in the back) due to trauma(injury) or weakening)
  • Herniated nucleus pulposus. This happens when backbone connective tissue is forced into the spinal cord.
  • Lumbar strain/sprain. This is injury of the tendons of the backbone at the level of lower abdomen.
  • Spinal stenosis.  This is narrowing of the bone channel of the backbone wherethe spinal cord passes through.
  • Spondylolysis. This is a defect in the joints in the bones of the backbone

Back pain should be taken serious if any of the following has happened;

  • There is unexplained weight loss and the pain is not relieved by rest. This may be a sign of cancer.
  • one is not able to hold stool or urine, there is progressive sensory(being able to feel) or motor(ability to move muscles) loss as this may be a sign of Cauda equina syndrome
  • If there is injury releted to age especially to people 70 years and above.
  • If there is prolonged use of steroids like prednisolone.
  • Infection or surgery within the last 12 months

Treatment and management

Exersice can be a amajor step to treating backpain.

see the figure below.

Nonsteroidal antiinflamatory drugs are also effective.

Steroidal drugs are not recommended.

For people with stomach ulcers use of coxibs is advised.

The underlying cause of the back pain should be investigated and treated accordingly.

 

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    Dr Mathu

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