Back pain is possibly the price human beings have to pay for being members of the only fully erect species on earth – and one of the most sedentary.
Back pain can come suddenly or course of time; it can be the immediate result of an attempt to lift a large object or the cumulative effect of endless hours camped in front of a television set. In most cases, the actual cause is weak muscle tone in the lower back and abdominal areas, muscles that are critical in the support of the arching spinal column. When they are not doing their job – or are straining to do it under pressure – back problems are all but inevitable. In fact, most people experience back pain at some time int their lives, and millions of dollars are spent every year in search of relief.
CAUSES BACK PAIN
Back pain can have several causes, and more than one may be involved simultaneously. The pain is usually located in the lower lumbar region, where the spine curves inwards just before it reaches the buttocks. A sudden wrenching movement or prolonged stress on this are can cause muscle spasms, in which the tensed muscles cannot relax, or tiny tears in the muscles or ligaments – any of which can cause pain.
In some cases, a sudden injury or the prolonged failure of the surrounding muscles to support the lower spine may cause the vertebrae to squeeze one of the discs that separate them. As the disc flattens, its jelly-like core may protrude to the side. Called a prolapsed or slipped disc, this protrusion can press on one of the nerves branching out from the spinal cord and produce sharp pain that often extends down the leg.
To relieve the pressure of a slipped disc, the muscles surrounding the spinal cord may go into spasm. But this protective response can also cause a problem the muscle on one side of the spine may contract so strongly on the other are drawn up several centimeters higher than normal. Such a spasm can result in pain as acute as that cased by a pinched nerve itself.
Another common cause of lower back pain, especially in middle-aged and older people, is osteoarthritis of the the spine. The pain in the facet joints that link pairs of vertebrae can also mimic that caused by a slipped disc.
HOW TO AVOID BACK PAIN AND KEEP IT FROM RECURRING
Your first defense against back injury is to get in shape and learn how to use your body properly. There are many recommended exercises that will benefit our back by improving the body tone generally, but pay special attention to strengthening your abdominal and leg muscles, which together do most of the work of supporting the back. Ask your doctor or physiotherapist to give you an exercise schedule. Aerobic classes may sometimes aggravate your condition.
Sit-ups (with legs bent) are excellent for the abdomen, as are swimming, cycling and rowing. Regular walking is great but beware of sports like tennis, in which bursts of exertion alternate with sudden stops, lurches and periods of inactivity. If you are overweight, slim down: extra fat means extra strain on your back.
Learn how to walk, sit, sleep and lift properly. Good posture also helps: when standing or walking, contract your abdominal muscles and tuck your buttocks under slightly. Keep your shoulders back (but not in an exaggerated arch) and your torso loose. If it is necessary to stand for a long time, raise one foot to take some of the weight off your lower back. Avoid high heels or any other uncomfortable shoes.
Straight-backed chairs that keep you from slumping are better for the back than rounded ones. When sitting, keep your knees higher than your hips. and when rising from your chair, bend your knees and push off with your hands.
Make sure your mattress is firm, and never sleep on your stomach, since this forces the spine into an exaggerated curve that can cause aggravation. If you can’t sleep lying on your back, try lying on one side, with knees tucked up in the foetal position.
Let your legs, not your back, do the real work whenever you lift anything. Get close to the object you want to lift, slowly bend your knees, and then come up with your back straight. Be especially careful not to bend at the waist.