We discussed in the last issue about various causes of back pain and the overall picture of the evaluation of the back pain. In this issue the various modalities of treatment, broadly management and relief, correspond to the various minor and major sources. An attempt is made to illustrate a mammoth picture of back pain.
As explained earlier that the back pain is a symptom of a strain, sprain, spine disorder, or condition affecting organs in the pelvis or belly. Pain can range from mild to severe, and it may spread to the legs or elsewhere; hence, a healthcare provider can identify the cause of the back pain and recommend the remedy accordingly.
Types of back pain
Healthcare providers often describe back pain according to its location as upper and middle back pain that is felt between the base of the neck and the bottom of the rib cage. The thoracic spine runs through this area. Secondly, lower back pain, which is felt below the ribcage, where the lumbar spine runs through this area. Nevertheless, muscles, tendons, ligaments, and nerves surround the spine to help with its movement. Many different injuries and chronic conditions can affect all these moving parts, leading to back pain. Lower back pain is more common than upper and middle back pain. This is because the lumbar spine bears most of the body’s weight and also most of the stress that arises during lifting or carrying things. So, this section of the spine and the structures surrounding it are especially vulnerable to painful injuries and wear and tear from overuse.
Acute vs. chronic back pain based on its location the healthcare providers also describe back pain according to how long it lasts. Acute back pain lasts less than four weeks. Sub-acute back pain can last anywhere from four to twelve weeks. Chronic back pain lasts more than twelve weeks.
Other Causes to select treatment
Back strains and sprains are the most common causes of back pain. These injuries can occur suddenly (that “ouch” moment) or over time. Strains are injuries to the muscles or tendons. They can occur from a single event (like lifting a heavy object) or from prolonged, repetitive movements (like constantly bending down at work). Sprains are injuries to the ligaments. They typically occur after a sudden fall, twist, or blunt force injury that stretches a ligament beyond its normal range of motion. With a strain or sprain, muscle spasms may be noticed.
Pain that gets worse during movement, where decreased range of motion, making it hard to walk, bend, or stand normally. When there is a sudden injury, a pop or a tearing sensation may be heard right when it happens.
Mechanical or structural problems in the back that cause referred back pain it means the pain is felt in back due to a problem somewhere else in body such as infections, tumours, other issues where the bones that make up the spine (vertebrae) may be flat, round cushions between the vertebrae (intervertebral disks) damage of the soft tissues surrounding the vertebrae and disks, including muscles, tendons and ligaments.
Several forms of arthritis can affect the back, including osteoarthritis and ankylosing spondylitis. One may feel pain and stiffness in the lower back, with additional symptoms depending on the type of arthritis.
Degenerative disk disease and which pain in felt in the lower back that extends into the arms, legs or butt. The pain may come and go or get worse after certain movements, like bending or twisting. Sudden injuries that cause spinal fractures involve sharp, intense back pain that may get worse while walking or moving.
Management
To have relief of back pain, one has to modify the activity, such as limiting heavy lifting, twisting and gradually returning to normal. Further light activity like walking, swimming, also physical therapy, for example, exercises to strengthen the core, improve flexibility, and correct posture. The person suffering from a backache can try all these manoeuvres, a movement that needs care or skill, either independently or under the physiotherapist or a trainer, till satisfactory results are achieved.
Medications
Coming to medications, drugs like Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) like ibuprofen, naproxen, muscle relaxants, topical pain reliever creams, gels, and sprays. For chronic pain, antidepressants are found to be useful. Applying heat, ice are good home remedies. Decent sleep posture (for some people, if side sleeping is a habit, keeping a pillow between knees gives pleasing relief. Medical Procedures where Injections of epidural steroids, nerve blocks are indicated for severe pain
Mind-Body Therapies
Yoga, acupuncture, massage, and cognitive behavioural therapy (CBT) have been proven to beat back pain. The presentation of back pain, the types of back pain, the usual causes and rare causes of back pain have to be evaluated before determining the type of management. The back pain presentation is also important to understand. Back pain is discomfort one can feel anywhere along the back of the body, from the base of the neck to the top of the butt. It’s a common symptom of many different underlying injuries and conditions. Back pain is one of the top reasons why people visit healthcare providers. Back pain can feel different depending on its cause. Some might describe the pain as burning, aching, dull, sharp, shooting, stabbing, throbbing, Muscle tightness or stiffness, Tingling, numbness or weakness, sudden muscle twitches or contractions, which can range from mild to extremely painful back spasms. Pain or other sensations may spread from the back to other areas, like the butt, hips, or legs. Certain positions like standing up, bending over or lying down may worsen or increase symptoms. Pain may come and go. It may be worse at certain times of the day like during first wake-up.
The modern research, such as blood clots in the vessels responsible for back pain and various remedies, will be discussed in the next issue. (To be concluded).
