Backpain Questions - the FAQ's
How does the backbone work?
Backpain questions range from 'What causes backpain' to qustions about treatment, exercise, backache while driving, and so on. It is probably helpful if we start with an understanding of our spinal structure.
The spine, or backbone, is made up of a column of 33 bones and tissue extending from the skull to the pelvis. These bones, or vertebrae, enclose and protect a cylinder of nerve tissues known as the spinal cord. Between each one of the vertebra is an intervertebral disk, or band of cartilage serving as a shock absorber between the vertebrae.
The types of vertebrae are:
Pain that hits you suddenly - after falling from a ladder, being
tackled on the football field, or lifting a load that is just too
heavy, for example - is acute pain. Acute pain comes on quickly and
often leaves just as quickly. To be classified as acute, pain should
last no longer than 6 weeks. Acute pain is the most common type of
Backpain questions about Chronic pain are more difficult to answer since it may come on either quickly or slowly, and it lingers a long time. In general, pain that lasts more than 3 months is considered chronic. Chronic pain is much less common than acute pain.
estimate that approximately 80 percent of us will experience significant
back pain sometime in our lives. Back pain is the second most frequent
complaint in doctor's office visits (after the common cold) and it results
in more lost productivity, both at home and at work, than any other
Fortunately, back pain usually is preventable. While back pain can result from inevitable situations such as trauma or illness, it also can be caused by lifestyle factors which you can control. The use of proper lifting techniques, a healthy diet, and regular exercise are some of the keys to promoting good back health. Take a look at your everyday habits to reduce the risk factors that may be causing your back pain.
Stretch and strengthen the muscles that support the spine, including those in the abdomen and lower back. Exercising can make the back more resistant to strain and injury.
When lifting, keep your back straight and bend only at the knees. This shifts the weight of what you are lifting to your legs, thus taking the pressure off of your spine and back muscles. And always try to keep the item you are lifting close to your body, even if it's light.
Excess weight puts additional strain on your back by stretching and weakening the muscles. It can increase the risk of back pain and prevent quick healing of injuries.
Nicotine has been shown to increase the risk of disc degeneration and
back pain. It can also slow or prevent recovery by reducing the amount
of blood flow to tissues that are trying to heal.
The discs in your back are under the most pressure when you are sitting.
While sitting, keep your upper back straight and your shoulders relaxed.
Try to take short walks periodically if you must sit for great lengths
Stress can cause your back to tighten, and can prolong your recovery
once the hurting begins. Imagine yourself in a tranquil place and
take a vacation in your mind
your back will thank you!
That's a really good question and a hard question to answer. How do
you get people who know enough about pain and how do you get your primary-care
doctor to refer you to specialists? There simply aren't enough experts,
and a lot of insurance companies won't pay for patients to go to outside
In the UK your obvious first call should be to your GP. He or she will
have knowledge of local specialists but do bear in mind that not all
doctors agree on the cause or treatment of backpain. In the US, the
American Pain Foundation
and the National Pain
Foundation can help patients find physicians throughout the country.
They even have directories. In the UK you can try BackCare,
the new name for the National Back Pain Association.
Most people with back pain can be treated conservatively. For most patients surgery is deferred until all non-surgical modalities are exhausted. All patients with severe or persistant back pain, or back pain associated with other symptoms, such as fever, burning on urination, or weight loss, should consult their GP at an early stage.
An MRI is necessary to image the intervertebral discs, because these do not show on a plain x-ray. Imaging of the disc allows your GP to diagnose disc herniation, disc protrusion, disc bulging, as well as other related conditions, such as spinal or foraminal stenosis.
Plain x-rays are helpful to examine the bony structures. These can
be abnormal in case of fracture or metastatic disease.
Back surgery is less risky now because less invasive procedures are used for the majority of patients with disc disease. Nevertheless, surgery is invasive and requires anesthesia, which also poses a risk by itself. For a more detailed discussion, please click here.
Epidural steroid injections involve the placement of cortisone solution adjacent to the inflamed nerve root through the use of a long needle which is passed through the skin of the back. Bruising is common, and discomfort is minimized through the use of anesthesia. This procedure is much less invasive than surgery, and can result in symptom relief for those patients with radiculopathy (e.g. sciatica due to disk herniation).
See also our glossary of
If you have a specific backpain question or if you
don't understand anything on this site - because we haven't fully explained
it - please use our contact form
and be sure to head it Backpain questions. We always try to answer promptly.
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