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Oh my aching back!! Back pain is the number one problem facing the workforce in the United States. Low back pain is one of the most expensive benign conditions in America. Every year 5-10% of the population 00-150,000 people get low back pain. Risk factors are repetitive lifting, vibration, smoking, alcohol abuse, multiple pregnancies, inactivity, osteoporosis, and a familial trend. There are no quick fix or total cure for most back problems. The good news is that chronic back problems can be treated effectively to limit the impact on your every day life. Most people with low back pain do not simply injure their back suddenly. Over many years your back is subjected to repeated stress which may not result in pain at the time the injury.
The anatomy and physiology of the spine is simple yet difficult to describe. Consider a pile of childrens blocks alternated with cushions and stablilized with guy ropes. In your spine, the blocks are boney vertebrae, the cushions are soft golf-ball like sacs, and the guy wires are the muscles and ligaments of your back. Back pain is caused by vertebral injury or cushion (disc) trouble, but without muscle strength, the spine is unstable and susceptible to injury.
Signs and symptoms can be divided into two areas. The first is mechanical type pain. Mechanical type back pain results from inflammation caused by irritation or injury to the back. Mechanical type pain usually starts near the lower spine. It rarely extends below the knee. Compressive or neurogenic (meaning nerve related type pain occurs when the nerve roots that leave the spine are irritated or pinched. A common case of compressive pain is herniated disk. The nerves that leave the lower lumbar spine spin to form the sciatic nerve. One of the earliest signs of pressure on a nerve root is numbness in the area supplied by the nerve. Another compressive pain is spinal stenosis. In some people, degeneration of the spine can result in a narrowing of the spinal canal and this causes all the nerves within the spinal canal to become inflamed and fail to work properly.
There are many tests that can be done to diagnose back problems. However the very first step is going to see your doctor and based upon your signs and symptoms the doctor may order an XRAY, MRI, and or CT just to name a few. Xrays are usually done on the intial visit. Magnetic Resonance Imaging (MRI) is the most common test that is done because it allows for visualization of bones, nerves and disks of the spine. The CT (Computer Assisted Tomography) the next most common test is simular to the MRI but allows for improved visulization of the spine.
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Treatment options include conservative versus surgical. Conservative treatment is exercise, medications, physical therapy and rest. New on the market for back pain which Jerry Lewis utilizes is the Epidural Steroid injection. Surgical treatment is laminectomy, disketomy and spinal fusion in some selected conditions. Treatment usually involves two goals. The first goal is relieve the immediate problem and number two is to reduce the risk of re-injury.
Prevention is the Key with good posture, body mechanics when lifting and exerciseing.
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