the bones and muscles (spine and back)
I know that my spine plays an important role in holding me up, but what holds up the spine itself?
The spine is in fact a flexible column of bones called vertebrae that supports the body from the base of the skull to the pelvis and is supported in turn by other skeletal bones and a network of ligaments and muscles. stacked one above the other and increasing in size the top, the vertebrae are separated by shockabsorbing pads called discs. Extending from each vertebra are three bony projections called processes, to which supporting ligaments and muscles are attached and which form a protective channel for the spinal cord.
It seem as if everyone I talk to these days is suffering from back trouble. Why is back pain so common?
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 on suddenly or in tha 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 aeching spinal column. When they are not doing their job-or are straining to do it under a pressure-back problems are all but inevitable. In fact, most people experience back pain at some time in their lives, and millions of dolllars are spent every year in search of rilief.
What actually is hurting when my back aches? Is it my spine or my muscles?
Back pain can have several causes, and more than one may be involved simultaneously. The pain is usually located in the lower lumbar regionm where the spine curves inwards just before it reaches the buttocks. A sudden wrenching movement or prolonged stress on this area 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 injuruy 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 muscles on one side of the spine may contract so strongly that the hip and shoulder on the other are drawn up several centimetres higher than normal. Such a spasm can result in pain as acute as that caused by a pinched nerve itself. Another common cause of lower back pain, especially in middle-aged and older people, is osteoarthritis of the spine. The pain in the facet joints that link pairs of vertebrae can also mimic that caused by a slipped disc.
What is the difference between back strain and back sprain?
Back strain is not a medical term, but people often use it to describe pain that develops over time and is nonspecific, that is, it lacks an immediate and obvious cause. Such pain is usually the result of poor conditioning and posture. Back strain, however, can also refer to a pulled or torn muscle resulting from a specific action or injury. Back sprain, on the other hand, is aterm reserved for ligament damage. It is often caused by a fall or an attempt to lift a heavy object: a ligament partially tears, pain results and muscle spasms produce more pain.One condition is not necesserily worse than the other; pain and treatment of both are identical. If you are a victim of a specific back injury, however, there may be some comfort in knowing the immediate cause of the pain-such knowledege can also make a big difference when applying for a disability allowence.
How can I tell if what I have is a sillped disc rather than a strain, a sprain or facet joint pain?
The pain of a slipped disc is extreme, piercing and usually specific. If it occurs in the neck, you will feel the pain there, sometimes accompanied by pain, numbness, or a tingling sensation in the shoulder or arm. More usuallym however, slipped discs occur in the lower spine, causing pain and spasm at the site as well as pain in the buttocks. If the resultong pinched nerve root is part of the sciatic nerve, which extends all the way down to the toes, you are likely to feel sharp, radiating pain down one leg, known as sciatica. Unlike the other common cause of lower back pain, a slipped disc can result in numbness and weakness in the leg, or it can damage the damage the nerves that control bowel or bladder function.If you think you havee a slipped disc, see your doctor right away. Depending on your condition, he may recommend one or more of the treatment options described in the following questions. If the problem is in the neck area, he may also suggest that you wear a neck collar for a few weeks. In certain cases, surgery may be recommanded to relieve the pain of a slipped disc and prevent furthere nerve damage.
What can my husband do to ease his lower back pain?
There is no single standard treatment for lower back pain, but the measures recommended are usually rest, moderate applications of heat, such as warm baths or conservative use of a hot-water bottle, and mild analgesics (aspirin,paracetamol or ibuprofen). To relieve acute sapsms, get your husband to sleep on his back with a pillow under his knees. Your doctor may prescribe muscle-relaxing or anti-infalmmatory drugs; a back brace or traction treatment may be recommended for a chronically bad back. Most back problems, however, respond to rest and home care; without preventive care the problem is likely to return.
What can I do to avoid back pain in the first place or keep it from recurring?
Your best defence against back injury is to get in shape and learn how to use your body properly. There are many recommended exercises that will benefit your 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 conditionSit-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 sports like tennis, in which bursts of exertion alternate with sudden stops, lurches and periods of inactivity. I fou 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 ecaggerated 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 exaggrated 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 the waist!
When should I see a doctor about back pain?
That depends on the type of pain you have and its severity. If you are only mildly uncomfortable, and if the home treatment measures previously described bring relief within a few days, a visit to your doctor probably isn`t necessary. But if pain persists, and especially if you feel pain down the back of either leg, seek medical attention. Similarly, if you are immobilised, with or without persistent pain, for more than two or three days, consult your doctor.Back pain that is unrelenting or accompanied by other symptoms such as a high temperature, fainting or abdominal pain may be a sign of a serious underlying condition; in such a case, arrange to see your doctor right away.
Under what circumstances is back surgery usually recommended?
Before suggesting surgery to a patient with bak pain, most physicians recommend nonsurgical treatment followd by extensive studies to determine the exact cause of the pain. Even then, bak surgery is not always successful, and it should be undertaken only after careful consultation with a higly qualified surgeon. There may still be circumstances in which surgery is appropriate: for example, if a slipped disc threatens to cause irreversible damage to the spinalcord. Even then, it would be a good idea to get a second opinion.
Can electricity really be used to relieve back pain?
Transcutaneous electric nerve stimulation, or TENS, is the name of this procedure, which works on the theory that the stumulation of certain nerve pathways with a mild electric current will block the transmission of pain messages. The technique is now widely employed by physiotherapist, and the equipment can be bought or leased by the public. If used properly, TENS appears to have few drawbacks and no side effects, but the benefits vary with the individual.
What can a chiropractor actually do for back pain?
Chiropractors treat back problems by physically manipulating the back and spine. The manipulations are usually part of a more comprehensive therapy programme including heat applications and exercise. Many people claim they have gained relief from chiropractic treatment. Many medical doctors, however, consider that the spine is so tightly constructed that it cannot be truly realigned by manual manipulation. More importantly, if there is an underlying disease or structural problem, a chiropractor`s efforts may make it worse, or delay needed medical treatment. A full history and medical examination are necessary before manipulation is undertaken. Some doctors recommend chiropractors, just as they would physiotherapists, as part of a broader treatment programme.
My neighbour`s daughter has scoliosis. What is this condition?
Scoliosis is a lateral curvature of the spine that can range from a barely perceptible condition to a serious deformity. The curvature may progress with age, and in very severe cases sause heart and lung problems. For this reasons, early diagnosis and treatment are essential.Why it should be is not known, but scolisis appears in girls more often than in boys, starting between the ages of 10 and 14, and increasing until growth stops. It may be the result of a childhood disease such as juvenile arthritis or polio, but in the majority of cases the direct causes is unknown; the condition seems to run in families.Scolisis can be spotted by examining the curvature of a child`s spine as she bends over to touch the floor. But there are many other indications, including a shoulder that apperas to be higher than the other, a hip that just out when the child stands up, a hump on the back or a noticeably prominent shoulder blade, an arm that hangs at a lower level than the other, or an unusual gait.
How is scoliosis treated?
There are several treatment alternatives for scolisis; the one a doctor chooses depends on the type and severity of the curvature. In mild cases, regular medical checkups and physiotherapy to strengthen the muscles supporting the spine may be all that is necessary. When the curvature is more pronounced, the standard treatment involves the wearing of a brace to realign the spine gradully. Two types of brace are currently in use: the traditional Milwaukee brace, which provides support from the neck to the pelvis; and a modified plastic design that fits under the shoulder blades. To be effective, either type must be worn virtually around the clock (the brace may be removed for bathing) for many months.People with scoliosis often have muscle imbalances that cause the spine to curve towards the stronger side. This problem is usually treated with physiotherapy and exercise. A new treatment involves electric stimulation of the muscles on the weaker side, in the hpe that they will pull the spine towards the centre of the back. In extreme cases, surgery may be required to correct the curvature.
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