BACK PAIN

General Information

DEFINITION--Pain in the lower back usually caused by muscle strain. It is often accompanied by sciatica (pain that radiates from the back to the buttock and down into the leg). Onset of pain may be immediate or occur some hours after exertion or an injury.

SEX OR AGE MOST AFFECTED--Adults of both sexes, usually between ages 20 and 40.

SIGNS & SYMPTOMS

• Pain. It may be continuous, or only occur when you are in a certain position. The pain may be aggravated by coughing or sneezing, bending or twisting.
• Stiffness.

CAUSES

• Exertion or lifting.
• Severe blow or fall.
• Back disorders, ruptured lumbar disk.
• Infections.
• Nerve dysfunction.
• Osteoporosis, tumors.
• Spondylosis (hardening and stiffening of the spinal column).
• Congenital problem.
• Childbirth.
• Often there is no obvious cause.

RISK INCREASES WITH

• Biomechanical risk factors.
• Sedentary occupations.
• Gardening and other yard work.
• Infrequent sports and exercise participation.
• Obesity.
• Poor muscle tone, poor posture.
• Wearing high heels (women).

HOW TO PREVENT

• Exercises to strengthen lower back muscles.
• Learn how to lift heavy objects.
• Sit properly.
• Back support in bed.
• Lose weight, if obese.
• Choose proper footwear.
• Wear special back support devices.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and exam by a doctor.
• Laboratory blood studies to determine if there is an underlying disorder, x-rays of the spine, sometimes a CT or MRI scan.

APPROPRIATE HEALTH CARE

• Treatment will depend on severity of the pain and discomfort.
• Recent medical studies indicate that staying more active is better for back disorders than prolonged bed rest.
• Options are available such as surgery for damaged disk (see Disk-Removal, Ruptured in Surgery section); electrical nerve stimulation; acupuncture; orthopedic care; physical therapy; treatment by a chiropractor, physiatrist or neurologist and others.
• Massage may help. Be sure person is well-trained or massage could cause more harm than help.

POSSIBLE COMPLICATIONS--Chronic low back pain and restricted lifestyle.

PROBABLE OUTCOME--Gradual recovery, but back troubles tend to recur.

How To Treat

GENERAL MEASURES-- Some self-treatment guidelines include: When your back starts hurting, apply an ice pack for 10 to 15 minutes every hour. After two days, apply heat (a heating pad, hot towel, or hot showers). This will increase blood flow and help with healing. Use a firm mattress (place a bed board under the mattress if needed). Sleep on your back with a pillow under your knees, or sleep on your side with a pillow between your knees. Wear a special back support device. Learn stress reduction techniques, if needed. Take breaks if you have to stand or sit for long periods.

MEDICATION--Your doctor may prescribe:

• Mild pain medications such as aspirin or ibuprofen.
• Stronger pain medicine or a muscle relaxant for severe pain.
• Note: Medications do not hasten healing. They only help to reduce symptoms.

ACTIVITY--

• Try to continue with daily work or school schedules to the extent possible. Use care in resuming normal activities.
• Avoid strenuous activity for 6 weeks.
• After healing, an exercise program will help.

DIET--No special diet. A weight reduction diet is recommended if obesity is a problem.

Call Your Doctor If

• You have mild, low back pain that persists for 3 or 4 days after self-treatment.
• Back pain is severe or recurrent.
• New or unexplained symptoms appear.