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Back Pain Back pain is one of the most common medical conditions that many of us encounter at some point of our life. One in five adults have suffered from back pain and the problem was severe enough for 10% of those who suffered to warrant medical leave. However, even mild back pain is a warning sign that special care is needed to help prevent more serious problems. HOW THE BACK WORKS It is important we look after out teeth and feet but it is equally important for us to look after our spines. By doing so, you can help to prevent back damage, and gain an overview of what you can do if you suffer from problems. Your back is one of the most important parts of your body. It contains the SPINE, which supports the whole body and is in use 24 hours a day - even when you are asleep. The spine is made up of a stack of bones (33) called vertebrae, which are connected together by strong muscles and ligaments. In between each of the vertebrae are discs, which act as cushions and 'shock absorbers'. The main functions of the back are to support the upper body, protect the spinal cord and allow flexibility and movement of the body. SYMPTOMS Generalised lower back pain is a condition that occurs mainly in people 20 to 40 year of age. Pain can be in the back, buttocks and upper thighs. Most lower back pain will recover spontaneously in four weeks. Usually there is pain and/or stiffness for 12 to 36 hours after an injury. The lower back pain syndrome is a vicious cycle in which an injury causes muscle spasm, the spasm induces pain and the pain results in additional muscle spasm. Rest and pain relief is used to interrupt this cycle. Pain may be the result of injury to the soft tissues of the back, leading to swelling and inflammation around the injured structure. In response to the pain, the back muscles often try to protect the back by going into contraction or spasm, to keep the area immobile. Muscle spasm can, in turn, cause pain and stiffness if prolonged. With persistent pain, the back may become progressively weaker and stiffer. The overall fitness of the individual may also decline because of fear of activity. CAUSES Back pain affects people of all ages. It is commonly caused by faulty body biomechanics (improper lifting techniques, poor posture, etc), obesity, and the natural wear and tear of the ageing human skeleton. Minor strains or spasm of the large muscles and ligaments along the spine that serve to support the spine causes most back pain. A general ache along the spine can be due to stretching or tearing of muscles, back trauma or mechanical stress. There are some serious conditions not due to stress that causes back pain that warrant immediate medical evaluation.
WHO IS AT RISKS? Anyone can have back trouble. We don’t always stand and sit properly, so when we lift, pull, or bend we can end up with back pain. Backache due to stress may be caused by fatigue or general stiffness, due to remaining in a fixed position for extended periods of time, such as sitting at a desk at work for long hours. People who may be at more risk includes: Mother/Housewives, they are especially vulnerable to back pain because of the taxing nature of their jobs.
People whose work involves heavy lifting and bending. People who sit stooped for long periods in poorly designed work areas. People who are overweight – being overweight puts more strain on your back. WHAT YOU CAN DO To reduce pain and swelling: for acute episode, place
WHEN TO SEE A DOCTOR Consult a doctor if the pain does not go away or worsens, if your limbs exhibit weakness or numbness, or if you have difficulty controlling your bladder. WHAT THE DOCTOR CAN DO FOR YOU
Specialist attention may be recommended for:
PROTECT YOUR BACK STANDING Stand with your lower back straight. If standing for prolong periods, use a footrest.
Most people spend long hours sitting, it is all too easy to slouch on the sofa all evening, but for the sake of the back, you should avoid oversoft or bucket-shaped chairs and opt for those, which support the small of the back.
DRIVING Use a firm seat. Sit close enough so that your legs are not fully extended when using the pedals. LIFTING Make sure load is manageable. Bend your hips and knees, not your back. Keep the load close to your body. Do not lift heavy load with your back (i.e. bending over then raising the load by straightening the back). The best way is to couch then raise the weight by straightening the knees, keeping the back straight. BEDS As most beds and mattresses are kept for a number of years, a good, supportive mattress is essential if you are to sleep well and avoid long-term back discomfort. Note that a SUPPORTIVE mattress need not necessarily mean a HARD one - its should allow some absorption of the hip and shoulder. Use a firm mattress. SLEEPING There is not a best' posture for sleeping - it depends on which position is most comfortable for you. Too many pillows, however, will provoke neck pain Do not sleep on your stomach. If you sleep on your side, keep your legs bent at your knees and hips. EXERCISE Back pain experts now agree that safe exercises may help back pain sufferers generally. There are specific exercises for spine strengthening and others to help you relax. Exercise certainly helps keep your back supple - and your whole body fit at the same time. Walking and swimming are excellent for the back, and back pain sufferers often benefit from hydrotherapy sessions. Exercise regularly, after recovery from a backache so that muscles are well toned but warm up and stretch before attempting anything strenuous. THINK ‘BACK’ BEFORE YOU ACT BACK PAIN has brought many a career, both sporting and otherwise to an untimely end. Back pain can strike at any time-but it does help to be prepared. Remember this advice is for short-term, acute back pain only-not necessary for long-term chronic pain. First and foremost, DO NOT IGNORE THE PAIN. It is there for a reason – the body’s way of telling you something is wrong. It may sound obvious, but the first step is to stop doing whatever started the pain attack in the first place and ease yourself gently into a more comfortable position. IF YOU NEED HELP OR SOME ONE TO TALK TO, CALL: SAF Medical Centre : Helplines
Compiled by Office of the Chief Air Force Medical Officer CPT (DR) WANG SHI TAH and MWO JOHNNY LIM
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Chronic pain behaviour including dependence on analgesics for prolonged
periods.
sitting
Placing
a small firm cushion - or rolled-up towel - at the small of the back
gives vital support to the lower back back area and encourages correct
seating posture.
