“My Back is Killing me!”

You and 27 million other Americans over the age of 18 have the same complaint. Annually.

About 19 million of us see a doctor. More women were treated for backaches than men. Intensity levels of back pain range from muscle- and posture-related pain to life-altering, potentially fatal injuries involving the spinal cord. Everyone from children to seniors can experience back problems.

Pain in the back is a pain in the pocketbook.
Back pain is one of the most expensive health problems reported. Recent research placed the price tag for spine care at $86 billion. The number of back pain treatments has been on the rise and, over one eight-year-period, costs increased as much as 65 percent.

Not only is back pain, which includes neck pain, the most common physical complaint among us, it is the leading cause of lost time on the job. Here,
I can personally testify why —
it’s because every move one makes includes the back. So …
it’s hard to get up, sit up, stand up, brush teeth, comb hair, get dressed and drive to work, much less sit in one position all day. Back pain refers to sore muscles and tendons, herniated disks, fractures, and most frequently, pain that has developed over
a long period of time.

Causes of back pain
Injuries. Contact sports, accidents and falls can cause the full range of back problems, from minor muscle strains and tears to herniated disks to fractures causing severe damage to the spinal column and the spinal cord. Scoliosis, which causes curvature of the spine. Osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, spinal stenosis can cause narrowing of the spinal column, pressure on the spinal cord and nerves, and weakened bones, leading to more bone fractures. Kidney stones or skeletal infections like endometritis, fibromyalgia affecting trigger points of pain and cancerous tumors.

Cauda equina syndrome. Disk material expands into the spinal canal, causing compression of the nerves. One would experience pain, possibly loss of sensation and bowel or bladder dysfunction. Although not as frequent as many back problems, this must be considered a medical emergency. Self-inflicted pain. Back pain resulting over time from bad habits such as poor posture, sitting incorrectly, slouching, pushing, pulling and lifting things carelessly, overexertion in work and play. Sometimes, you can feel the pain immediately. Other times, problems take some time before the pain is really bothersome. Much of the time, muscle strains are the culprit. The most common area of this pain is … wait for it … the lower back. The next most prevalent place is the base of the neck.
“Out- of-the-blue” or nonspecific back pain. This is discomfort that is not initiated by a specific pull or blow to the back. Weakened muscles don’t allow one to perform daily activities like bending, stretching, even walking, without pain.

Myofascial strain. This is chronic backache resulting from tension, stress or other emotional problems, such as depression and anxiety. Lack of proper sleep. You need seven hours of the good, uninterrupted kind of sleep, leaving you refreshed in the morning. Pregnancy. Yes, there it is in black and white. Hormonal changes, coupled with weight gain, place extra stresses on a woman’s spine and legs. Weight gain or just being overweight places extra stress on your spine.
Sneezing, bending at a certain angle, even for a few seconds … these can cause pain that is just as intense as that caused by lifting or other actions

Treatments for back pain Back pain is usually divided into two categories:

Acute: This pain lasts less than three months and usually gets better with home treatment. Some steps you can take when you first get back pain include using heat or ice, taking over-the-counter medicines like Tylenol or Advil, and not resting too much (contrary to past thinking.)
Chronic: Pain that has lasted longer than three months, requiring more intensive treatment. Longer-lasting back pain requires adding other treatments, like manual therapy, maybe a muscle relaxant or stronger medicine or even a steroid or other applicable localized shot. Perhaps you’ll want to try acupuncture, massage or a more comprehensive rehab program.

Who you gonna call?
There are a variety of doctors who deal with spine problems, beginning with your own family or general practitioner or pediatrician, as applicable, who will look at your medical history, your symptoms, the type of work you do and the physical activities you participate in regularly or occasionally, followed by a physical exam. Based upon this, the doctor will prescribe medication or physical therapy or perhaps send you for a test such as an X-ray, an MRI or CT scan or other evaluation procedure. Your doctor may then refer you to a specialist for further evaluation.

What about back surgery?
When it is determined you need back surgery, the problem is usually one of the following: a spinal fracture, an infection, disease or tumor in the spine, a herniated disk, an instability or weakness in the back or legs, a loss of control of the bowel or bladder.
Back surgery is a really BIG decision, and many times the outcome is less than is hoped for, so you should consider getting a second opinion. Another consultation can help you be as informed as you can be, help you weigh pros and cons of types of surgeries available and how soon you need to make your decision.
Don’t hesitate to ask your doctor for a recommendation or source for a second opinion. It’s actually a pretty common request. Find out if a second opinion is covered by your health insurance. Ask your first doctor to send your records and test results to your doctor giving a second opinion. Write down your questions and concerns to take to your appointment. Make an informed decision based upon your research.

There will be rehab.
Just face it — a comprehensive rehabilitation program is a very important part of the success of back surgery. Physical therapy will help you regain flexibility, condition your back and stomach muscles, increase your endurance for activities. If you are not willing to commit to the rehab program after surgery, you may not be a good candidate for the surgery.
Since four out of five of us will experience some form of back problem, be prepared! Avoid problems by exercising regularly, eating healthy, losing excess weight, quitting smoking, not lifting heavy objects, using good posture, trying to lower the stress in your life and … stop being a weekend warrior!

by Anne Moore

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