Symptoms of back pain

A variety of symptoms may be present when your back hurts. Symptoms may be: tingling or burning sensation, accompanied by a dull, aching, or sharp shooting pain. This may be accompanied by weakness in the legs or feet. The pain may be worse from movement or while lying down.

Common causes of back pain

Most often, back pain is felt when you:

• Lift a heavy object
• Move suddenly, or hastily
• Sit in a particular position for long hours
• Suffer an injury — a fall, or an accident.

There are several possible “prompts” that lead to lower back pain. This may be due to osteoporosis, spasm of the muscles in the lower back, hernia, or poor alignment of the vertebrae.

Other local factors that may present on evaluation, by the doctor, may include spinal stenosis [narrowing of the spinal canal], ligamental tear or strain, scoliosis or kyphosis [spine curvature gone haywire due to a genetic defect; this is also seen in children and teenagers]. Another cause may be fibromyalgia, a condition characterised by general muscle pain, stiffness, fatigue, sleeplessness, and numerous sensitive points at the sites where the muscles join the bones.

Technically speaking, lower back pain usually involves spasms of the large, supportive muscles alongside the spine, irrespective of the cause. The spasm and stiffness can, at times, be extremely painful.

Other important risk factors

Your job could be one of the determining factors — of positions that require heavy lifting, bending and twisting, or truck/lorry/bus driving [whole body vibration] may cause back pain. There are other causative indicators too, viz., bad posture, or pregnancy, if you are over age 30, if you smoke and/or obese. The chances expand if you don’t exercise.

Medical conditions may also cause low back pain — these include arthritis [bone joint disease], bladder infection, kidney stone, ovarian cancer or cysts, and twisted [torsion] testicles. People with a low pain threshold and/or those who feel stressed or depressed also often present with backache.

Managing back pain

It’s commonly found that most people with backache feel better within a week’s time. It is also often seen that back pain is likely to be completely gone in four to six weeks. It would, of course, do us all a great deal of good, if we get better quickly, because if this does not happen, for whatever reason, back pain may become a difficult customer to handle.

It is not that back pain calls for extreme measures, including complete bed rest. Bed rest does more harm than good — because, the more active you are the better. Besides, unless you have symptoms such as loss of bowel or bladder control, weakness, weight loss, or fever, doctors recommend that you stay as active as possible. If you wish, you could reduce physical activity for the first two-three days after onset of back pain and get on with your usual activities thereafter.

Home remedies for back pain

Try to alleviate your symptoms and reduce any inflammation in the area of the pain in the first few days by way of reduced activity, if needed. You may apply ice pack to the painful area, for the first 48-72 hours. Thereafter, you can use heat, or hot water fomentation. You may also use a pain-relief pill, or natural remedy, under the guidance of a therapist [Please remember that some medications, including over-the-counter pills should not be used by individuals with a stomach ulcer, stomach inflammation, or a liver disorder]. If you do not get relief, in a couple of days, it is time you sought an appointment with your doctor.

Some auxiliary measures can also provide relief in many cases:

• Try to sleep in the curled-up, foetal position with a pillow between your legs
• For those who prefer sleeping on their back, a pillow or rolled towel may be placed under their knees.

Prevention is your best bet

The best way to prevent backache is, of course, by way of regular exercise. Exercise helps you avoid repeat episodes of back pain. More important: it will help you avoid back pain in the first place. However, it is mandatory that you know how to exercise safely. Exercise provides you the means to improve your posture, strengthen your back and improve flexibility, lose weight, and avoid falls.

What makes a complete exercise programme, you may well ask. Answer: any of the aerobic activities, such as walking, swimming, or exercise bicycle, including stretching and strength training.

Seek your doctor’s advice if you have had unexplained fever along with your back pain, or your back pain started after a severe blow or fall. Or, if it shows redness, or swelling, on the back, or spine. Or, you have radiating pains, weakness, burning urination, and nightly aggravation of pain. You need to inform your doctor the medications you are taking, or have taken.

Prevention is better than cure

As for those who don’t have back ache, or have recently recovered, it would make sense to follow a simple “how-to” programme, viz.,

• When an object is too heavy, summon help; don’t resort to foolish bravado
• If you lift anything at all, make sure that you have spread your feet apart to give a wide base of support
• Stand as close to the object you are lifting as possible; also, bend at your knees, not at your waist. Keep your breathing on; don’t hold your breath
• When you lift, or lower the object, make sure that you tighten your stomach muscles, and hold the object as close to your body as you can
• Use your leg muscles, and as you stand with the object do not bend forward
• Do not stand for long periods of time. If you have to, try using a stool, and rest your left and right foot alternatively on it.

There are also a few more things you can do. Avoid using high-heeled footwear. You may use cushioned soles when walking instead. When working on a computer, make sure your chair has a straight back with adjustable seat and back, arm-rests, and a twirl seat. When you sit for long hours, try to rest your feet on a stool — so that they are higher than your hips. Use a pillow or rolled towel behind your lower back while sitting or driving long-distances. Avoid bending too much at the steering wheel. Also, stop and walk around every hour.

Try to relax. Meditate, and learn yoga or t’ai chi. Also, get a regular therapeutic massage.

Precautions to take during back pain

Avoid lifting objects or twisting of your back for the first six weeks after the pain begins. Do not exercise for the first 6-8 days following backache. Resume regular exercise after four weeks, following recovery, and slowly get back to your original rhythm. Don’t try to get back your lost exercise days in a hurry.

When you are ready and confident, you should start easy to begin with. Light cardiovascular training, such as walking, riding a stationary exercise bicycle, and swimming may be resumed two weeks after your symptoms surfaced. The reason is obvious: aerobic activity helps the blood flow to your back and quickens the healing process. It also strengthens the muscles in your stomach and back. Stretching and muscle strengthening exercises may be started slowly; they are useful in the long run. However, stretching exercises are best avoided immediately after an injury. They often aggravate pain. You may, for safety, seek the advice of a physiotherapist before you get back into your fitness/exercise routine, or regimen.

You would also need to avoid playing games like cricket, tennis, football, basketball, and golf. Jogging and weight-lifting too are not suitable soon after injury. Your physiotherapist may recommend some simple exercises like lifting your legs when lying on your stomach [the yogic bow pose], or sit-ups with straight legs, not bent knees.

Alternative therapies for back pain

Besides treatment provided by a doctor and self-care steps taken at home, many people turn to complementary and alternative therapies for relief of back pain.

Chiropractic

Back pain is one of the most common reasons that people see a chiropractor. If you’re considering chiropractic care, talk to your doctor about the most appropriate specialist for your type of problem. In addition to chiropractors, many osteopathic doctors and physical therapists have had training in spinal manipulation.

Acupuncture

Some people with low pack pain report that acupuncture helps relieve their symptoms. According to the National Institutes of Health, results from a number of studies suggest that acupuncture may help ease chronic low-back pain. In acupuncture, the practitioner inserts sterilised stainless steel needles into the skin at specific points on the body. Acupuncture is thought to stimulate your central nervous system to release the body’s natural pain-relieving endorphins. Acupuncture may also alter how your blood pressure, blood flow and body temperature are regulated and respond to pain.

Aromatherapy

Aromatherapy or treatment with essential oils can often help relieve the painful muscle spasms that contribute to back pain. Sage, rosemary, thyme— are rich in thymol and carvacrol, compounds that help muscles relax. Add a few drops to a couple of tablespoons of any carrier oil [warm it] and rub the mixture directly on the affected area. Alternately, you can add a few drops of the oil to a hot bath and soak for a while, inhaling the steamy vapours. Essential oils useful for back pain are:
1. Muscle fatigue: lavender, marjoram, rosemary, clary sage;
2. Acute pain: black pepper or ginger, birch. (Warning: Always use essential oils along with carrier oils.)

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According to The National Center for Biotechnology Information (NCBI), more than 200 million people are estimated to be suffering from osteoporosis. 1 in 3 women and and 1 in 5 men over the age of 50 years will experience fragile fractures in their lifetime, resulting in hospitalisation. Osteoporosis is the major risk factor for fragile fractures but there are other reasons too such as muscle weakness or muscle spasms.

Osteoporosis

Osteoporosis or “Porous Bones” is a bone disease that occurs when the body loses too much bone mineral, resulting in weak and fragile bones which are more likely to suffer fractures with even a mild fall. Porous bones are more likely to occur at hips, spine, or wrist. The risk of osteoporosis increases with age and can lead to fragile fractures, causing permanent disability. The reasons for osteoporosis are varied—hormonal disorders, blood or bone marrow disorders, autoimmune disorders etc.

Muscle Spasm

The involuntary movement of one or more muscles at a time leads to a muscle spasm also called ‘twitch’. The main reason for muscle spasms can be fatigue, overuse, stress, or anxiety. It is most likely to happen in elderly people who are suffering from nerve disorders. Some symptoms can be pain in the neck, back, and head, muscle weakness, skin numbness etc.

To avoid fragile fractures, elders should take all possible care to prevent the above-mentioned conditions. If they already suffer from these conditions, they would do well to alter their lifestyle such that they minimise the risk of worsening their condition. Seniors should avoid sitting on the floor, as much as possible, as doing so can cause unnecessary strain on their bones and muscles. Regular exercises like walking, yoga and cycling have great benefits. Lastly, the importance of having a balanced diet and regular health checkups cannot be stressed enough.

6 tips to minimise fragile fractures in the elderly

Here are few tip that can help prevent falls that can lead to fragile fractures:

1. Install handles/railings at strategic places in the house

Hand railings enable seniors to walk safely to the washroom, or up and down the stairs; Using a walking stick to move around the house can also help keep the balance and prevent falls.

2. Comfortable, slip-free footwear

Elderly people should avoid wearing normal slippers that can cause them to trip; instead, they should wear comfortable, slip-free footwear with cushioned soles.

3. Keep the floor free of clutter

Items lying around the floor can inadvertently cause tripping. It helps to keep the floors of the house as clutter-free as possible. Likewise, ensure that carpets and rugs are properly tucked to the floor and clean off spilled liquids, grease or food the floor right away.

4. Bathroom accessibility

During winters, the elderly get frequent urges to use the washroom. It would help if their beds are near the bathroom but if that is not possible, usage of urine pots should be encouraged during nighttime. Install slip-proof tiles on the bathroom floor.

5. Limit water-intake

Seniors should avoid tea/coffee or milk after sunset. Also, they shouldn’t drink more water than necessary to quench their thirst as that can increase their need to use the washroom at night.

6. Keep a night lamp switched on at night

A night lamp will ensure that the room is not pitch dark when they need to visit the washroom at nighttime. A night lamp will help them navigate their way without danger of getting hurt due to poor visibility. Also, in general, keep the home well lit to avoid any untoward mishap.

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