Tuesday, 26 May 2015

Monday, May 25, 2015 How to deal with back pain

By DR TOROOTI MWIRIGI
More by this Author
Most cases of back pain are rarely a sign of a serious condition and gradually get better with home treatment and self-care. However, it is advisable to seek medical treatment immediately if you notice an abnormality or swelling. PHOTO | FILE
Most adults will experience back pain at some point in their lives.
According to Dr Hamisi Kote, most backaches are felt in the lower back but it can also be felt in other places along the spine, between the neck and down the hips.
The intensity of pain ranges from a dull, continuous ache to an abrupt, stabbing sensation.
The pain runs down to the leg and a person may be unable to stand straight or have limited flexibility.
Generally, with treatment and self-care, back pain improves within a couple of weeks or months.
However, there are people who experience pain for a long-term or the pain may keep going and coming back.

Dear Doc,
What usually causes people to have back pain?
Cleopatra

Dear Cleopatra,
Common causes of backache include strain on the ligaments or muscles due to abrupt awkward motion, frequent heavy lifting, and poor posture. At times, the soft substance in the inner part of the disc (which cushions the bones in the spine) can rupture or bulge of out their place hence pressing on a nerve and this can result into back pain. Skeletal abnormalities can cause back pain if for some reason the spine bends in an irregular manner. Other causes may include traumatic injuries like falls, accidents, or during sporting activities. These injuries can hurt ligaments, muscles or tendons which can cause back pain. Infections involving the bones and other underlying conditions such as endemetriosis, osteoporosis, and inflammatory illnesses affecting the joints like arthritis, can also cause back pain.

Dear Doc,
I am eight months pregnant. My back feels sore and it hurts a lot when sleeping, walking and even when I am sitting. What is causing the pain and what can I do to ease the pain?
Mildred

Dear Mildred,
First, congratulations on your pregnancy. Most pregnant women experience back pain, so you are not alone in this. The pain is mostly related to hormonal changes as well as the extra weight your body is carrying.
Therefore, since the weight is on the front part of the body, it tends to place more pressure on the lower part of the back. Changes in posture as the pregnancy changes the center of gravity, doing strenuous activities or lifting heavy loads when pregnant can also cause back pain. To help you feel better, exercise regularly for instance swimming or taking a walk.
Talk to a doctor about other safe exercises during pregnancy.
Practice good posture as stooping can strain the spine. When sitting, change position often, sit straight with the back supported on the chair and slightly elevate the feet whenever possible.
Sleeping on your side may help take excess weight off your back. Apply a cold or warm compress such as a warm damp towel on the painful part to help reduce the pain. Also, avoid any strenuous activity and unnecessary lifting.
Most cases of back pain in pregnancy are not permanent and usually disappear after delivery. See a doctor if the pain is too much and does not go away with self-care.

Dear Doc,
When is back pain a sign of a serious problem?
Wesonga
Dear Wesonga,
Most cases of back pain are rarely a sign of a serious condition and gradually get better with home treatment and self-care.
However, it is advisable to seek medical treatment immediately if you notice an abnormality or swelling in the back, unable to pass urine normally, fever, tingling or numbness in the legs, unexplained loss of weight, chest pain, continuous pain that does not ease after rest and other home treatments, or if the back pain follows an injury such as a fall.
These could signify a more serious problem and need immediate assessment.

Dear Doc,
What is the treatment for back pain and when is surgery an option for chronic pain?
Mwanzia

Dear Mwanzia,
There are various treatments for back pain which include taking painkillers such as ibuprofen or paracetamol, application of cold or warm compresses or hot water bottles on the painful area, exercises, manual therapy like massage and muscle manipulation, and surgery. However, surgery is considered as the last option usually when symptoms worsen or do not improve and conservative care has failed. Surgery may thus be recommended for a patient who has constant or recurrent pain that interferes with the person’s ability to live a normal life for several months. Since every surgical procedure carries some degree of risk, it is important for a person considering having a surgery for back pain to only do this when physical therapy and medications has failed to work. In addition, surgery does not work for all patients. Therefore, what is important when it comes to treating back pain is to find a treatment plan that eases pain and enables a patient to live a life that is as pain-free as possible.

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KNOW YOUR BODY
Preventing that ache in your back
It is always easier to prevent back pain than to deal with one. Some of the daily activities like sitting for long hours and lifestyle habits like poor diet can contribute to development of back pain. To prevent back pain and maintain a strong, healthy back;
  •   Always maintain good nutrition and healthy body weight. Having too much body weight places strain on the back muscles. If you are overweight or obese, try to cut off the excess weight. Eat a balanced diet with an adequate supply of vitamin D, and minerals phosphorus and calcium to promote healthy bones.
  •   Engage in exercises regularly to strengthen and allow the back muscles to function better. Walking is one of the simplest exercises you can do. Swimming and biking are also a good choice. You can also talk to a doctor or a physical therapist about other forms of exercises that are good for you. However, discontinue any type of exercise that makes the pain worse.
  •   Always stretch your body before engaging in an exercise or any other demanding physical activity like dancing.
  •   Practice good posture. The way you stand, sit or sleep can cause significant consequence on your back. Avoid slouching while sitting because when the curve is lessened, the lower back is in a better position to support the body’s weight. When sitting, sit up straight with your back supported on the chair. The hips should be at a level with the knees, and the feet flat on the ground or use a footstool to rest the feet if need be. Change your sitting position regularly and take breaks to stretch. Good posture helps lessen the amount of strain placed on the muscles on your back.
  •   When working at home, for example in the kitchen, ensure that the height of the working surfaces is comfortable to avoid straining your back.
  •   Sleep on a mattress that is adequately firm to provide support to your body.  Sleeping in a bed that does not provide adequate support to your back can cause back-stiffness. Sleep on your side. If you have to sleep on your back, put a pillow below the knees so as to help keep the normal curvature of the lower back. Improper sleeping positions can cause damage to your back without you realising it.
  •   If you are a smoker, quit the habit. Smoking restricts the flow of blood to the spinal discs, making smokers more prone to back pain.
  •   Wear comfortable shoes, at least two inches long. Very high heels interfere with body’s alignment and causes extra stress on the lower back. Also, avoid wearing heels for many hours or during long distances. Very flat shoes also should be avoided as they do not provide support to the arch of the foot hence can cause problems with hips and back.
  •   Maintain good position when carrying or lifting objects. Incorrect handling or lifting of objects is one of the major causes of back injuries. When lifting, make sure to hold the object close to your body and bend only the hips and the knees not the back. If the object is too heavy ask someone to help you lift it.
  • If you are carrying more than one bag, distribute the weight uniformly on both sides of the body. Buy school bags designed for wearing over both shoulders. Learning how to lift and carry correctly can effectively help prevent incidents of back pain.
  • Making simple changes in your lifestyle habits can go a long way in preventing and minimising incidents of back pain. But, if you develop back pain, do not disregard it. See a doctor for prompt treatment.

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