- Over a lifetime, 60 to 90% of people experience significant bouts with low back pain.
- The annual incidence of low back pain involves 5% of the population, and over an average lifetime, sciatica —involving pain in the lower back and legs — occurs in 40% of the population.
- Risk factors for lower-back pain and sciatica include:
- Repetitive lifting by bending forward from the waist and twisting the body as the lift is executed.
- Vibrations of vehicles or machinery.
- Cigarette smoking.
- Osteoporosis — progressive loss of bone mass that typically occurs after the age of forty — may account for the fact that elderly women have more low-back
symptoms than elderly men.
- Low-back pain is generally self-limiting, and 50% of patients with sciatica recover within a month.
- Basic treatment for acute low-back pain is bed rest, which has been shown to cut the time to recovery by half. Other treatments include use of hot water rubber pillows, painkillers, application of ice, traction, physiotherapy and exercise programmes.
- Manipulative treatment (that is osteopathic or chiropractic manipulations) may temporarily decrease pain and improve back function, but it has little or no lasting benefit. There is no convincing evidence that it corrects spinal malalignment.
- In 10% of the patients, low-back pain persists for more than six weeks, though the cause may still be elusive.
- With sciatica, the most important cause is pressure from a herniated disk. Neurosurgical treatment includes bed rest, medication, injection of steroids around the nerve and spinal braces.
- About 5 to 10% of patients with unrelenting sciatica may require an operation.
||KEEPING YOUR SPINE SUBLIME
Often back pain is easily relieved without surgery or drugs. In fact, 60% of people with acute back pain return to work within one week, and 90% are back on the job within 6 weeks. Here are some tips for preventing and treating back pain.
- Do an early morning stretch: Always start off your day by stretching while you are still in bed. Before you get up, slowly stretch your arms over your head, then gently pull your knees up to your chest one at a time. When you are ready to sit up, roll to the side of the bed and use your arm to help prop yourself up. Put your hands on your buttocks and slowly lean back to extend your spine.
- Walk away from it: Walking keeps your back healthy by conditioning your whole body. It strengthens the postural muscles of the buttocks, legs, back and abdomen. A brisk stroll may also help your body release endorphins, hormones that subdue pain. Swimming, cycling and running are good, too. Try walking or some other aerobic exercise for 20 minutes a day, thrice a week.
- Take a break: Sitting puts more strain on your back than standing. If you must sit at your desk for an extended time or you are traveling by plane, train or car, change position often and give your back a break by standing up and walking around every hour or so.
- Let the luggage lie: Instead of leaping out of your car or airplane and grabbing your bags, take a couple of minutes to stretch. Slowly bring your knees toward your chest and gently swing your arms around to loosen up stiff muscles. Avoid lifting with overstretched arms and try to keep the bags close to your body. Consider getting a collapsible luggage carrier with wheels.
- Kneel, do not bend: Avoid bending over at the waist to pick up something. That creates tension in the back and increases your risk of injury. Instead, use long-handled tools and kneel on a cushion or knee pad to do gardening, vacuum cleaning or any other 'low-level' activities.
- Let your legs do the work: If you are lifting something, no matter even if it weighs 5 pounds or 50 — bend your knees, keep your back straight and lift with your legs. The legs are much stronger than the back and can lift a lot more weight without strain.
- Test the load: How many of us have strained back muscles when we tried to pick up boxes that we thought were empty but were actually filled with encyclopaedias? Always nudge a box with your foot or cautiously lift an inch or so before really trying to lift it. If it is too heavy for you, do not be macho — ask for help.
- Turn your back on heavy lifting: If you cannot find someone to help you move a heavy object, try this manoeuvre as a last resort. If the object is at table height, turn your back to it to drag or lift it. You can also use this technique for raising windows. This position reduces the pressure that would be exerted on your spine by forcing you to use your legs for leverage.
- Straighten up: Maintaining good posture is one of the best ways to prevent back pain. To improve your posture try to do this exercise. Stand against a wall or sit in a dining room chair, make sure that your shoulders and buttocks touch the wall or your chair. Slip your arm into the space between your low back and the wall or chair, tilt your hips so that the extra space is eliminated. Stay in that position till you count uptil 20 while looking at a mirror to see what your posture looks like. Try to maintain that posture for the rest of the day. Do that exercise once a day for three weeks to ensure that maintaining good posture becomes a habit.
- Check your mattress: Your mattress should provide proper support, be flat and even and not sag. So if you feel like you are sleeping in the middle of a pita bread, it is probably time to get a new mattress. A bed loses a tremendous amount of firmness as it ages. A mattress is like a pair of shoes. It may suit your needs at one time, but it wears out as time goes by.
- Roll it up: A lumbar roll, a round foam rubber pad that can be purchased at most medical stores, can help maintain the natural curve in the small of your spine and prevent lower back pain. Whenever you sit, stick the roll between your low back and the chair.
- Dress for success: Wearing tight pants can prevent you from using proper biomechanics such as bending your nees, especially when lifting. Try wearing loose-fitting clothing for a month.
- Forgo the tobacco: Smoking decreases the blood flow to he back and can weaken discs. So if you do smoke, quit the habit as soon as possible.
- Do the big chill: Apply ice to your aching back as soon as possible to reduce pain and swelling. Wrap an ice pack in a pillow case or towel (never place ice directly on your skin) and put it on the sore spot for ten minutes each hour until the ache subsides.
- Then warm it up: Once ice relieves the swelling that maybe usually within 48 hours you can begin using heat. Heat increases the blood flow to the wound, relaxes tissues and can improve your mobility. Apply a warm, damp cloth to your back for 5 to 10 minutes every hour, or take a warm 15 minute shower or dip in a whirlpool.
- Reach for over-the-counter relief: Taking one or two aspirins or ibuprofen tablets every four to six hours can relieve pain and reduce swelling. Do not exceed prescribed dosage.
- Put up your feet: When minor back pain strikes, lie on the floor and put your legs up on a chair so that your thighs stay at a 90-degree angle to your hips and your calves rest at a 90-degree angle to your thighs. This position relaxes key back muscles and is least stressful for your spine.
- Keep moving: Although lengthy bed rest was once recommended for back pain, doctors now believe that the more active you are, the sooner you will recover. In fact, two weeks of bed rest weakens the muscles and the spine, and that can actually slow the pace of recovery and make you more likely to have a relapse. So do not stay in bed for more than two days, and make sure you get up at least once an hour to walk or stretch.
- Get manipulated: "Chiropractors are gaining respecta bility in the medical community," says Dr. Bensman. The analysis of 25 studies of spinal manipulation — the heart and soul of chiropractic treatment — found that manipulation does provide at least some short-term relief for uncomplicated, acute back pain. They have become quite knowledgeable and their treatment has brought about some real benefits. In a typical case, a chiropractor may do a series of thrusts with the heels of his hands along the troubled area of your spine. Ask your doctor for a referral to a chiropractor in your area.
- Get a second opinion: More than 4,00,000 surgeries, such as spinal fusion and disk removal or destruction, are done each year to relieve back pain, according to the American Academy of Orthopedic Surgeons. Yet, a Blue Cross and Blue Shield study found that almost 13 per cent of spine operations are performed for inappropriate reasons. Get at least one more opinion if your doctor has suggested surgery.