Banishing Back Pain

Nearly every adult will experience some type of back pain, and it can be excruciating. The good news is, back pain is often preventable, and thereare new and better ways for treating it.

If you’ve never had an episode of back pain, consider yourself one of the lucky ones. By most estimates, about 80% of adults will suffer at least one episode of back pain. While common back pain usually goes away in a matter of days or weeks, in more serious cases, a back injury can be long-lasting and debilitating. One reason why back pain is so prevalent is because the back is the body’s workhorse; its muscles, tendons and ligaments carry most of the body’s weight. Nearly every movement of the human body involves at least some part of the back.

HOW THE BACK WORKS

The backbone, or vertebral column, is a stack of more than 30 bones called vertebrae. Together they create a bony canal that surrounds and protects the spinal cord. Small nerves enter and exit the spinal cord through spaces in the vertebrae.

The vertebrae are held together by muscles, tendons and ligaments. Between the vertebrae are intervertebral discs which act as “shock absorbers” to prevent the vertebrae from hitting one another when a person walks, runs or jumps.

COMMON CAUSES

The lower back bears most of a person’s body weight and is the site of most back pain.

Common back pain is often related to the spinal joints, discs or supporting muscles of the back. One of the main worries for sufferers is the fact that pain can occur at any moment. In most cases, the pain can be successfully treated in a few days through over-the-counter pain relievers such as ibuprofen. Most people recover from minor episodes with minimal treatment within two weeks. If pain persists beyond four weeks, further medical evaluation is strongly recommended to rule out the possibility of a more serious ailment.

Back strain ranks as the leading cause of back pain, accounting for about 80% of cases. Other major causes include:
 

•  Fracture or Trauma: injuries that may arise through accidents or falls.
•  Disc herniation: a rupture or tearing of the cartilage that surrounds the vertebral discs.
•  Osteoarthritis/spinal stenosis: the constriction or narrowing of the vertebral canal.
•  Ankylosing spondylitis: an inflammatory disease of the vertebrae that causes them to fuse together.
•  Spondylolisthesis: the partial dislocation of one vertebra.
•  Non-spinal causes of back pain include cancer, kidney stones, or infection.

 
To help identify the possible causes, your doctor will ask a series of questions beginning with your medical, surgical and family histories. This will help determine when your pain began, where it’s located, and what impact it's having on your daily activities. In more serious cases, diagnostic imaging such as X-rays and MRI/CT scans may be required.

TREATING BACK PAIN

Most back pain can be successfully treated without significant medical intervention. In typical cases, a combination of a few days’ bed rest, anti-inflammatory medication and cold packs to reduce swelling and muscle spasms will relieve the painful symptoms within one or two weeks.

In cases of persistent back pain, a more comprehensive approach may be needed. Your physician may bring in experts in physical therapy and pain management to formulate a treatment plan. Injury or damage to a disc can be serious and persistently painful. In a healthy spine, the discs are flexible enough to allow the spine to bend. Thanks to advances in technology, patients with damaged discs are often treated successfully by undergoing disc replacement.
 

TOTAL DISC REPLACEMENT

One of the newer and more successful treatments for damaged discs is Total Disc
Replacement (TDR). As the name suggests, TDR involves the removal of most or all of the tissue of the damaged disc, which is then replaced with an artificial disc that the surgeon implants between the vertebrae.The artificial disc replicates normal disc functions, like carrying loads and allowing motion. Usually made of metal, plastic-like (biopolymer) materials, or a combination of the two, these materials usually last for many years.

The TDR procedure has proven the best treatment option in many cases. Like all medical procedures, TDR involves some level of risk and may not be the optimal choice for some patients.

Your doctor is best able to determine the treatment options that are right for your individual situation. In addition to TDR, fusion surgery is a proven alternative to disc replacement, and has a long-standing record of success.

MINIMALLY-INVASIVE TECHNIQUES

Several years ago, a patient who had undergone spinal surgery would have had to recuperate for as long as one year before resuming normal activities. Recent advancements in surgical
 
technologies and techniques allow doctors to use minimally-invasive procedures such as laparoscopic spinal fusion and microsurgical treatment to successfully treat painful back problems such as severe spinal bone degeneration or herniated discs. Typically, minimally-invasive surgery is done using one or more tiny incisions, usually with the aid of endoscopic  visualization or a microscope to guide the surgeon. These techniques are transforming the face of surgery; what used to involve a week-long hospital stay, a year to recover and a large permanent scar has been reduced to a few days, a few months and a few tiny scars.

PREVENTING BACK PAIN

When your back is pain-free, strengthening and stretching exercises are among the best ways to keep it healthy and less susceptible to injury and pain.These exercises can be done at home and don’t require any special equipment. Some simple exercises include:

Pelvic tilt: Lie on your back with your knees bent. In this relaxed position, the small of your back should not touch the floor. Tighten your abdominal muscles so that the small of your back presses flat against the floor. Hold for five seconds then relax. Repeat three times and gradually build up to 10 repetitions.

Knees-to-chest: Lie on your back with both legs straight. Bring one knee up to your chest, pressing the small of your back into the floor (pelvic tilt). Hold for five seconds and repeat five times. Repeat the exercise using the other leg.

Back stretch: Lie on your stomach. Use your arms to push your upper body off the floor. Hold for five seconds. Let your back relax and sag. Repeat 10 times.

In addition to stretching, walking, swimming, yoga and pilates are among the best exercises for the back. It is important that you don’t let the fear of pain keep you from performing healthy activities. Staying active even with minor pain generally speeds up the recovery process, helps prevent re-injury, and reduces the risk of disability.
 
If you have a history of back problems or are currently experiencing back pain, talk to your doctor before starting any exercise or stretching regimens.