BACK PAIN

Possible Cause

Back pain often develops without a specific cause that your doctor can identify with a test or imaging study. Conditions commonly linked to back pain include:

• Muscle or ligament strain :Repeated heavy lifting or a sudden awkward movement may strain back muscles and spinal ligaments. If you're in poor physical condition, constant strain on your back may cause painful muscle spasms.
• Bulging or ruptured disks: Disks act as cushions between the individual bones (vertebrae) in your spine. Sometimes, the soft material inside a disk may bulge out of place or rupture and press on a nerve. The presence of a bulging or ruptured disk on an X-ray doesn't automatically equal back pain, though. Disk disease is often found incidentally; many people who don't have back pain turn out to have bulging or ruptured disks when they undergo spine X-rays for some other reason.
• Arthritis: Osteoarthritis can affect the lower back. In some cases, arthritis in the spine can lead to a narrowing of the space around the spinal cord, a condition called spinal stenosis.
• Skeletal irregularities: Back pain can occur if your spine curves in an abnormal way. Scoliosis, a condition in which your spine curves to the side, also may lead to back pain, but generally only if the scoliosis is quite severe.
• Osteoporosis: Compression fractures of your spine's vertebrae can occur if your bones become porous and brittle.

Risk Factors

Anyone can develop back pain, even children and teens. Although excess weight, lack of exercise and improper lifting are often blamed for back pain.

One group that does appear to have a greater risk of back pain are people with certain psychological issues, such as depression and anxiety, though the reasons why there's an increased risk aren't known.

Care and Treatment

You may be able to avoid back pain by improving your physical condition and learning and practicing proper body mechanics.To keep you’re back healthy and strong:

• Exercise: Regular low-impact aerobics activities — those that don't strain or jolt your back — can increase strength and endurance in your back and allow your muscles to function better. Walking and swimming are good choices. Talk with your doctor about which activities are best for you.
• Build muscle strength and flexibilit: Abdominal and back muscle exercises (core-strengthening exercises) help condition these muscles so that they work together like a natural corset for your back. Flexibility in your hips and upper legs aligns your pelvic bones to improve how your back feels. Your doctor or physical therapist can let you know which exercises are right for you.
• Maintain a healthy weight: Being overweight puts strain on your back muscles. If you're overweight, trimming down can prevent back pain.
• Stand smart: Maintain a neutral pelvic position. If you must stand for long periods of time, alternate placing your feet on a low footstool to take some of the load off your lower back. Good posture can reduce the amount of stress placed on back muscles.
• Sit smart: Choose a seat with good lower back support, arm rests and a swivel base. Consider placing a pillow or rolled towel in the small of your back to maintain its normal curve. Keep your knees and hips level. Change your position frequently, ideally at least once every half hour.
• Lift smart: Let your legs do the work. Move straight up and down. Keep your back straight and bend only at the knees. Hold the load close to your body. Avoid lifting and twisting simultaneously. Find a lifting partner if the object is heavy or awkward. Learning to lift properly may be more effective at preventing a recurrence of back pain than a first episode.

Buyer beware

Because back pain is such a common problem, there are numerous products available that promise to prevent or relieve your back pain. But, there's no definitive evidence that special shoes, shoe inserts, back supports, specially designed furniture or stress management programs can help. In addition, there doesn't appear to be one type of mattress that's best for people with back pain. It's probably a matter of what feels most comfortable to you.

When to Call the Doctor

Most back pain gradually improves with home treatment and self-care. Although the pain may take several weeks to disappear completely, you should notice some improvement within the first 72 hours of self-care. If not, see your doctor.

In rare cases, back pain can signal a serious medical problem. Seek immediate care if your back pain:

• Causes new bowel or bladder problems
• Is associated with pain or throbbing (pulsation) in the abdomen, or fever
• Follows a fall, blow to your back or other injury

Contact a doctor if your back pain:

• Is constant or intense, especially at night or when you lie down
• Spreads down one or both legs, especially if the pain extends below the knee
• Causes weakness, numbness or tingling in one or both legs
• Is accompanied by unexplained weight loss
• Occurs with swelling or redness on your back

Also, see your doctor if you start having back pain for the first time after age 50, or if you have a history of cancer, osteoporosis, steroid use, or drug or alcohol abuse.