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Sep 2016
Back Pain by Vipul Patel

There can be many reasons why back pain can strike; some of which are listed below:

  • minor physical injury
  • pregnancy
  • whiplash injury
  • chronic disease such as ankylosing spondylitis
  • pain from sciatica (inflammation of the sciatic nerve).

I remember when my wife was pregnant; she used to suffer with back pain, making it difficult for her to go about her daily routine. Whatever the cause, the pain can affect you physically and even mentally.

The majority of patients that I treat over the counter in the pharmacy suffer from acute back pain, presenting with typical symptoms of a pain that comes on suddenly, which resolves with treatment after several days. Occasionally, the pain can continue for months and in these cases, I would refer you to your doctor for further investigation.

For patients that I see with acute back pain, I would usually recommend the following:

  • Take analgesics such as paracetamol, co-codamol (codeine and paracetamol) and /or ibuprofen to help reduce inflammation (avoid if you have allergies to the drug, are pregnant, suffer from gastro-intestinal complaints or have been advised by your doctor not to take it)
  • A hot water bottle, heat patch or sometimes cold compression (available at the pharmacy or a bag of frozen vegetables wrapped in a towel) These will also aid with recovery.
  • Try and continue with your daily activities, keeping active and mobile. This will ensure the muscles in the back do not stiffen up, which could prolong the recovery time. Start off with light activity; if the pain is severe, gradually increase as the pain improves.

The incidence of back pain during pregnancy can be reduced by:

  • asking for help with lifting heavy objects
  • ensuring that your back is straight when sitting
  • wearing comfortable shoes which are flat and designed to minimise slips.
  • exercise; your local leisure centre may run aqua natal swimming & exercise classes
  • regular walking; this will ensure your ligaments are subtle and ready as your body adjusts.

If your baby is positioned at a particular angle in the womb, you may experience back pain; unfortunately, in this case you may have to be patient until he or she moves.

Chronic back pain is mainly managed by your doctor, who may recommend stronger analgesics and a referral to a physiotherapist. The goals of physical therapy are to decrease back pain, increase function, and teach the patient a maintenance program to prevent future back problems.

Common forms of physical therapy include:

  • Passive physical therapy (modalities), which includes things done to the patient, such as heat application, ice packs and electrical stimulation. For example, a heating pad may be applied to warm up the muscles prior to doing exercising and stretching, and an ice pack may be used afterward to sooth the muscles and soft tissues or a TENS (transcutaneous electrical nerve stimulation) machine may be used to alleviate the pain.
  • Active physical therapy, which focuses on specific exercises and stretching. For most low back pain treatments, active exercise is the focus of the physical therapy program

Patients suffering from most types of low back pain are often referred for physical therapy as an initial conservative (nonsurgical) treatment option before considering other more aggressive treatments, including back surgery.

Sciatica is the name given to any sort of pain that is caused by irritation or compression of the sciatic nerve, which normally manifests as a tingling sensation that radiates from your lower back and travels down one of your legs to your foot and toes. The pain can range from being mild to being extremely painful. Treatment for this, over the counter, remains the same as above; although if you experience more severe symptoms then make an appointment with your doctor or if you experience a loss of feeling, then seek urgent medical care.

My approach to treating back pain involves ensuring my patients follow a healthy lifestyle. Therefore, when recommending treatments for back pain, I always advise the following steps:

  1. Maintain an ideal body weight.
  1. Ensure you get regular exercise. If you haven’t undertaken any exercise for a while start of slow and build it up to avoid injuries; walking and swimming are ideal. Stretching exercises and activities can also help such as Yoga and Pilates.
  1. Quitting smoking. Smoking reduces the flow of blood to the spine and so may exacerbate back pain.
  2. Bend your knees when lifting objects of the floor and ensure the weight is manageable.
  3. When sleeping, place a pillow under your knees and lower your back.
  4. Avoid sitting for prolonged periods.
  5. If you work at involves sitting at a desk for long periods, then:
  • Ensure you use a support for the lower back
  • Keep your keyboard and monitor at an adequate height and distance.
  • Take standing and walking breaks

Nearly everyone will experience back pain of some form; with these simple treatments, I hope the pain and duration will be kept to a minimum and you’ll be back to your active self in no time.

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