Acute Back Pain
Handle acute back pain with care and it won't keep you down for long.
Almost everyone experiences acute back pain at some point in their life. A trip to the doctor is often an unfortunate result of a spirited soccer match or ambitious afternoon of garage cleaning!
Most sudden attacks of acute back pain are the result of overstretched muscles (strains) or ligaments (sprains). The pain may be most severe immediately after injury, or it may worsen gradually over a few hours. In most instances, back pain as a result of strain or sprain can be resolved following a conservative course of treatment-usually within two to six weeks-provided there are no serious underlying medical conditions. Identifying the cause of the pain, alleviating the pain- either at home or with your physician's help-and avoiding re-injury are key to the healing process.
What Caused My Acute Back Pain?
Common causes of strains and sprains that can trigger acute back pain include : -
- Improper lifting.
- Sudden, strenuous physical effort.
- Accident, sports injury or fall.
- Sleeping position and/or pillow positioning.
- Poor sitting or standing posture.
- Bending forward too long.
- "Hiking" your shoulder to hold the phone receiver to your ear.
- Carrying a heavy purse, briefcase or backpack.
- Stress and muscle tension.
Physical conditions that can possibly contribute to the onset of acute back pain include : -
- Lack of muscle tone
- Excess weight
What Are My Treatment Options?
Home Or Hospital?
The first step is to assess the severity and cause of your acute back pain to determine whether you need to see a physician.
Consult a physician immediately if you : -
- Are experiencing numbness in, or having difficulty moving, your extremities.
- Experience bladder control loss or impairment.
- Develop a fever or severe headache.
- Are over 60 and have been taking steroids for a long period of time.
- Experience chest pain or pain in the left arm.
- Are pregnant.
- Do not experience any improvement after 72 hours of self-treatment at home.
If you're not experiencing any of the above symptoms, there are several things you can do at home to help soothe your sore back : -
Bed Rest Isn't Best. Going about your normal, everyday activities-but perhaps at a slower pace, and definitely avoiding what may have caused your pain in the first place-is a good way to start the healing process. A little "couch time" won't hurt, but light activity speeds recovery, so avoiding lying down for long periods of time.
Hot And Cold. Heat and cold, in the form of a hot bath or hot and cold compresses, can help relieve sore and inflamed muscles and tissue. Remember-cold comes first! Wrap an ice pack (or a bag of frozen vegetables) in a thin cloth to avoid frostbite, and apply to the affected area for up to 20 minutes several times a day. Ice slows inflammation and swelling, numbs tissue and slows nerve impulses to the injured area.
Once the acute pain and muscle spasms subside (about 48 hours after the first onset of pain is recommended), you can apply heat-to loosen muscle tightness - by taking a warm bath or using a heating pad, heat pack or heat lamp.
Pain Relief In A Pill. Non-steroidal anti-inflammatory drugs, such as aspirin, ibuprofen, acetaminophen or naproxen sodium, can ease pain, swelling and stiffness. There are a number of over-the-counter and prescription options. Your pharmacist can help you determine which is best for you.
Support Yourself. If you must sit or stand for long periods of time, consider using a brace or corset. Worn properly, they can relieve pain and provide warmth, comfort and support. But, don't rely on this type of external support too long-allowing it to perform your muscles' job will eventually weaken them, making re-injury easier.
If your back pain hasn't improved noticeably after 72 hours of self-care, contact your health care provider.
How Can I Prevent Re-Injury?
To prevent re-injury of your back-and hopefully avoid any recurrence of acute back pain-it's important to build and maintain the strength and flexibility of those muscles, tendons and ligaments that support your back and spine.
You can do this through : -
Exercise : -
Regular, low impact cardiovascular exercises that don't jar your back and are easy on the joints, such as bicycling, walking or swimming. If exercising outdoors is not option, consider using a treadmill, elliptical trainer or stationary bicycle. These can be found at almost any exercise studio, or you can buy a home version at your local sporting goods store.
Core strengthening exercises. By conditioning your abdominal and back muscles, you can develop a "natural corset" to support your spine.
Gentle stretching to improve and maintain flexibility.
For back-strengthening programs at the beginner, intermediate and advanced levels, check out these exercises for the back and spine.
A Healthy Lifestyle : -
Eat a nutrient-rich, balanced diet, with sufficient intake of calcium, Vitamin D and phosphorus. (Phosphate makes up more than half the mass of bone mineral; Vitamin D helps maintain appropriate calcium/phosphorus levels. When phosphorus is too high, the body takes calcium out of the bones to bind with the phosphorus and remove it from the blood. Bones become brittle as a result.)
Avoid smoking and excessive alcohol use.
Maintain a healthy weight - additional pounds place excess strain on spinal vertebrae and discs.
Stay well-hydrated. The body is 70% water, and sufficient hydration contributes to intervertebral disc health and that of other back related structures and functions.
Get your vision checked. Poor vision can affect the way you carry yourself, which can contribute to back problems.
Proper Body Mechanics
- Place feet shoulder width apart, don't lock your knees;
- Avoid arching your lower back or slumping your upper back and shoulders;
- Keep your breastbone up, shoulder blades down;
- Keep your chin level, relax jaw and neck muscles.
- Rest your feet on floor with knees and hips bent 90 degrees;
- Maintain a neutral arch in your lower back;
- Keep your breastbone up, shoulder blades down;
- Keep your chin level, relax jaw and neck muscles.
- Adjust your seat so that the back is vertical. Your back should be supported by the seat back and your head should rest against headrest with your chin level;
- Knees should be bent, and at least at the same height as your hips;
- Elbows should be slightly bent and relaxed, with your shoulders down.
- Use a firm mattress. Placing a board between the mattress and box spring can provide a temporary fix for one that is sagging.
- Lie on your back or side. When lying on the side, a pillow between the knees helps maintain a neutral spine.
- Use a cervical roll (a foam roll approximately 3 inches in diameter and 18 inches long) to support the natural curves in your neck or low back.
Acute Back Pain Treatment and Relief
Acute back pain stands a good chance of improvement within a few days to weeks. The following will help : -
Continuing with your day-to-day activities, wherever possible.
Treatment with over-the-counter (OTC) painkillers and anti-inflammatory medicines in consultation with your GP. These provide back pain relief to patients with mild to moderate pain.
Short-term treatment with a muscle relaxant will provide relief
Limiting bed rest to the minimum, since complete rest does not aid recovery.
Muscle strengthening exercises and improving the posture through activities such as stretching exercises, swimming, and walking. Yoga, too, can gently stretch muscles and facilitate pain relief. The mild discomfort that you will experience when you begin these exercises usually disappears as muscle strength improves.
Applying cold compresses (for example, a bag of frozen peas wrapped in a tea towel) to reduce the initial inflammation. This should be followed by local heat application (you can use a heat pad, a hot water bottle, or take a hot shower) after a few days to help ease muscular pain and provide back pain relief.
Chronic Back Pain Treatment and Relief
Self-help treatments for pain relief : -
Staying active is one of the best ways to keep your back mobile, provide relief and help you get better. It can also reduce your chances of getting back pain again. Bed rest is not recommended as this is likely to make your back pain worse.
Paracetomol is very effective for back pain relief and is often recommended as a first step. There is evidence that paracetomol is effective in helping people deal with long term or chronic back pain.
Anti-Inflammatory Treatments : -
You doctor may prescribe an anti-inflammatory or stronger pain killer depending on the amount of pain and how it is affecting your daily life. NSAIDs, which include ibuprofen, reduce swelling (inflammation) and pain. There is good evidence that short term treatment with NSAID's provides relief. The evidence is not as strong for long term or chronich back pain. Note that there are posible side effects with NSAIDs that include stomach irritation and ulcers.
COX 2 inhibitors are gentler on the stomach but some have been withdranw recently due to possible links with heart disease and stroke.
Muscle relaxants : -
Muscle relaxants may help with muscle spasms. These are usually only used for short periods of time as they can be addictive.
Physiotherapy and Manipulation : -
Consider seeing a qualified physiotherapist, osteopath or chiropractor as some of the treatments they provide, like physiotherapy or back or spinal manipulation, may provide short term relief in some people with acute back pain or nerve root pain.
Complimentary Therapy and Treatments : -
The Alexander Technique is a way of learning to use your body better by becoming more aware of balance, posture, and movement. It can help reduce the strain and discomfort that are the result of poor posture and coordination. The Alexander Technique is based on the principle that we function as a whole and, to make improvements, we need to learn to prevent unnecessary and harmful habits such as tightening muscles and joints and putting too much effort and tension into our posture and movements.
Counselling may also be helpful in dealing with how back pain affects daily life.
Acupuncture works by stimulating certain nerves in muscle and other tissues providing relief. This affects the processing of pain and stimulates the release of natural painkillers as well as substances which can assist with healing. See more on acupuncture here.
Interventional Therapy : - Pain pathways can be blocked or numbed in several ways to achieve pain relief. This is achieved by means of epidural steroids, nerve blocks, and analgesic pump devices.
Treatment at a pain clinic : - If you have chronic pain, your doctor may refer you to a pain clinic. Pain clinics work with you to help relieve your pain by treating your symptoms and also by giving you counselling to help you deal with the pain.
Surgery : -
In rare cases you may require surgery to repair a slipped or ruptured disc.
Nutritional Therapy and Supplements for back pain
Vitamin C : -
Collagen is largely responsible for the strength and resilience of the discs of cartilage located between the vertebrae of the spine. One study has shown that a daily dose of 1500 to 2500g of vitamin C (which is important in the formation of collagen) can help provide back pain relief.
Glucosamine Sulphate : -
Glucosamine is a constituent of intervertable discs. Clinical experience suggests that taking 500mg of glucosamine sulphate 2 - 3 times per day may stimulate healing and repair. Glucosamine hydrochloride may also be used.
The list of of world class Spine hospitals in India is as follows : -
||Apollo Hospital, Chennai, India
||Indraprastha Apollo Hospital, Delhi, India
||Apollo Hospitals, Bangalore, India
||Apollo Hospitals, Hyderabad, India
||Wockhardt Hospital, Bangalore India
||Fortis Hospital, Delhi, India
||Fortis Hospital, Mohali, India
||Sparsh Hospital, Bangalore, India
||Artemis Hospital, Gurgaon ( Delhi ) , India
||Max Super Specialty hospital, Delhi, India
||BGS Global Hospital, Bangalore, India
||BGS Global Hospital, Chennai, India
||BGS Global Hospital, Hyderabad, India
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