We’ve got a great blog for you this month from the perspective of our acupuncturist Ed Waller, detailing a common problem for many – back pain! (Just one of Ed’s specialist subjects)!
Back pain is a condition that affects over 80% of adults at some time in their life.
Please note due to the complex nature of the back and the variables that can be involved in back pain (and good back health) the following post provides information in a general fashion for guidance. Specific cases of back pain should be investigated uniquely as to cause, treatment and prevention.
As a general rule back pain falls into 2 categories: Acute back pain, usually resolved within six weeks but can last up to three months; and chronic back pain, lasting three months or longer.
Acute back pain
Acute back pain can be due to soft tissue injury (sprain /strain). When treating acute back pain due to injury, (correct) rehabilitation of the injured tissue should be prioritised.
When an obvious injury or diagnosis is not immediately apparent the acute back pain is often labelled as “non-specific” but clearly there is a cause. Non-specific acute back pain may (and frequently does) clear up however if the underlying cause isn’t addressed it is likely to recur. There is also a chance that a chronic situation can develop if the cause of acute pain is not addressed. Resolving the underlying cause (where no trauma has occurred) to prevent recurrence can usually be managed by:
- Education around posture – postural awareness, at work, rest and leisure to maintain correct alignment and prevent strain.
- Improving flexibility – tight muscles both in the back or other areas (hamstrings, hip-flexors, trapezius, pectorals, etc) to prevent unnecessary tension or misalignment.
- Improving core strength – ensuring that the correct muscles are working to hold the spine in a heathy and correct neutral position.
- Weight loss – excess weight is known to cause extra pressure on the spine
- Cardiovascular exercise – regular exercise improves the ability of the body to oxygenate the blood, as well as the circulation of the blood to ensure tissues are nourished and healthy. Studies show that low-impact aerobic exercise is beneficial for the maintaining the integrity of intervertebral discs.
- Hydration – good hydration is important maintaining the integrity of intervertebral discs.
Chronic back pain
Chronic back pain can be the result of damage, degeneration or neuropathic changes to the body.
This can be caused in a number of ways:
- Intervertebral disc degeneration – one of the most common mechanical causes of low back pain, it occurs when the usually rubbery discs lose integrity. In a healthy back, intervertebral discs provide height and allow bending, flexion, and torsion of the lower back. As the discs deteriorate they lose their cushioning ability.
- Herniated or ruptured discs – the intervertebral discs become compressed and bulge outward (herniation) or rupture.
- Spinal stenosis – narrowing of the spinal column that puts pressure on the spinal cord and nerves.
- Skeletal irregularities – scoliosis, lordosis, etc can over time lead to chronic back pain.
- Spondylolisthesis – vertebra of the lower spine slips out of place, pinching nerves exiting the spinal column.
- Soft tissue changes – scar tissue, muscle spasm or misalignment following trauma.
- Inflammation – arthritis (osteoarthritis and rheumatoid arthritis), spondylitis (inflammation of the vertebrae).
- Osteoporosis – decrease in bone density and strength can lead to painful fractures of the vertebrae.
- Fibromyalgia – chronic pain syndrome involving widespread muscle pain and fatigue.
- Endometriosis – buildup of uterine tissue in places outside the uterus.
- Neuropathic changes – cause of pain resolved but changes in the nerve pathways and brain cause hypersensitivity.
Although I have listed a number of conditions that may be involved in chronic back pain, it is interesting to note that often there is no anatomical defect that can account for the pain. For this reason, the rapidly developing area of chronic pain treatment in healthcare focusses on a multidisciplinary approach to pain management with one or a number of options being best suited to individuals. Treatment should also provide support to changes in mental and emotional health that frequently accompanies chronic pain such as frustration and depression. Due to the nature of chronic pain even when a source can be identified there isn’t a cookbook step-by-step treatment for pain so again multidisciplinary approaches often give the best results.
In summary PREVENTING acute back pain can reduce the likelihood of developing chronic back pain bought on without obvious anatomical causes.
Where an anatomical cause of pain exists, individuals’ responses vary greatly to each treatment type available and often a multidisciplinary approach is needed, including lifestyle and emotional support.
Where mechanical and physical causes of pain have been addressed and a chronic pain situation has developed, neuropathic changes have taken place which need to be managed / treated.
You can find out more about Ed by checking out his profile on our Team page: http://mwfitness.co.uk/team/