How is the back constructed?

The back's system of bones, muscles, ligaments, tendons and nerves work together to bear the weight of your body and the loads you carry.

What can I do to prevent back pain?

In order to prevent back pain, you must lose weight if you are overweight, get regular exercise, such as walking or swiiming, learn to maintain the correct posture, take care when lifting or moving things, and choose comfortable chairs and mattresses.

What is a herniated disc? And sciatica? And spinal stenosis?

Spinal movement is made possible by joints between the vertebrae that consist of two flat faces or "facets". If these degenerate, the two halves of the joint grate painfully against each other. Firstly, the disc herniates or wears down and secondly, this puts more stress on the facet joints behind it. These joints become inflamed and later wear out (osteoarthritis). The inflamed joints cause backache. Later the arthritic joints become big and swollen (like an old lady’s arthritic finger joints) and these enlarged joints protrude into the spinal canal and cause narrowing of the spinal canal (spinal stenosis). This causes pinching of the nerves running down the buttocks and legs with nerve pain and weakness down the legs (sciatica).

What type of back pain is the most common?

Back pain can occur at any point along the spine, but the most common site is the lower back, also called the lumbar region. This is because the lower part of the back bears the weight of the upper body plus any weight you are carrying. It also twists and bends more than the upper back does.

Does bed rest help for back pain? And back braces?

Bed rest for more than a few days is not recommended, as this can reduce your muscle strength. When the pain lessens, activity levels must be increased gradually and carefully. Back braces and can relieve strain and support your back temporarily. But prolonged use may result in weakened muscles, so the use of this must be limited to less than a week.

What are the causes of back pain?

In about 85% of acute back pain cases, the exact cause cannot be identified. Among the possible causes, are strains, sprains and injuries, often after making an abrupt movement or lifting a heavy object. A sedentary lifestyle, obesity, joint problems, osteoarthritis and tumours in adjacent organs can also be the underlying cause of a backache.

What is the difference between acute and chronic back pain?

Most cases of back pain are acute, i.e. the pain starts suddenly and intensely and lasts for a short time – usually less than a month. Acute back pain is not usually caused by a serious medical condition and most cases resolve within a few days without treatment. Chronic back pain persists beyond three months and even slight movements can trigger it. Chronic back pain often requires specialist advice.

When is back surgery necessary?

In fewer than 2% of cases of back pain is surgery necessary. There are many other effective treatments and surgery is only considered when a patient experiences unrelenting pain or progressive muscle weakness caused by nerve compression, or incontinence, which can point to spinal cord irritation.

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Backache expert

Susan qualified as a Physiotherapist in 1990, and completed her master’s degree in Physiotherapy in 2013 at the University of Pretoria. She has a special interest in human biomechanics, as well as the interaction between domestic and work-related ergonomics. Read more here.

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