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It's a pain in the back

Most people will experience backache at some stage in their lives and men are particularly prone to this painful condition. It may be intermittent, continuous or chronic and can involve muscle spasms and sharp, shooting pains radiating all the way to the knee, ankle and foot. But don’t despair, there are many things you can do to prevent and treat backache.

Causes

While in most men, back pain is related to age and overuse, there is a very wide range of possible causes. Here’s just a small selection:

• Trauma to the back, for example from a fall, a heavy blow or a sports injury.

• A prolapsed, herniated or ruptured disc, in which the tough coat surrounding the cushion between two vertebrae tears, allowing the soft, inner part of the disc to protrude and irritate a nearby nerve or cause the bones to grind against each other.

• A tear or strain of a ligament or muscle supporting the spine.

Scoliosis, a condition in which the curvature of the spine causes an unequal pull on the supporting muscles.

Ankylosing spondylitis, an inflammatory arthritis of the spine of young men.

Prostate cancer, which along with other cancers can spread to the spine causing persistent pain that worsens over time.

Osteoporosis, a weakening of the bones that leaves them brittle – and yes, men get it too.

• Spinal stenosis, in which the intervertebral disc loses moisture and volume with age, gradually narrowing the spinal canal and leading to inflammation or a pinching of the spinal cord or nerves leaving it.

• Various forms of referred back pain that are the result of a problem elsewhere, but are felt in the back. Examples include urinary infections, kidney stones and abdominal aortic aneurysms.

Prevention

There are many everyday activities which can lead to backache that can easily be avoided by remembering a few basic rules:

• When sitting, sit upright with your buttocks against the back of the chair and your feet flat on the ground. Put a small cushion into the small of your back and if you’re using a computer, make sure that the monitor is at eye level. Stand up and stretch every half-hour.

• When standing, stand upright, with your tummy pulled in and your legs slightly apart. Don’t slouch!

• When bending to pick something up, keep your back straight and squat by bending your knees to lower yourself.

Other ways to prevent backache include:

• Losing excess weight which puts strain on your spine and may cause lower back pain.

• Using supportive furniture, including a good quality work chair and bed mattress.

• Regular back-supporting exercise, like swimming, walking, aquaerobics, yoga and Pilates, which will increase the strength of your abdominal and back muscles, improve your mobility and help prevent backache. Make sure to stretch before you exercise and ask you GP or physiotherapist for the best back exercises.

Treatment

There are many different treatment options for backache, but beware, not all of them may be effective for your particular back problem. It may take some trial and error to find which one works best for you, but with the help of your health practitioner you’re sure to find some relief.

• Keeping active has been shown to speed up recovery from acute lower back pain. Bed rest should be limited to a couple of days at most.

• Analgesics or painkillers, including paracetamol, co-proxamol, aspirin and Tylenol, muscle relaxants, such as diazepam, as well as anti-inflammatory drugs, such as ibuprofen, diclofenac and Advil, may provide some respite from pain.

• Spinal manipulation, as practiced by osteopaths and chiropractors as well as some physiotherapists and massage therapists, involves various techniques that can improve mobility and reduce back pain.

• A well-chosen exercise regime may be effective not only in preventing backaches, but also in speeding up recovery. Only do this on the advice of and under supervision from a qualified medical practitioner.

• Although ice and heat as well as acupuncture haven’t been scientifically proven to be effective backache treatments, some people swear by them.

• If the most painful spots causing chronic back pain can be identified, steroid or local anaesthetic injections into these trigger point may provide some pain relief.

Back surgery should be your last resort, only considered after thorough consultations with medical specialists and exhausting all other options. While it’s not guaranteed to solve the problem, back surgery, including spinal fusion and the removal of disc material compressing nerves, may be necessary in cases of severe mechanical problems such as herniated discs, spinal stenosis, degenerative disc disease and vertebral fractures.

(Andrew Luyt, Health24, November 2010)

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