Tips to live with chronic back pain

Everyone experiences back pain at some point in their lives, men and women alike. In our previous posts, we read about the causes, diagnosis and some treatment modalities to treat chronic back pain. In this post, we explain more about how physiotherapy can help.

Back pain can be either acute or chronic. Pain that lasts less than a month is diagnosed as acute back pain and if the pain continues for over three months, it is diagnosed at chronic back pain . Amongst the different types, almost 3-5% of people are diagnosed with chronic back pain, of which a large number have localized pain in the lumbar region.The most common causes for chronic back pain include:

Mechanical Problems: Problems associated with the muscles surrounding the back or the spinal column are known to increase the risk of chronic back pain. If the cause of your back pain is mechanical in nature, you might be suffering from a herniated disc, scoliosis, kyphosis, lordosis, muscle tension, or disc degeneration.

Injury: Even a minor injury can sometimes cause spasm of the muscles of the lower back. Pain caused by injury can develop either due to repetitive damage over time or accidents. some of the most common type of injuries are spinal fractures, ligament damage, and muscle strains and sprains.

Diseases: Diseases like arthritis, rheumatoid arthritis, spondylitis, and osteoarthritis can result in chronic back pain if they directly or indirectly target the back causing excessive strain. Other medical conditions that can cause back pain are kidney stones and osteoporosis.

Tumours or Infections: Although very rare, tumors and infections can also cause back pain. Some examples are osteomyelitis, disc infections, and spinal tumors or abscesses.

Factors like obesity, pregnancy, bending, sitting or standing for long periods, lifting, pushing or pulling heavy loads, stress, bad posture, inappropriate sleeping positions and smoking can make you more susceptible to back pain or can aggravate the pain.

Patients who have been diagnosed with chronic back pain, are usually on a variety of painkillers and assistive devices, to help reduce the pain. Some of these are:

Home Remedies: It is important to remain active and carry on with your daily chores as much as possible. Absolute bed rest may worsen the back pain. According to a Finnish study conducted in 1996, people who continued to be active without bed rest after experiencing symptoms of back pain actually had better back flexibility than those who took to their bed for a week. Application of cold and hot backs on the affected part of the back helps to relieve the pain. Ice packs and hot packs are available in the local pharmacies.

Medication: Pain-killers like paracetamol and aspirin or anti-inflammatory medicines like ibuprofen can relieve pain to some extent. Lotions, gels, and creams are also helpful in the early stages. However, once the doctor determines the cause of your chronic back pain, he may prescribe other stronger medicines.

Physical Therapy: Physical therapy or physiotherapy for chronic back pain involves exercises, postural advice, massage, spinal manipulation and mobilization. Other techniques like ultrasound and traction are also used depending on the severity of the problem. Treatment must be continued regularly for about six to twelve weeks or as advised by the therapist. Your physiotherapist is likely to use the following methods to rectify your back pain, some of them are:

• Exercise: It is the most effective approach to strengthen the muscles of the back and abdomen and speed up the recovery. Muscle strengthening exercises are of special importance to patients with spinal irregularities. Physiotherapists will provide you an exercise regime consisting of gentle exercises to keep the muscles active. Activities like swimming, walking, movement therapy and mild stretching exercises that develop good posture, muscle balance and improve coordination are also encouraged. Yoga is another way you can stretch your muscles and relieve pain. You may feel slight pain and discomfort when you start your exercises, but it should disappear as your muscles become stronger. However, if there is severe pain which lasts for more than 15 minutes of onset of exercise, discontinue the exercises and consult your physiotherapist.
• Traction: Here, weights are used to apply intermittent or constant force to 'pull' the skeletal framework into better alignment. This method of treatment should only be done under a physiotherapist's or doctor's supervision.
• Ultrasound: This is a non-invasive approach where sound waves pass through the skin and into the affected muscles and soft tissues to help them relax.

Surgery: Chronic back pain can be managed successfully for most cases. Only one in ten people may continue to have pain even after trying out all treatment options. For such cases, back surgery is the last resort. Doctors only consider this option if they find a specific cause for the pain.

Living With Chronic Back Pain

Sometime chronic pain can be treated, other times it has to be managed. Here are some things you can keep in mind that will make living with chronic back pain more bearable: '

• Practice deep breathing and other stress management techniques to promote relaxation.
• Set realistic goals and don't over-strain yourself on days when you feel your back pain is relatively less.
• Right amounts of exercise, rest, and relaxation should be incorporated into your daily schedule.
• Know everything about your medications, including benefits and side effects.
• Eliminate alcohol consumption. Pain disrupts the sleep cycle and alcohol can further disrupt it.
• Quit smoking. Smoking has been identified as a risk factor for conditions like degenerative disc disease. It also slows down the process of recovery.
• If there is a chronic pain support group in your neighborhood, join one. It is always good to learn from others who face the same problems.

Read more about causes, symptoms, diagnosis and treatment of back pain.

Sometimes, certain other health problems could cause or aggravate back pain. It is important that you do not take these 'red flags' lightly. You must seek medical attention immediately:

• Fever may be indicative of an infection.
• Pain along your leg or below the knees - may indicate a disc problem.
• Tingling, numbness, or weakness in one or both legs - may indicate a disc or nerve problem.
• Loss of bowel and bladder control - may indicate a disc or nerve problem.
• Persistent pain that has become worse over time - may indicate injury or a serious back condition.
• Frequent painful urination with traces of blood - may indicate a problem with the kidneys or the bladder.

Leading a healthy lifestyle - eating right, getting adequate exercise, maintaining a good posture go a long way in preventing backaches. However, if you do fall prey to it, we would advice you not to neglect it.

Also read:

• Lower back pain: Why you shouldn't ignore it
• Diagnosis and tests for back pain
• Treatment and surgeries for back pain

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