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Today in Health & Wellness
HEALTH CONDITIONS

Back Pain

Overview
Symptoms
Risk Factors
Commonly Prescribed Drugs
Treatment and Management
Home Remedies
Doctors to Consult
Overview

Common name: Backache; lumbar pain (Eng.); pananakit ng likod (Fil.)

Pain in the lower back is a very common problem experienced by almost 75 percent of the population at some point during their lifetime.

Range of pain depends upon the cause. It can occur gradually or suddenly. It is termed acute low back pain if it lasts for less than four weeks and subacute if the duration is four to 12 weeks. If the pain goes on for more than three months, it is considered as chronic.

Severe lower backpain is usually associated with a number of conditions including bulging disc/disc herniation, sciatica, spinal degeneration, spinal stenosis, osteoporosis, skeletal irregularities, fibromyalgia and spondylitis.

Symptoms
  • Pain, may be continuous, or only occur when in a certain position.
  • Lower back stiffness and spasm.
  • Inability to stand up straight.
  • Inflammation in rare situations
Risk Factors
  • Trauma or injury
  • Compression fractures of the spine.
  • Lack of regular exercise.
  • Overweight or pregnancy
  • Poor posture
  • Stress and other emotional factors
  • Long-term use of medication that weakens bones, such as corticosteroids.
  • Underlying disease
  • Osteoporosis
Commonly Prescribed Drugs

A. Non-Opioid Analgesics

  • p-aminophenol derivatives are used to relieve fever and low-intensity pain. They do not have anti-inflammatory activity and do not affect platelet function. Side Effects: Mild side effects if taken within therapeutic doses such as nausea and skin rashes, and overdosage may lead to severe liver damage.

  • NSAIDs or Nonsteroidal Anti-inflammatory Drugs Inhibit enzyme cyclooxyenase that helps in the production of prostaglandin, the mediator of pain, inflammation and fever. Side Effects: Gastrointestinal disturbances but can be minimized if they are taken with or after food or milk. Contraindication: In patients with asthma, peptic ulcer, bleeding disorder and impaired renal, hepatic or cardiac function.

  • Salicylates Analgesics for low-intensity integumental pain, antipyretic, and anti-inflammatory. Caution: Aspirin and other salicylate-containing preparations should not be given to children with previous viral infection, e.g., influenza, cold, or chickenpox because of association to Reye's syndrome.

B. Opioid Analgesics

  • Also known as narcotics, are used for moderate-to-severe pain. Contraindication: Patients with respiratory depression and obstructive airways disease. Side Effects: Confusion, drowsiness, nausea, vomiting, and constipation may occur when these drugs are taken.

C. Skeletal muscle relaxants

  • They are also considered in the management of acute low back pain. Central-acting relaxants and benzodiazepines are used to relieve painful muscle spasms or spasticity in local trauma or musculoskeletal and joint disorders.
Treatment and Management
  • Exercise regularly to strengthen the muscles in the back and stomach so as to support the spine and maintain its flexibility.
  • Maintain proper posture when standing and sitting. Stand up straight. Having proper posture is a major factor in the prevention of lower back pain. When standing for long periods of time, wear flat shoes with good arch support and alternately rest one foot on a low footstool.
  • Use chairs that support your lower back. Choose a comfortable seat with good lower back support or try using lumbar roll using a pillow or rolled towel to maintain the normal curve of the back. Maintain a good sitting position. Sit with your feet flat on the floor. Sitting with one leg under you or crossing ones legs adds stress to the lower back.
  • Apply the correct lifting and moving techniques. Bend only at the knees and not at the waist. Let the legs do the work while keeping the back straight. Do not lift and twist at the same time.
  • Wear comfortable, low-heeled shoes. The less impact the heel takes as it hits the ground during walking, the less chance the back will become strained.
  • Maintain ideal body weight to avoid causing excessive pressure to the spine. Being at least 10% overweight can dramatically increase one's risk of having lower back pain. A diet with sufficient daily intake of calcium, phosphorus, and vitamin D helps to promote new bone growth.
Home Remedies
  • Hot and/or cold compress. Hot compress dilates the blood vessels thus increasing supply of oxygen and decrease muscle spasm. The cold compress numbs deep pain.
  • Gentle and soothing massages that can promote proper blood circulation.
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