Considerations and Recommendations for Back Pain

Recommendations for Back Pain

❑ Avoid all meats and animal protein products until you are healed. Animal protein contains uric acid, which puts undue strain on the kidneys that can contribute to back pain. Do not eat gravies, oils, fats, sugar, or rich or highly processed foods.

❑ Follow a fasting program.

❑ When pain hits, immediately drink two large glasses of water. This often gives relief within minutes. Muscle ache and back pain is frequently connected to dehydration. The body needs a minimum of ten 8-ounce glasses of water daily to keep acidic wastes from building up in muscles and other tissues.

❑ If pain follows an injury or sudden movement, apply ice for the first forty-eight hours, and then apply heat. Rest on a firm bed. When getting up, roll to your side, draw your knees up, push up to a sitting position, and stand by pushing up with your legs.

❑ To relieve back muscle pain, soak in a very warm bath or apply a heating pad directly to your back. Be careful not to set the heat too high, however.

❑ Rhus toxicodendron, a homeopathic remedy, is helpful in relieving stiffness. Take it as directed.

❑ Once the acute pain has subsided, doing exercises to strengthen the abdominal muscles may help to prevent recurrences; these muscles help to support the back. Sit-ups are good for this purpose. Always do sit-ups with your knees bent, not with your legs flat on the floor.

❑ When sitting, try to keep your knees a little higher than your hips and keep your feet flat on the floor. Placing your feet on a pillow or other support to hold this position might be helpful.

❑ When carrying things on your shoulder, switch the weight to the other side from time to time. Carrying heavy shoulder bags may produce neck, back, and shoulder pain.

❑ Learn to recognize and reduce stress. Relaxation techniques can be very helpful.

❑ Always push large objects; never pull them.

❑ Wear comfortable, well-made shoes. The higher the heels of your shoes, the greater the risk of backache.

❑ Move around. Do not sit in the same position for long periods of time.

❑ Never lean forward without bending your knees. Lift with your legs, arms, and abdomen—not with the muscles of the small of your back. Avoid lifting anything heavier than twenty pounds. If you must work close to the ground, squat down so that you avoid bending at the waist.

❑ Do not sleep on your stomach with your head raised on a pillow. Instead, rest your back by lying on your side with your legs bent, so that your knees are about an inch higher than your hips. Sleep on a firm mattress with your head supported on a pillow. If your mattress is not firm enough, place a board between the box spring and the mattress.

❑ Maintain a healthy weight and get regular moderate exercise. A lack of exercise can cause back pain. Activities that are good for the back include swimming, cycling, walking, and rowing. Find one that you like and commit to doing it regularly.

Avoid the following activities if you have back problems:

• Baseball, basketball, football. The quick responses needed for these sports involve sudden twisting and jumping motions.
• Bowling. Lifting a heavy weight while bending and twisting puts strain on the back.
• Golf. The twisting motion involved in the swing, and the body’s tendency to bend forward at the waist, are stressful to the lower back.
• Tennis. Playing tennis puts strain on the back due to the quick “stop-and-go” action of the game.
• Weightlifting. This sport is potentially the most damaging because it places great strain on the lower portion of the spine and back.

❑ 1- If pain lasts longer than seventy-two hours, if pain radiates into the legs, or if other symptoms such as unexplained weight loss occur, consult your health care provider. If your backaches are chronic, look for a physician who specializes in backs—and who does not rush to recommend surgery. Get a second opinion if surgery is recommended.

❑ 2- If your back pain also involves a high temperature or weight loss, or if you have a past history of cancer, bowel or bladder control problems, any numbness in the groin or lower back, or loss of feeling in the legs or feet, see your doctor.

❑ 3- If you have pain in one side of the small of your back, feel sick, and have a fever, see your physician immediately.

❑ 4- If pain follows an injury and is accompanied by sudden loss of bladder or bowel control, if you have difficulty moving any limb, or if you feel numbness, pain, or tingling in a limb, call for medical help immediately. You may have damaged your spinal cord.

Considerations for Back Pain

❑ People seeking professional advice about back pain face a bewildering array of generalists and specialists to choose from. Complex back problems are rapidly becoming a specialty. For alternative treatment of back pain, you can try any of the following types of therapy:

• Acupuncture has the backing of the World Health Organization for the treatment of back pain. However, new data questions its efficacy. In a large study of over six hundred patients with back pain, some patients were given an actual acupuncture treatment while others received a simulated one. Patients reported the same symptom relief regardless of which procedure they received.

• Chiropractic is conducted by professionals who are licensed to perform spinal manipulation and who may recommend nutritional and/or lifestyle changes. It primarily involves the use of high-velocity manipulations of the neck and back to correct problems. According to a 1994 report issued by the U.S. Agency for Health Care Policy and Research, spinal manipulation may be the most effective treatment for acute back pain. Chiropractors are not medical doctors and therefore cannot prescribe drugs or perform surgery. A good chiropractor should be willing to recommend a medical doctor if necessary.

• Kinesiology can sometimes alleviate back problems. By testing muscle response, practitioners can pinpoint the origin of the pain and use various methods, including gentle manipulation, to treat it.

• Magnet therapy is gaining ground in some quarters. A magnetic mattress pad has been developed, and some people have found relief from chronic back pain after sleeping on it for only a short time. Experiments have shown that magnet back support has proven useful for golfers.

• Massage therapy involves different techniques like muscle kneading and compression to lessen tension in the muscles. This increases circulation and helps the body flush out cellular debris, which speeds tissue repair and aids in healing back problems.

• Orthopedic surgery is performed by medical doctors who prescribe medication (painkillers, muscle relaxers, anti-inflammatory drugs), bed rest, and physical therapy for some cases of back pain. Since these doctors can perform surgery, they may be more likely to recommend it than other practitioners.

• Vertebroplasty, for vertebral compression fractures, has offered relief for some people. In this outpatient procedure, a needle inserted through the skin into the affected vertebra fills the vertebra with a cement-like substance called methylmethacrylate, and when this substance hardens (in about fifteen to twenty minutes), it offers support to an otherwise weak part of the backbone.

• Osteopathy, or osteopathic medicine, is based on the belief that most diseases are related to problems of the musculoskeletal system. The musculoskeletal system is made up of the nerves, muscles, and bones—all of which are interconnected and form the body’s structure. Osteopaths (D.O.s) can prescribe drugs and perform surgery in many states, but because of their philosophy of treatment, they often try manipulation or physical therapy first.

• Physiatry is nonsurgical physical medicine and rehabilitation for patients who have been disabled as a result of a disease, disorder, or injury. Physiatrists, also known as doctors of physical rehabilitation medicine, are medical doctors who treat back pain by the use of various physical therapies, lifestyle changes, and back braces, which promote healing by reducing the load on the spine. Physiatrists are not licensed to perform surgery, and are less likely than other doctors to hospitalize their patients. They have a good record for treating back problems, including low back pain and herniated disks.

• Physical therapy focuses on improving joint and spine mobility and muscle strength. Physical therapists are not medical doctors, and are strictly limited to physical therapy.

❑ There is a theory that backache may be caused by repressed rage. This may be something to consider pursuing with a psychiatrist or other mental health professional.

❑ Bed rest makes little difference with sciatica. Both the long-term and short-term consequences of sciatica remain the same whether you observe complete rest or continue your usual routine.

❑ With signs of rapidly progressive nerve damage (increasing weakness in a leg, or loss of bladder or bowel function), back surgery moves high on the list of options. It must also be considered when pain is unremitting or getting worse. Surgery always entails a degree of risk; there is always the chance of permanent damage and impaired mobility.

❑ According to U.S. government data, only 1 percent of those who suffer from back pain appear to benefit from surgery. Back surgery is useful only for problems in four broad categories:

1. Disk displacement (a protruded or “slipped” disk).
2. Painful (and abnormal) motion of one vertebra in relation to another.
3. Narrowing of the spine around the spinal cord itself from overgrowth of bone (spinal stenosis).
4. Some cases in which misalignment of one vertebra with another (spondylolisthesis) leads to pain.

❑ In the past, removing a damaged disk and fusing a section of the spine was a major surgical procedure. Up to one year was required for recovery from this surgery. A procedure called minimal access spinal technologies (MAST) allows the operation to be performed through small incisions that do not even cut through muscle tissue. Someone who absolutely requires surgery should investigate this option. Recovery time is in the days-to-weeks range rather than months-to-years.

❑ X-rays are often considered a routine part of back pain diagnosis, yet only a few back conditions show up on X-rays. If muscle strain or a herniated disk causes the pain, an X-ray will do little to aid the diagnosis, since disks, muscles, and ligaments are all soft tissues. X-ray exposure bears special hazards for pregnant women.

❑ With imaging procedures such as computerized tomography (CAT) and magnetic resonance imaging (MRI), disks can be seen. However, Dr. Richard A. Deyo, of Oregon Health and Science University, notes that 20 to 30 percent of people with back pain have herniated disks that are not the source of their discomfort. If these disks show up during imaging procedures, a person may end up having surgery for a condition that, while present, is not really the cause of his or her pain.

❑ If pain comes after lifting something heavy, after coughing, or after unusually heavy exercise, and the pain prevents you from moving or shoots down one leg, you may have a herniated disk.

❑ Epidemiological studies in the United States, as well as studies of smoking and nonsmoking pairs of twins in Scandinavia. Have shown that smoking aggravates problems in the disks.