Kauvery Hospital | Patient Newsletters | How to Deal Effectively With Back Pain

What is Pain?

Pain is a subjective, personal experience involving both sensory and emotional qualities. Fear/anxiety can increase the perception of pain and is positively associated with the pain intensity in chronic pain patients. Pain is a physiological protective mechanism of the body. It is also the response to associated feeling states in a person.

Pure pain is never detected as an isolated sensation. It is always accompanied by emotion and meaning so that each pain is unique to the individual.

Types of Back Pain

  • Acute
  • Chronic
  • Somatic
  • Visceral
  • Non receptive
  • Neuropathic

Causes of Back Pain

  • Disease
  • Surgery
  • Trauma
  • Emotional Imbalance

Amongst the different kinds of pain people experience the most commonly experienced is the 'back pain'. These days back pain affects people irrespective of their age gender or occupation. To understand this we need to know how the back works.

When we say 'back' it involves the:

  • Spinal column (extension of the hind brain)
  • Vertebra (33 small bones of the spinal column)
  • Inter-vertebral discs (shock absorbers of spinal column)
  • Ligaments (small fibrous cords that hold the vertebrae together)
  • Muscles (3 layers)
  • Curves (3 natural curves)
  • The spinal cord and the brain together form the Central Nervous system.

Back Pain is categorized depending on the duration of its presence.

  • Acute (less than 6 weeks)
  • Sub-acute (6-12 weeks)
  • Chronic (more than 12 weeks)

Causes of Back Pain

  • Sprains and strains
  • Myofacial pain
  • Fibromyalgia syndrome
  • Disc problems
  • Joint degeneration
  • Osteoporosis
  • Osteomalacia
  • Other diseases

Factors increasing risk of Back Pain

  • Smoking- reduces the body's ability to repair itself, promotes inflammation and interferes in calcium absorption.
  • Obesity- There is a continuous strain on spine due to weight of the body.
  • Congenital structural problems- any malformation that needs the body to adopt.
  • Scoliosis- sideward bend in the back
  • Older age- there is a consistent bone loss and bone thinning as age advances.
  • Being female- bones in women are smaller and thinner compared to those of men. Hormonal changes in menopause or hystrectomy reduces flow of oestrogen which is the female hormone that also protects the bones. Conditions like hypothyroidism and parathyroidism
  • Strenuous work
  • Sedentary lifestyle- causes weakness of supporting muscles.
  • Work stress- leads to reduced self-repair mechanism and inflammation.
  • Anxiety
  • Depression
  • Psychosomatic disorders
  • Long term oral steroids- anti epileptic drugs, drugs used to treat breasts and prostate cancers.
  • Other conditions- rheumatoid arthritis, diabetes, renal calculi, chronic respiratory diseases and in organ transplantation, kidney infections, bowel disorders.
  • Red-light warning symptoms: An immediate medical assistance to be sought if any of the following symptoms is positive.
    • any history of cancer
    • feeling of numbness, tingling or pin and needles sensation down one or both legs. This may have a nerve root irritation and requires medical intervention.
    • urinary symptoms-incontinence(the immediate urge to empty the bladder) and renal calculi. This can also happen in case of high temperature states.

First aid for Back Pain

  • Rest
  • Release stiffness by stretching first thing in the morning
  • Hot and cold fermentation. Heat dilates blood vessels and may make the inflammation worse. Cold reduces inflammation when ice packs are used less than 20 mins within the first 24 to 48 hrs.
  • Apply local applications like Moov, Linaments, Balms, etc.
  • Massage
  • Taking pain killers on the advice of a general Practitioner.
  • Taking anti-inflammatories.

Management of Back Pain

  • Improve posture:
  • sit in an upright position, avoid crossing legs, and choose a comfortable chair.
  • stand with straight shoulders with head held high.
  • wear comfortable shoes over fashion
  • lift weights only if there's a need.
  • avoid using a lumbar corset or stick as it does not allow your original muscles to do their action rather it creates a dependency and deterioration of the condition. But if you need one, choose the right one for the purpose.
  • yoga
  • physical exercise involving those strengthening the back , stomach and abdominal muscles.
  • choose a sport of choice.

Adapting your lifestyle

  • Reduce or stop habits like smoking etc
  • Reduce or stop junk food and aim at a healthy BMI (body mass index)
  • Use anti-inflammatory foods and spices
  • Increase foods containing omega 3 fatty acids and antioxidants
  • Consider taking nutritional supplements
  • Choose a right bed and pillow
  • Enjoy sex-life
  • Meditate
  • Feel independent and be independent
  • Avoid holding grudges!

For all you know pain is not an enigma .It is an entity in itself. When pain has gone you can't reproduce it by thinking about it. You can probably recollect that it was unpleasant and made you feel in a particular way. Enjoy a pain free life!

Article by Dr. Mahalakshmi Selvam, M.Phil (Psy), (Ph.D).,
Psychiatrist, Kauvery Hospital

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