Back on Track
Prevention can go a long way toward warding off back pain and injury
Sometimes, an afternoon of gardening, a fall or simply growing older can lead to an unwelcome result: back pain.
The causes of back pain can vary, but what’s certain is that prevention of this widespread issue is key.
“Eighty-five percent of the population will have an issue with their back at some point in their life,” says Dr. Joseph Riina, an orthopaedic spine surgeon at OrthoIndy and Indiana Orthopaedic Hospital.
“We really should be stressing more preventative care for the back than ‘if you’re injured what’s the best way to treat it,’” he says. “If we can protect the back, injuries will be less severe and recovery will be shorter.”
Common causes
Riina calls it a “growing issue” among middle school and high school athletes –– sports-related back sprains, strains and stress fractures.
“We’re seeing a growing number of stress fractures, all the way to college level,” he says.
These injuries typically stem from overuse of muscles and joints. Stress fractures occur when a certain bone in the lower back gets bent repeatedly, potentially leading to weakness and cracking.
“When people push their bodies to limits, they commonly extend beyond what we’re expected to do,” says Dr. Edward Kowlowitz, founder and medical director of the Center for Pain Management.
Because they’re placing added pressure on their lower backs, pregnant women commonly complain about back pain, Riina says. He suggests doing core- and back-strengthening exercises, like yoga and Pilates, before getting pregnant. Even a simple walking routine can help.
“It’s not uncommon for women after pregnancy to have degenerative disc disease,” Kowlowitz says, referring to a condition where discs in the spine lose their cushioning. “Sometimes (pregnant women) need to be evaluated for disc protrusions.”
Elderly patients often get back pain related to arthritis or osteoporosis. Compression fractures, where vertebrae bones collapse, also are more common in older adults.
Certain conditions, like spinal arthritis, osteoporosis of the spine, pelvic inflammatory disease, pancreatitis or spinal stenosis, in the spine narrows and pinches nerves, can also cause back pain.
Treat yourself
The good news about back pain is that it frequently goes away on its own.
“Most back pain is attributed to overuse or muscle strains or recent injuries to the muscle or ligaments,” Kowlowitz says. “Most goes away in four weeks.”
With a little TLC, like rest, placing a pillow between your legs when sleeping on your side, and ice or heat for comfort, the pain can be controlled, he says. But if the pain lasts for more than four to six weeks, physical therapy, additional testing or injections may be needed.
Anyone with a recent significant trauma, like falling down stairs or being in a car accident, those older than 70 with recent onset back pain, lower back pain that’s worse when you’re resting, and those with decreased bladder and bowel control should seek immediate attention, Kowlowitz says.
What you can do
Preventing back pain can be as simple as using good practices.
Stretch before exercising or heavy activity. Know your limits and don’t overextend. Lift heavy weights close to the body rather than reaching out, and lift with your legs rather than your back.
“The use of proper body mechanics is extremely important,” Kowlowitz says.
Riina likes using the physioball or the BOSU ball for core exercises. Avoid extreme weight fluctuations, and quit smoking, he adds.
“There is good documentation that cigarette smoking leads to earlier degeneration of the lumbar discs, and that can lead to greater episodes of back pain,” he says.
Back Pain Myths
- Drs. Riina and Kowlowitz debunk back pain myths.
- Surgery is a cure. There are several options, like physical therapy, before resorting to surgery, Riina says. Kowlowitz adds that surgery does not always mean the pain will go away. But it’s most likely necessary with spine instability, loss of sensation and muscle strength, or loss of bowel or bladder function.
- Back pain can be isolated to one cause. Many times, Kowlowitz says, there is no one identifiable cause of back pain.
- An MRI is needed. Riina says an MRI will not change anything. “To get an MRI would be a waste of a medical resource and will not change the treatment plan,” he explains.
- A back injury will lead to paralysis. Riina says though most back injuries may cause pain, the vast majority will not lead to paralysis.
Facts
- In a given year, between 12 percent and 15 percent of the U.S. population will visit their physician with a complaint of back pain.
- In 2004, more than 44.6 million patients visited their doctors with back pain complaints.
- Back pain is reported more frequently than other musculoskeletal pain, including that in the arm, shoulder, hip or knee.
- Back pain is the leading cause of work limitations in adults ages 18 to 64.*
- Back pain is the leading cause of work limitations in adults ages 18 to 64.**
*Source: The Burden of Musculoskeletal Diseases in the United States
**Source: The Center on an Aging Society
