HealthyCanada.com

Who doesn't get a backache from time to time? Low back pain affects 8 out of 10 Canadians at some time in their lives. There is no condition, other than the common cold, that causes so many people to lose time from work.

Low back pain may be acute, lasting less than one month, or chronic, lasting longer than three months. While getting acute back pain more than once is common, continuous long-term pain is not. Ninety per cent of acute low back pain resolves within a month; most within the first week or two.

There is no single cause of low back pain. You might have strained a muscle, sprained a ligament or suffered a slipped disk. These and other injuries can occur if you use your back muscles in activities that you are not used to, for example lifting a heavy couch, planting a new tree, or playing sports .the so-called "weekend warrior" type of injury. More than 70 per cent of back problems begin during routine daily activities. Accidents and other forms of trauma account for the rest.

No matter how you get it, low back pain usually involves spasms of the large, supportive muscles alongside the spine. Like most things, there are factors that may increase your risk of hurting your pain, including:

• Working in construction or another labor intensive job
• Bad posture
• Pregnancy
• Lack of exercise
• Excess weight
• Over the age of 30

You may also have an underlying condition that causes back pain such as arthritis, osteoporosis, kidney stones or a bladder infection.

They don't call it back "pain" for nothing. It hurts. But you may feel a variety of symptoms if you injure your back, including pain in your lower abdomen, groin, leg or foot. In fact, the distance the pain travels can be an indicator of the seriousness of the injury. These are some common symptoms:

• sharp pain
• dull aching
• a tingling or burning sensation
• weakness in your legs or feet
• slow and restricted movement

If there is no serious underlying cause for your back pain, it will usually go away on its own within 48 hoursYou may be able to speed up the healing by doing the right things early on. When your doctor advises you to "take it easy", don't make the mistake of interpreting this to mean bed rest. That's one of the worst things you can do for your sore back. Reduce your activities for a few days and then gradually get back to it. Motion is lotion!

Many patients wonder if they should have an x-ray or other test. Your doctor can assess you for any "red flags" that merit further investigation, but tell them if the accident was because of a high impact injury, or if you are having sudden bowel or bladder incontinence, unexplained weight loss, sustained fever, or a history of cancer. For acute low back pain in people without any red flags, only about one in 2500 x-rays actually change your outcome. For the majority of people with back pain, especially those under 50 years of age, an early x-ray is not helpful.

For pain relief apply heat or ice to the area that hurts and take over-the-counter pain relievers. Do not perform activities that involve heavy lifting or twisting of your back for at least six weeks. When you're ready, go for a walk or a swim, but don't go out and play football or golf or try to lift weights until you are completely healed.

Treatment of ongoing back problems is directed at the specific cause. This may mean losing weight, exercising, and improving your posture when you're standing, sitting and sleeping. Pilates is helpful for strengthening the core muscles that support the back. It is important to recognize that many people are active but that the activity they do does nothing for their back muscles.

If your doctor discovers nerve damage or if your back pain becomes chronic, your doctor may send you to a bone specialist, a pain specialist or neurologist to further investigate the cause and recommend surgery or other treatment.

Prevention

Recent studies indicate that the most important factor in avoiding back injury may be your general physical conditioning. This suggests that regular aerobic exercise, such as walking or swimming, may provide the conditioning a back needs to stay healthy.

The Canadian Physiotherapy Association offers the following tips to help you prevent back pain:

à Lifting - with your feet shoulder-width apart, bend your hips and knees, keeping your back as straight as possible. Grip the load firmly and hold it close to your body, tighten your stomach muscles and use the strong muscles of your legs as you lift the object. Keep your back straight and avoid twisting - point your feet in the direction you want to go.

à Posture - think tall with your chest lifted, shoulders relaxed, chin tucked in and level. Posture should be stable, balanced and relaxed when sitting, walking or standing.

à Sitting - don't sit for long periods of time; stand up, stretch and walk around. Use a back support in your chair if necessary but make sure it fits you.

à Exercise - a healthy body-weight puts less strain on your back. A physiotherapist can show you how to keep your back flexible and strong with correct back and stomach exercises.

à Driving - position your car seat so your back is supported and your legs are relaxed and slightly bent. If you need extra lower back support, use a lumbar roll or a rolled-up towel.

à Sleeping - your mattress should be firm enough to support your spine in a neutral position - no sagging! Consider adding a layer of foam for added support.