Back pain : 10 questions to understand and relieve

lisafx/epictura

Published the 18.10.2017 at 17h24

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In the framework of the world day of the vertebral column and the pain, the writing looked on the back pain.

What is lumbago ?

Lumbago, otherwise known as “acute low back pain” is pain in the lower part of the back, just above the pelvis, which is usually associated with a contracture of the muscles of the back.

The pain appears suddenly, usually after an effort of lifting, or during a rotation of the back. It can be very intense : one sometimes speaks of a sensation of “stabbing” in the back.

The pain is typically eased by rest and increased during effort, coughing or going to the saddle.

It only lasts a few days to a few weeks and is generally accompanied by a muscle contracture that interferes with the movements.

What are the causes of back pain ?

In the vast majority of cases, its cause is related to poor functioning of the spine, mainly as a result of damage in different structures of the back : the discs between the vertebrae of the spine (tear of the disc), joints facet joints between the vertebrae (osteoarthritis), and ligaments or muscles. Often, not all the lesions are entangled.

It is important not to confuse it with a bad back that wakes us up in the second part of the night and which is accompanied by an ongoing stiffness in the morning, stiffness that fades in the day and effort. In the latter case, it is a “low-inflammatory” that must make mention of all other causes, and in particular the spondylarthrites. Another cause of a back pain discomfort may be caused by your bed. That’s why you should always try to sleep on the best mattress for back pain to ensure that your back is aligned correctly.

What is it that favors the appearance of back pain ?

Age is, of course, associated with an increase in back pain, but the episodes of back pain in the past, a failure of the muscles of the abdominal wall or back towards the age of fifty, or a history of back pain in the family favour the onset of a sore back.

Pregnancy also promotes back pain : the increased weight and distention of the uterus and your stomach muscles are moving the center of gravity of the body, which causes a camber exaggerated back.

The constraints in relation with a professional activity, domestic or leisure activities, are also element that support the low back pain such as poor posture (stress positions, prolonged sitting), carrying heavy loads, exposure to vibration, or when it falls.

What can we do to combat back pain ?

A few tips can help relief the pain : it is necessary to take medication against the pain we have and continue the usual activities, adapting them in order to keep a right position to the back. He must be careful not to force and to avoid sudden movements.

It is also interesting to use the relaxation of the muscles, especially in the case of stress associated with it. Here are a few positions of relaxation :

• Extended, the back is well-tackled to the ground, legs bent resting on the seat of a chair, hands crossed behind the head.
• Lying on your back, bring both knees to the chest, one after the other. Keep both knees together and pull them toward the chest.
• Kneeling, sitting on heels, back wound, forehead against the ground, and framed by the elbows, forearms resting on the ground.

These positions, which allow you to rest the back can be performed a few moments every day.

How to relieve acute back pain ?

In case of lumbago, the most important is to reduce the pain as soon as possible, both to relieve themselves, but also to raise the contracture of the muscles, which is harmful for them.

Pain medications are commonly called ” pain killers “. It is possible to take paracetamol (3 to 4 grams per day) or an association of paracetamol-derived morphine if the pain is intense. A nonsteroidal anti-inflammatory drugs (or NSAIDS) such as ibuprofen, ketoprofen may be associated with it if the pain is not declining rapidly, and in the absence of contraindication (anticoagulant therapy, peptic ulcer, renal insufficiency, etc.).

It is essential to maintain physical activity, even minimal. Inactivity increases the risk of disrupting the proper functioning of the muscles, which are essential to the support of the column. The reversal of an adapted physical activity is the best guarantee for a fast healing.

When to see a doctor ?

In 90% to 95% of the cases, the back pain is a disorder benin, and the rest, and the pain medications will relieve without the help of your doctor.

But sometimes, the deterioration of an intervertebral disc, which is common to a certain age, is not in question. A number of warning signs must evoke a different disease and immediately consult a doctor :

• A beginning of sorrows under the age of 20 or over the age of 50.
• An apparition is the result of a violent traumatism (accident of the highway or fall violently).
• A context of cancer, substance abuse or HIV infection.
• Taking a long-term treatment with cortisone.
• Back pain of gradual onset and not improved by rest.
• Pain the predominant the night with nocturnal awakenings, and a stiffness of the back in the morning for 15 minutes.
• A deterioration of the general condition or fever.
• The appearance of paralysis of the lower limbs, loss of urine or stool, with sensitivity disorders.
• The existence of a pain in the chest.

One of these signs is sufficient to call into question the diagnosis of “acute low back pain common” and should lead to consult a doctor in an emergency.

When it is necessary to do x-rays or other tests ?

In the acute pain secondary to a bad back mundane (called ” acute low back pain common “), x-rays of the lumbar spine are not useful in the vast majority of cases.

On the one hand, this can be normal while the pain are very important, on the other hand, from the forties, and sometimes in the absence of pain, x-rays show very often osteoarthritis, with what is called a pinching of the intervertebral disc and osteophytes (commonly referred to as ” beaks of a parrot “).

A fortiori, it is not necessary to perform a ct scan or MRI of the spine.

Further examinations are only necessary when a different source than the low back pain original disc is suspected.

Does it rest in the case of lumbago ?

Rest in bed is absolutely not advisable, the scientific studies have even shown that it may paradoxically prolong the pain. This is due to the disruption of the functioning of the muscles it induces.

An early recovery of activities of daily living is therefore recommended for a better protection of the muscles and promote healing.

In the case of a professional activity and if the pain is not too great, a work stoppage is not always necessary. When the doctor prescribes a work stoppage, it takes into account the nature of the work and the journeys to get there.

If the work is sedentary with periods of time of transport little prolonged, the interruption of work is not systematic. On the other hand, if the work is physical and transport long and difficult, the stop will be adapted to these constraints (of 3 days in average in case of physical work, a lightweight, five weeks in the case of physical work, heavy).

How is lumbago ?

Thanks to the early treatment against the pain and the preservation of a moderate physical activity, 9 low back pain acute common on ten heal in a few days (less than four weeks), but relapses are possible in the months or years following.

An acute low back pain that does not heal in three to four weeks is at risk for become chronic, and requires a new consultation and a re-evaluation to the doctor, or even a infiltration.

Chronic low back pain (more than 3 months of evolution) is, indeed, more complex to deal with because it is associated to a disorder pronounced in the functioning of the muscles of the back, main support of the body.

How to avoid acute low back pain ?

To avoid back pain it is important not to be too sedentary and have a good back position in the gestures of everyday life.

The fight against the sedentary lifestyle goes through a regular physical activity : sport or leisure-time physical activity (dance, yoga, Tai Chi, etc.). Most physical activities are beneficial if you practice them regularly (you might as well pick a pleasing to for that practice to be regular) and in good conditions, that is to say, if the effort is preceded by a warm-up, if it is progressive and adapted to the physical abilities, with techniques well mastered and a quality equipment.

To prevent low back pain, it is also necessary to adopt good positions in daily life and at work : be good to sit back right in front of her workstation, keep the back straight when lifting a load (it is better to bend the legs), carry heavy loads close to the body and not at arm’s length, or divided into two, one for each arm, so as to keep the back straight. To pass the broom, vacuum, or even digging in the garden, it is better to lower the front by making the “slit-front” – one foot in front of the other like fencers – that lean before, and this will bend the hinge between the back and the pelvis.