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If you have been groaning and blaming your aching back for all the discomfort then be sure you are not alone. Back pain is a common medical problem that affects eight out of every ten people at least once at one point of their lives. Usually back pain may present as a dull but constant ache to a very sudden sharp pain.
Acute back pain, occurs suddenly and may last for a couple of days or even weeks. However, if the pain extends to more than three months, then it is categorized as being chronic. Chronic back pain is often progressive and it is extremely difficult to determine the cause without the assistance of a thorough clinical diagnosis.
Most of the times you don’t even need medications for back pain. In most cases it may persist for a few days then go away on its own without any medication whatsoever. In some cases, over the counter pain relief prescriptions or just resting may help you overcome the discomfort and the pain. But care should be taken because continued stay in bed for more that a day or two may actually make the situation even worse.
There are some cases where the back pain becomes so severe that it refuses to go away even with limited medication. It is advisable that if this happens for more than three days then it is time you consulted your medical health care provider. This is especially so when your back pain may have been caused by an injury.
Causes, Symptoms and Diagnosis
Such injuries may result from sports, stress on the spinal cord bones and tissues, or from a sudden jolt that may occur during an accident. For our old parents or grandparents,back pain may result from injuries sustained when tending the flower garden or just doing the normal chores in the house. Other potential causes are muscle spasms, muscle strains and muscle imbalances but these causes are not supported by imaging studies.
However, this does not imply that muscle abnormalities cannot be employed as a diagnostic tool as new attention has currently shifted on non-discogenic back pain, where diagnostic results showing normal or near normal MRI And CT scans are not disregarded altogether.
Back pains can also be caused by spinal disc herniation and isthmic spondylolisthesis or degenerative disc disease, spinal stenosis, osteoathritis, cancer, fractures, infection or inflammatory diseases.
So how do you know that you have back pain? As a medical condition, back pain usually present with a range of signs and symptoms such as muscle ache, stabbing or shooting pain, limited range of motion, limited flexibility or an inability to stand upright.
Treatment of Back Pain
Most patients with back pain can be treated with over the counter pain relief prescriptions which help to reduce the discomfort. Anti-inflammatory drugs can also be prescribed to prevent the inflammation of the affected tissues. Generally, most treatment regimens are instituted with the aim of restoring proper bodily functions and strength to the back, and also prevent the recurrence of the back injury. These medications are especially influential in the treatment and management of acute and chronic low back pain.
Effective therapeutic pain relief may include a combination of physician prescriptions and over the counter remedies. However, treatment is not limited to the use of medications alone. In fact, may people employ the use of hot and cold presses as a primary treatment option even before they consider rushing to the pharmacy to restock their back pain relievers. These compresses reduce pain and inflammation and promote greater mobility for a majority of individuals with back pain.
Bed rest is recommended, but it should not exceed 1-2 days. Longer periods aggravate the situation. Note that even as you go through these treatment modalities, the trick of recovery lies in resuming your normal activities as soon as possible. For this reason, exercise is also recommended because it speeds recovery in addition to strengthening back and abdominal muscles.
More serious cases may not respond to these common therapies. Such cases of back pain may have been caused by serious musculoskeletal injuries or back problems. For serious and chronic back pain, surgery is the most viable option in offering pain relief.
While most patients recover fully from back pain other do not for one reason or the other. If you realize that there is no noticeable reduction in either the pain or the inflammation after three days of self care, then you should contact a doctor for further diagnosis and medical assistance. Recurrent back pain results from non traumatic causes or from improper body mechanics and they are often preventable. Such patients should engage in exercises that do not strain or jolt the back, maintain a correct posture and learn how to lift heavy objects properly so as to avoid spinal cord or other back injuries.
A majority of occupation related injuries are a consequence of stressors like heavy lifting, awkward posture, vibration and repetitive motion. Perhaps it can even be better a lot better if you stick to furniture and tools that are designed with the application of ergonomic principles because it is no secret that most of our back pains are caused by inappropriate sitting posture or using chains that are unhealthy for the spinal cord.
Whether it is at home, when walking or at the workplace, there are simple easy to follow steps that every single individual can adopt to help alleviate the potential for back injury hence helping in the maintenance of a healthy back.
Given the fact that more than 80% have been through one or multiple episodes of back pain, it follows that understanding the causes, symptoms and treatment options for back pain is a necessity for everyday living. The causes of back pain, except in more complex situations that progress to chronic back pain that can only be treated with surgery, are simple so are the options for preventing its occurrence and recurrence. Lifestyle changes that promote a healthy back should be adopted for a painless living.
Low Back Pain
Did you know that low back pain is second most prevalent neurological ailment in the United States? It comes second to only headache, it interferes with recreational activities, it interferes with work. Americans spend not less that $ 50 billion annually on low back pain related medical expenses. Back single most contributor to missed work and job related disability. Fortunately, low back pains may go away after only a few days if you are lucky, but for some it may take longer to resolve or even worse progress to severe conditions.
Sometimes generally called lumbago, low back pain is symptomatic of musculoskeletal disorders, lumbar vertebrae disorders or related soft tissue structures like intervertebral discs, muscles, nerves and ligaments. Low back pain can either be clinically classified as acute, sub acute or chronic depending on the duration of affliction. The majority of patients fall under the acute clinical classification. In this case, the symptoms may just go away after a few days with minimum over the counter prescriptions or just by relaxation. A select proportion of patients usually exhibit symptoms that are recurrent. These symptoms may wax or wane alternatively. This proportion constitutes the sub acute cases. A small proportion of patients are classified as chronic.
Causes of Low Back Pain
Most cases of low back pain are triggered and or aggravated by a combination of muscle strain, overuse and injury to the ligaments, muscles or the discs that support the spinal cord. If untreated, muscle strain may result to an imbalance of the spinal structure leading to a constant tension on ligaments, muscles, discs and bones. Such an imbalance make an individual to become increasingly prone to injury or re-injury.
Therefore the causes of back pain are many and they are all interrelated. The most common causes include;
Low back pain can also be caused by other spinal cord conditions such as spinal tumors, alkylosing apondylitis, bacterial infections, Scheuermann’s disease, and Paget’s disease. Apart from the spinal cord conditions which are directly associated with low back pain development, there are other medical conditions that may indirectly cause of aggravate low back pain. Pelvic inflammatory diseases, peptic ulcers, pancreatitis, gall bladder diseases, prostate disease, aortic aneurysm and a host of urinary disorders.
All these causes aside, you should also realize that you state of mind has a profound influence on the degree of pain and the duration. It has been demonstrated that if you are stressed, unhappy at the workplace, or depressed, your chances for quick recovery are greatly diminished.
Treatment of Back Pain
There are a wide of treatment options to chose. While some can be used by almost everybody, other options are restricted to other select groups owing to the need to prevent the occurrence of unfavorable complications. A vast majority of patients often prefer the conservative treatment modality. For instance, for the treatment and management of acute lower back pain, analgesics( pain relievers) are recommended. Common analgesics in the market include the NSAIDs and acetaminophen.
If the cause of the pain has a muscle overuse or strain origin, then you can use muscle relaxants for both chronic and acute cases but these relaxants are not highly recommended owing to their side effects. At the same time you should try to remain physically active though normal activities and light exercises. Note that exercises cannot work in isolation if the other conservative treatments are disregarded.
Currently, there is controversy as to the efficacy of spinal manipulation therapy for non specific low back pain. There are strong evidences that spinal manipulation therapy has the same effects as those of physical therapy hence its use in chronic and acute low back pain is also recommended.
For chronic low back pain which characterizes pain that persists for more than six months, there are a set of options that have been found to be highly beneficial for the treatment of non specific low back pain.
Exercise,though beneficial, is slightly effective where low back pain is concerned. Acupuncture has been used for back pain treatment for a long time and its efficiency is proven. Others include, behavioral therapy, arch support. back schools and the Alexander Technique or a multidisciplinary treatment program approach. Some patients usually benefit from massage and the application of hot or cold pads on painful joints
Surgical treatment is an option that is only advisable after the conservative treatment modalities have failed to achieve the desired therapeutic results such as reducing pain or when the patient under treatment develops progressive and functionally limiting symptoms like bladder or bowel inconvenience or leg weakness which result in severe central lumbar disk herniation which in turn cause spinal abscess or cauda equina syndrome. Unless, there exists an underlying condition that further complicates low back pain, a majority of patients recover fully.
If you have back pains, if you have been experiencing varying degrees of weakness on the lower extremity muscles or if you have leg pains, then you have probably been or will be diagnosed with a herniated disc. In context, a herniated disc occurs when the cushion which sits between two spinal vertebra is pushed outside its normal anatomical position. The movement in itself is would have been no problem at all save for the spinal nerves which are very closely located to the edge of the spinal discs.
As we age, the spinal disc becomes more rigid as opposed to being soft and elastic among the younger individuals. Just like the other structures in the body, these discs lose their elasticity and become more vulnerable to trauma. It therefore follows that as the discs become more and more rigid coupled with the loss of elasticity, it can rapture. If it raptures, a portion of the disc is pushed outside what is considered its normal territory. This is what is called a herniated disc. Since it bulges out of the normal position of the spinal vertebra, it can pinch the spinal cord often leading to spinal cord compression.
Causes and Symptoms
A herniated disc may suddenly occur following events such as a fall or an accident. Alternatively, it may also occur gradually following repetitive straining of the spinal cord. Most of patients who are diagnosed with a herniated disc are already diagnosed with spinal stenosis; which refers to any problem that causes the narrowing of the space that separates the spinal nerves and the spinal cord. Given the fact that a herniated disc occupies a position where it does not naturally exist in, it causes the diminishing of this same space resulting in the irritation of spinal nerves.
The symptoms used to diagnose a herniated disc only occur because the disc pushes out hence pinching the nerves and when the nerves are compressed they do not carry out their physiological functions properly. Abnormal functioning of the spinal cord may lead to the transmission of abnormal signals or if the compression is too much, the signals may not be transmitted at all. Common symptoms include;
Some people experience bowel and bladder problems which may be symptomatic of cauda equina syndrome: a condition that results from a herniated disc. If you experience bowel or bladder problems, then it is a matter of urgency and you should see your doctor immediately.
Diagnosis and Treatment
Diagnosis of herniated disc can be made simply by physical examination. Physicians can test sensation, reflexes and muscle strength to establish a herniated disc diagnosis. Apart from the physical diagnosis, an MRI can also aid in confirmation of the diagnosis.
I t is advisable to note that MRI can only be used as a confirmatory diagnostic tool if it is combined with other examination findings. Why is this so? It is normal for MRI findings to show lumbar spine as having abnormalities even if there is no abnormality especially among the aged.
After the diagnosis, the mode of treatment chosen is largely dependent on the findings from physical examination, symptoms exhibited by the patient and the MRI and X-Ray results. A reasonable treatment plan depends on;
Most treatment plans are significantly conservative and the treatment usually commences with;
There are those who may opt for surgical treatment, but is surgery a necessary option in the treatment of herniated disc? Unless the first steps outlined above have failed to offer relief, surgical treatment is not recommended. In cases where a significant neurological deficit, following an injury, is specifically demonstrated, surgical treatment may be recommended.
Pain and abnormal sensations can be treated by the conservative plan, but when the patient has significant weakness, have been diagnosed with cauda equine syndrome or have a rapidly progressing problem, prompt surgical treatment should be considered. Surgery is done with the aim of removing the herniated disc to eliminate nerve compression by freeing up space. The end result is pain relief and the treatment of associated conditions.
Sciatica can simply be understood as pain that originates from the irritation of the sciatic nerve. Sciatica pain is usually felt from the low back, behind the thigh and down below the knee. This type of pain radiates along the sciatic nerve. It is the largest nerve in the human body and it originates in the nerve roots in the lumbar spinal cord situated in the low back, it extends through the buttocks area but the nerve endings reach down the lower limb.
Causes and Symptoms of Sciatica
Sciatica is caused by disc herniation which leads to an increase in pressure on the nerves. Specifically, it is caused by the compression of lumber nerves L4 and L5 or the sacral nerves S1, S2 or S3 or compression of the sciatic nerve itself. This results in irritation and inflammation of the nerve. It is the inflammation and the irritation and the inflammation of the nerves that lead to the reproduction of sciatica symptoms.
It should be understood that sciatica is a set of symptoms rather than the diagnosis itself. Even the symptoms of sciatica may be the same the underlying causes are very variable and spinal disc herniation is just one of the causes. it can also be caused by roughening, misaligning or enlarging of the vertebrae or alternatively by the degeneration of spinal discs as a result of diseases such as osteoarthritis and spondylolisthesis.
Thus, in general tumors, irritation of the nerves from adjacent bones, infections, internal bleeding and injury can reproduce sciatica symptoms.
These symptoms include;
While the pain may be severe and debilitating in some people, in others, the pain is infrequent and irritating but possesses the potential to worsen. Unless there exists an underlying neurological condition that progresses to nerve damage, pain in sciatica rarely progress to nerve damage and in acute cases, the pain may die off within two weeks. Chronic cases require a more integrated treatment plan.
Diagnosis and Treatment
The clinical diagnosis of sciatica sometimes called radiculopathy which means that a spinal disc has protruded out of its normal anatomical position and is putting pressure on the radicular nerve in the lower back, the radicular nerve is part of the sciatic nerve.
Physical examination can be used in diagnosis. Owing to the specificity of the symptoms, the nature of the radiating pain can also be used as a diagnostic tool. CAT scan, electromyogram or MRI scans can also be used in conjunction with physical examination results to yield a confirmatory diagnosis.
Because, of the variety of the variety of conditions that can compress the nerves, and that the symptoms of sciatica differ from one individual to the other, diagnostic tests are carried out in a series of examinations in which the you will be asked to adopt various positions and actions like squatting, bending forward and backward, walking on toes, rotating the spine, lying on the back, sitting and raising one leg at a time.
These positions and actions will undoubtedly create a situation where pain is more pronounced in other activities than others, hence giving the physician the benefit of understanding the pattern of pain.
For a most people sciatica usually gets better without any medication. Treatment of sciatica usually involves the treatment of the underlying causes. When the cause is lumbar disc herniation or due to a prolapse, then the enlistment of supportive treatment is enough to help in the recovery of the disc prolapse even in the absence of any other intervention.
Pain can be managed conservatively by administering anti-inflammatory medications such as oral steroids and NSAIDs but NSAIDs are no more therapeutically effective than a placebo for an acute case of sciatica.
Epidural steroid injections can be performed if the sciatica pain is so severe. an injection reduces inflammation which is the root cause of the pain. Given the fact that the injections are made at the painful site, the drug is absorbed rapidly hence help in the relief of acute sciatic pain.
Other treatment options addressing the underlying causes are relaxation, physical therapy, non surgical spinal decompensation, stretching exercises and surgical procedures aimed at eliminating the depression of the nerves.
Non surgical treatments include a single treatment intervention or a combination of medial and alternative treatments. In both cases, some form of stretching and appropriate exercise is included. Basically, the non surgical treatments are aimed at offering both the relief from the searing pain and the prevention of recurring sciatica symptoms.
Hot or cold ice pads can be used as a viable non surgical treatment option. During episodes of acute sciatica pain, heat and or ice packs can be placed on the legs especially in the initial phase of the radiation of pain. This is done for a duration of twenty minutes and repeated every 2 hours. The cold and hot therapy can be alternated to achieve pain relief.
Surgical treatments include laminectomy, microdiscectomy and discectomy. All these surgical operations remove the section of the spinal disc that is causing the nerve irritation. surgical removal of the herniated disc alleviates not only the pressure but also the inflammation and the associated pain.
Apart from the surgical and non surgical treatment options, other alternative treatment interventions can also be employed. They include massage therapy, acupuncture and chiropractic manipulation. Acupuncture generally relieves any form of back pain, massage therapy has so many benefits on muscle relaxation, increased blood circulation, and relief of back pain.
Although it is known that sciatic pain and its associated symptoms can better off without any medication, the underlying causes determine the extent of the progression of the disease. In case there is any evidence of the worsening of the condition characterized by bowel and bladder problems, progressive weakness of the legs and other symptoms which pertain to spondylolisthesis, spinal stenosis or degenerative disc diseases, and cauda equina syndrome, you should take immediate step and contact the doctor for a more comprehensive and effective treatment plan.