This page is a guide to medical conditions, compiled from published information.

You can use it to help to choose the most safe and effective management regime for your back. It is NOT intended to give a medical diagnosis itself, and you should interpret it carefully according to your doctor's advice. Stop at once if anything you are trying makes the pain worse. Naturally, you use this information at your own risk.

Most attacks of back pain show some improvement after 48 hours, if you keep the back unstressed. If you have more persistent back pain, you should see your doctor for a diagnosis. See your doctor straight away if you have any of these nerve-related symptoms:

 any loss of balance

 pain, numbness or weakness in the legs

 numbness anywhere around the pelvis

 difficulty urinating

If you have a major problem it will normally show up on X-ray or be recognisable to a doctor in some other way as a known medical condition. However a very large majority of back pain is not from a serious medical condition.

Down to:	Muscle Spasm	Slipped Disc
	Ankylosing Spondylitis	Osteoporosis

Muscle spasm is a protective reaction to strain damage, which locks the back to prevent further strains. It can be very painful. Episodes of muscle spasm normally subside on their own, provided that further strain is avoided.

The strain can be to one or more of...

 muscle

facet joint (a bony joint at the back of the spine, where vertebrae brace on each other)

ligaments (elastic fibres which bind joints, adjacent bones and discs)

tendons (fibres which attach muscle to bone)

A strain may occur to several of these at the same time, and the spasm reaction can be over a large area so that the sensation is of the whole lower back being injured, even when the damage is quite localized.

Treatment...

is generally a matter of being careful and allowing the damaged body tissue to heal itself over time. Some specific treatments can help:

• Manipulation by a professional physiotherapist, chiropractor, osteopath or a trained doctor. Individual practitioners can vary widely, so check for meaningful qualifications and try a different one if you don't get an improvement in your condition.

• Electrical treatment by a professional, to help relax the muscle and to stimulate pain-reducing chemicals in the body.

• Anti-inflammatory or pain-relieving drugs.

• Application of heat or cold (or both) to promote blood flow and so speed the healing process. The choice of heat or cold seems to be one of personal preference, or may be according to whether the area is inflamed (may be helped by cold) or tense (may be relaxed by heat).

• Bed-rest is increasingly not recommended, especially after the first day: movement is important to recovery. Acute attacks can be helped by relaxing the back structure, lying on your back on the floor with a back support under the lower back, with the legs slightly bent, perhaps supported on a cushion. By temporarily removing stress and easing the pain, even short periods of this relaxation can allow a muscle spasm to release.

Prevention...
needs a continuing effort. People vary widely in susceptibility to all medical problems, and it is important to learn the lesson that you are at risk, whatever other people do. The strains build up over time and may not be caused by what you were doing at the time of the attack.

Respond to your first attack by changing your behaviour. The body's healing processes slow down with age, so if you don't systematically reduce the stress on your back and improve your fitness it is more or less a logical certainty that you will suffer a recurrence.

 Back to top 

A slipped disc is also called a 'herniated' disc or a 'prolapsed' or 'ruptured' disc.

It is a bulge in the wall of one of the discs between the vertebrae, often pressing onto the nerve roots. It is characteristically caused by lifting with a bent spine, though the final trigger may appear to be unrelated to this. The main symptom is 'sciatica' - referred pain, numbness or paralysis in the legs or buttocks. Often other damage occurs at the same time, so that muscle spasm and pain from damaged muscle and ligament are also experienced.

Treatment...
is as for muscle spasm - a minimum of stress to the spine, correct posture, and time to heal, possibly also using active treatments according to personal circumstances and medical advice.

Prevention...
needs the same care as muscle spasm, with particular emphasis on lifting:

avoid lifting heavy loads from the floor

take great care always to lift correctly

 Back to top 

Ankylosing Spondylitis is a form of arthritis, and can affect several areas of the body including the eyes and skin.

The most distinctive symptoms are inflammation of the facet joints in the spine and the sacro-iliac joints (joints between vertebrae and between pelvic bones respectively). Adjacent vertebrae can become fused together by bony growth bridging across the discs. Currently there is no actual cure, but its effects can be mitigated by treatment and management.

Treatment...
often includes anti-inflammatory and pain-relieving drugs, while exercise and posture are also important. Sitting still for long periods is particularly bad for the affected joints, especially sitting in a slumped posture.

Prevention...
is not possible, since it is largely an inherited disease. However in most cases careful management can allow a normal life to be continued.

more information:

Google search

http://arthritis.about.com/health/arthritis/msub11.htm

 Back to top 

Osteoporosis is a bone disease, in which density and strength is lost.

Bones, including particularly the vertebrae, hip and arm, can become so weak that even slight impacts can break them. Because the bone loss itself is painless, symptoms generally appear only when the disease is well advanced - often the first indication is a broken bone. The vertebrae can break at the front from bending loads, causing loss of thickness there which creates a heavily stooped upper body posture, like that associated with very old age. Diagnosis is often late, so get a second opinion if you suspect your doctor may have failed to recognise it.

Treatment...
is by one or more of a range of medications, including bisphosphonates, calcitonin, calcium, fluorides, hormone replacement therapy (HRT), ipriflavone, oestrogen derivatives, anabolic steroids anabolic, vitamin D and vitamin D metabolites. Movement and exercise is important, and if symptoms are severe then joining a support group is also crucial to maintaining a positive attitude and a good quality of life.

Exercise is important, both to help maintain bone material and to maintain muscle tone and balance and so reduce the risk of falling through unsteadiness. However exercises must be selected very carefully in order not to increase the risk of impacts or falls. Lifestyle management and personal organisation are also important to minimise these risks. Correct posture for sitting and lifting is essential to minimise damage to the weakened vertebrae, and in particular stooping and sitting in slumped postures must be avoided altogether.

Prevention...
is best done in advance, by exercising during the late teens and 20's when the bones are still forming - bone density is significantly increased by exercise and moderate loading of the bony structures. A healthy diet with plenty of vitamin D and calcium is also recommended, and sunshine.

more information...

Google search

http://www.nof.org/

http://www.endocrineweb.com/osteoporosis/

 Back to top