page is a guide to medical conditions, compiled from published
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. Always prefer professional advice based on a
personal examination to this general advice, and always stop at
once if anything you are trying makes the pain worse. Naturally,
you use this information at your own risk.
you have persistent back pain, you should see your doctor
for a diagnosis. Most attacks of back pain show some improvement
after 48 hours, if you keep the back unstressed. However, see
your doctor straight away if you have any of these nerve-related
loss of balance
numbness or weakness in the legs
anywhere around the pelvis
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.
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.
strain can be to one or more of...
joint (a bony joint at the back of the spine, where vertebrae
brace on each other)
(elastic fibres which bind joints, adjacent bones and discs)
(fibres which attach muscle to bone)
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.
is generally a matter of being careful and allowing the damaged
body tissue to heal itself over time. Some specific treatments
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
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.
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.
to your first attack by permanently 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.
slipped disc is also called a 'herniated' disc or a 'prolapsed'
or 'ruptured' disc.
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.
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.
reduce the amount of lifting you do
needs the same care as muscle spasm, with particular emphasis
avoid lifting heavy loads from the floor
take great care always to lift correctly
Spondylitis is a form of arthritis, and can affect several areas
of the body including the eyes and skin.
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.
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.
is not possible, since it is largely an inherited
disease. However in most cases careful management can allow a
normal life to be continued.
is a bone disease, in which density and strength is lost.
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.
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.
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.
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.