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The Straw that Broke the Camel’s Back

By Annie Dixon, PA-C at Primary Care Specialists

PE-BackPain_Figure2If you have not yet experienced an incidence of low back pain you are probably in the minority. Some studies report that in the U.S., acute low back pain is the 5th most common reason for physician visits and about nine out of ten adults experience back pain at some point in their life. Often these episodes cannot be traced back to one inciting event. People report waking up with the pain, or that the pain just developed over hours to days. Sometimes back pain starts with a seemingly innocent event like bending over to pick something up. The proverbial straw that broke the camel’s back.

During an episode of low back pain, as with other ailments, patients often want to know why the pain is happening. Bad habits, bad genes, or bad luck is often my answer. Although we have no control over genes or luck, there are some relatively simple habits that you can do to reduce your chance of developing back pain and to help yourself feel better more quickly if you are dealing with pain.

The following back pain prevention recommendations come from the NINDS “Low Back Pain Fact Sheet” (http://www.ninds.nih.gov/disorders/backpain/detail_backpain.htm):

  • Always stretch before exercise or other strenuous physical activity.
  • Don’t slouch when standing or sitting. The lower back can support a person’s weight most easily when the curvature is reduced. When standing, keep your weight balanced on your feet.
  • At home or work, make sure work surfaces are at a comfortable height.
  • Minimize prolonged sitting. Sit in a chair with good lumbar support and proper position and height for the task. Keep shoulders back. Switch sitting positions often and periodically walk around the office or gently stretch muscles to relieve tension. A pillow or rolled-up towel placed behind the small of the back can provide some lumbar support. During prolonged periods of sitting, elevate feet on a low stool or a stack of books.
  • Wear comfortable, low-heeled shoes.
  • Sleeping on one’s side with the knees drawn up in a fetal position can help open up the joints in the spine and relieve pressure by reducing the curvature of the spine. Always sleep on a firm surface.
  • Don’t try to lift objects that are too heavy. Lift from the knees, pull the stomach muscles in, and keep the head down and in line with a straight back. When lifting, keep objects close to the body. Do not twist when lifting.
  • Maintain proper nutrition and diet to reduce and prevent excessive weight gain, especially around the waistline that taxes lower back muscles. A diet with sufficient daily intake of calcium, phosphorus, and vitamin D helps to promote new bone growth.
  • Quit smoking. Smoking reduces blood flow to the lower spine, which can contribute to spinal disk degeneration. Smoking also increases the risk of osteoporosis and impedes healing. Coughing due to heavy smoking also may cause back pain.

A few other suggestions that may help if you have already developed low back pain include:

  • Hot or cold packs, or massage for pain relief.
  • Resume normal activity as soon as possible. Bed rest does not help.
  • Yoga and physical therapy helps ease chronic low back pain (pain lasting longer than 4 weeks).
  • Medications for low back pain include over the counter acetaminophen or nonsteroidal anti-inflammatory drugs such as aspirin, naproxen, or ibuprofen. Topical analgesics may also be helpful.

The good news is that most episodes of acute low back pain improve on their own. But if the pain is intense or radiating to the legs, doesn’t resolve after a few weeks, or keeps recurring and is limiting your ability to enjoy life, medical treatments may be helpful. The range of medical treatments for back pain includes prescription medication options, physical therapy, spine injection therapy, and maybe even surgery. Depending on your specific problem, there are often solutions that can speed your road to recovery from that straw that broke the camel’s back.