Most humans will at some time in their lives suffer from back pain. It is by far the most common of all human medical conditions. Most times, this pain can be traced directly to a physical event that leads to pain in the muscles, joints or ligamentous attachments and will resolve within a week or so from the injury. However, there are many times that either the cause is unknown or the original problem seems to re appear spontaneously and become a 'chronic' or recurrent pain. Many people wonder why their back pain will not clear up. These 'attacks' can be quite distressing and often affect the quality of our day to day lives. In this article, I hope to shed some light on some theories used to describe and treat the often over used term 'Back Pain'. We advise you to seek investigation from a medical professional before trying any new treatment approaches.
Discs Don't Slip!
First, let's deal with the most common myth about back pain. The term 'slipped disc' is often used to describe pain in the spine. You'll hear it on an almost daily basis. 'I've slipped a disc in my back again' or 'My back's gone out, I'll have to get it put back in again'. Well, let's be very clear, vertibral discs do not slip and they don't go out!' They may 'herniate' (bulge) or even 'prolapse' (burst) after trauma but they never 'slip' and you can't just push them back in. Although these terms are often used lightly as a way to describe the person's condition, they can lead to a false impression on the mechanisms involved in your back pain. Vertibral Discs serve as the shock absorbers for your spine, they are made of two main components. An outer fibrous casing called the 'annulous fibrosis' and an inner fluid core called the 'nucleous pulposis' much like the way old golf balls used to be made. The outer fibers run in many directions and are bound solidly into the bone of the vertibral bodies above and below. The soft nucleous of the disc allows the joint to move and absorb gravitational and mechanical forces from many different directions. The important thing to remember is that discs do not contain nerves for pain and they do not have much of a blood supply.
The pain most people feel from back pain associated with disc problems comes from the ligaments that surround the front, back and sides of the vertibrae. Other pain stems from inflammation and hypertonia (spasm) of the muscles and tendon attachments or 'referred nerve pain' (sciatica).
The reason it is important to understand the processes involved is because it can have a direct effect on the course, duration and type of treatment required to resolve the origin or cause of the problem.
Treatment Approaches
Many Doctors will agree that most back problems resolve in around 6 weeks without any treatment at all. That doesn't help you deal with the severe pain and distress that back pain can cause, so after investigating and eliminating any more serious causes, most practitioners will prescribe some pain killers and anti inflammatory drugs. Most manipulative therapists, such as Osteopaths and Chiropractors, will attempt to restore the articular mobility of the associated joints to help balance the mechanical strains acting upon the joints of the spine and its attachments. The idea being that this will aid the healing process, speed the recovery time and reduce the mechanical weaknesses that can lead to an ongoing or recurrent problem. Other alternative therapists, such as Acupuncture, Naturopathy and Herbalists will attempt to deal with the problem from a systemic or 'holistic' point of view. The key point to understand is that although many of these approaches do show a significant improvement and may well help slow recurrence, the problem will resolve or settle over time with or without treatment. Conditions that do not improve over time have a more serious underlying cause or pathology driving them that must be investigated.
How healing takes place
The amount of time it takes for a musculo skeletal problem to resolve is directly affected by its blood supply and lymphatic drainage. Muscles have an extremely good blood supply and most muscle strains will settle within a few days. Tendons and very fibrous ligaments do not have much of a blood supply at all and so the healing processes takes much, much longer. A broken bone will resolve far more quickly than a damaged tendon because of its excellent blood supply and drainage through the periosteum membrane that surrounds every bone in the body.
The term 'back pain' can involve any and all of these anatomical structures and so determining the exact recovery time or treatment approach can often be quite difficult. Pain from the site of the injury itself may involve a 'micro' tear of the muscle fibers close to the spine, strain to the spinal ligaments, damage to the tendon attachments to the bone, a bulging of the vertibral disc that places pressure on the surrounding nerves or tissues and inflammation of all of the above! The muscle will heal quickly in a few days unless re injured, the ligaments can take several weeks and the tendons may take even longer. The inflammation will only resolve when all of the problems have healed. Inflammation is a distinct physiological healing process of the body that speeds the removal of damaged tissue and aids the building of new tissue in its place.
After all these structures have healed, we may still be left with some pressure or minor scar tissue that irritates the nerves as they leave the spine, resulting in a 'referred pain' extending along the path of the nerve. In sciatic problems the pain may extend all the way down to your knee or calf or ankle and even into your toes! When this type of pain is continuous or if you are left with some numbness or tingling in the skin, it often indicates that the vertibral disc has been damaged and may be 'bulging' (not slipping!). This type of problem should investigated by a medical professional.
The Experts View
Osteopaths would argue that almost any recurrent, chronic or acute spinal problem, even a muscle strain acquired during a sporting incident, can have its origins in an imbalance to the mechanical forces travelling through the body... or that many recurrent tension headaches and some migraines can result from strains to the muscles, tendons and joints of the upper back, cervical spine and its attachments to the skull. There is a good deal of logic to this form of reason, however, even Chiro's and Osteo's will agree that there is no one particular treatment approach that works on every type of back pain, neck pain or headache. It is important to identify the cause and eliminate any more serious underlying conditions.
Another common myth is that being over weight causes back pain. Under weight people and even fitness devotees suffer as many back problems as people who are over weight, it has a lot more to do with the mechanical integrity of your body than the weight you are carrying. However, it is certainly true that being overweight will compromise your mechanical strengths and may lengthen the time it takes to recover. Lifting any sort of weight relies directly on the leverage and fulcrum of the forces being applied. The laws of physics apply to our bodies as well! So look according to your posture and remember, your knees when lifting heavy or bulky.
Conclusions
How many medical conditions, we have inherited a genetic predisposition that family, if you can start with our own daily lives, or act as a catalyst coupled recurring back problems. It 'also true that a balanced posture, regular exercise and a healthy lifestyle to reduce our risk of serious back pain and add the speed of our recovery.
People havewas standing upright in a relatively short period of evolution. In our modern life we tend to demand too much time sitting in an inappropriate location for an extended period. Our physiology and mechanics are designed for regular exercise, if you do not see them as "joint" should not be surprised if "not" being at the wrong time. Conversely, as our physical mechanisms can be returned are able to take some load. Who rarely worksResults in something other than pain ... No pain, no gain? ... Oh no, you should read ... No pain, no pain! We may not be able to prevent back pain from occurring, but we can ensure that your back to the highest attainable standard of health and balanced structural integrity for the job you ask them to do.
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