80% of the population has at least one low back pain episode during their life.
In most back pain pain, stiffness, tension are limited in the area above the buttocks (lumbar region). Irradiation to the thigh, leg, or foot suggests nerve root involvement (lumboscaiatica or sciatica).
There are well-defined risk factors, although their relevance can change a lot depending on the type of back pain. Obesity, unfair lifestyle habits and neurosis are at the top of the list.
The causes of back pain are numerous. They not only include alterations of a muscular and osteo-articular nature, but also peripheral and central nervous, visceral, infectious, vascular, tumor (benign or malignant) and psychiatric alterations.
Diagnosing back pain can be very complex. Being a disorder of extremely varied etiology, the patient's history is of substantial importance. The examination of the specialist also plays a primary role and, if appropriate, may request an "instrumental investigation of imaging."
Cures and treatments for back pain can be more or less decisive depending on the etiology. It is certain that, statistically, better results are obtained by intervening first of all on the primary cause.In the vast majority of back pain of low or moderate severity, the modification of lifestyle in its entirety - from diet to posture, to work position and footwear, without neglecting motor activity and the chosen place for sleep - it has an almost definitive impact on resolution Physiotherapy, specific drug therapy and, in a small percentage of cases, surgery complete the remission of back pain.
I'm:
- Obesity
- Cigarette smoking (addiction)
- Incorrect posture
- Hard works
- Prolonged standing
- Frequent twisting and bending
- Nervous depression
- Neurosis and anxiety.
It is also true that the guidelines adopted by the general practitioner suggest delaying for several weeks, during which, thanks to drug therapy and more, most of the back pain is totally recovered.
After this period, even if anticipating the timing and suffering would be reduced, the objective and functional examination of a specialist becomes substantial. Sometimes, only corrective gymnastics or other motor therapy, associated with drugs and manipulations, can prove to be completely effective.
Diagnostic tests for back pain are only required if the pain persists beyond 4 weeks. A standard radiograph, in many cases, does not help diagnose lower back pain; CT (computed tomography) or MRI (magnetic resonance imaging) are certainly more useful.
and anti-inflammatoryOn the other hand, it has been shown that other therapies such as:
- TENS
- Acupuncture
- Laser
- Ultrasound
- Tractions
- Massages
- Diathermy
- Biofeedback-EMG
- Back Schools
- Pilates
- Yoga
- McKenzie
- Other multidisciplinary treatments.
Please note: the fact that these methods are not effective in treating acute back pain does not mean that some of them cannot have a positive impact on prevention - such as Pilates and Yoga.
In the chronic form, which lasts more than 3 months, the treatment that doctors resort to most frequently consists of:
- Pharmacological therapy based on muscle relaxants, anti-inflammatories and / or antidepressants
- Spinal physical exercises
- Aerobic motor conditioning
- Physiotherapeutic manipulations in the spinal area
- Physiotherapy programs combined with preventive and rehabilitative motor therapy
- Bio-psychosocial multidisciplinary treatments
- Loss of excess weight, especially in the case of obesity
On the other hand, they did not show certain and constant efficacy:
- Acupuncture
- BackSchools
- Pilates
- McKenzie
- TENS
- Biofeedback-EMG.
- Muscle relaxation and traction massages.
In the forms with nerve compression (sciatica or lumbosciatalgia) medical therapy is indicated for at least 6 weeks.
Surgery enters the field only in those few cases that have neurological deficits or severe sciatica after 6 weeks of therapy (removal of the herniated disc).
For further information: Back pain and vertebral column For further information: Acute low back pain:
- Reduce general stress
- Eliminate inappropriate behaviors, such as smoking
- Maintain a normal weight, possibly lose weight if overweight or increase if underweight
- Constantly train the muscles of the entire spinal column; these are not exercises for the hypertrophic development of large superficial muscles - or, at least, not only - but above all training aimed at developing the tone and elasticity of the smallest flexors and extensors placed in the deepest bands
- If insufficient, ensure the stability and solidity of the core; this region includes the rectus abdominis, the transversus, the quadrate of the loins, the entire pelvic floor, etc.
- If present, compensate for posture defects, paramorphisms and dysmorphisms. This may include increasing the tone or flexibility of muscles that do not affect the spine and trunk generally, but also of the arms and legs.
- Get adequate sleep. This is very subjective, because not everyone reacts equally to the same mattress. Furthermore, some people can sleep for a long time without repercussions, others instead begin to suffer from various pains beyond a certain limit.
- In case it is necessary to maintain an upright posture for a long time, take care of the choice of footwear, possibly using specific insoles
- In case it is necessary to maintain a sitting posture for a long time, take care of the choice of the chair and the position of the backrest, possibly using an ergonomic product or lumbar support, and keep the back straight; while driving, remember that the distance from the pedals must allow the pelvis to rest against the backrest and keep the knees slightly bent
- In case it is necessary to maintain a long squatting posture, flex the knees, not the back
- Avoid - as far as possible - often adopting uncomfortable and wrong positions, such as staying bent forward, or arching upwards, etc; or taking frequent breaks, even if short
- Before lifting an object:
- Spread the feet adequately to increase the support base
- Orient your feet in the direction of movement, possibly placing them one in front of the other
- Bend your knees slightly
- Keep the load close to your center of gravity
- Maintain lumbar tone, without arching the back down, trying to keep the spine as perpendicular as possible to the floor, and use the strength of the buttocks and thighs
- In any case, avoid excessive loads and ask for help
- If you have to move an object placed high up, use a ladder or a step.
- Spondylolisthesis - Scoliosis
