What is back pain?

Causes and Symptoms

Most back pain is caused by disk problems, but the disk problems themselves have a
wide variety of causes and manifestations. Annular bulge, disk herniation,
muscular spasms, and strain from overexertion are just a few of these causes.
Among these manifestations are sudden and persistent attacks of sharp,
debilitating pain that exaggerate spinal kyphosis, may
create scoliosis, and make standing up or bending over without
assistance either impossible or very difficult.

The more the lumbar spine approaches either kyphosis or scoliosis, the more out of
alignment the natural curvature of the whole spine becomes and the more pain
results. Scoliosis or uncontrollable listing to one side is a frequent symptom of
disk damage, usually either annular bulge or herniation.

Referred pain may appear from any lumbar radiculopathy, but the two most common presentations are in the
thigh, from pinching the femoral nerve between L2 and L4 vertebrae, and as
sciatica, from pinching the sciatic nerve between L4 and the
sacrum. Shooting pains elsewhere in the leg, genital dysfunction, or incontinence
and other urinary or bowel complications may result from radiculopathy of any of
several other lumbar, sacral, or lower thoracic nerves. In very severe cases,
partial paralysis or constant, intolerable pain may occur.

Treatment and Therapy

Many ways of treating back pain exist, and the program of treatment must be adapted to the particular situation of each patient. Good posture is always essential. Learning to sit up straight, perhaps with a lumbar support roll, or a change of habits, such as learning to lift with the legs rather than the back, may be advised. Sometimes drug therapy with painkillers or muscle relaxants, or physical therapy with manipulation and exercises, is the only additional treatment required. As a last resort and in extreme cases, including emergency cases of incontinence or paralysis, surgery to repair a disk may be indicated.

Treatment options come not only from regular medicine but also from alternative,
complementary, or allied systems of health care. The McKenzie method of bending
the spine backward, thus emphasizing lumbar lordosis, has proved successful.
Techniques drawn from chiropractic, osteopathy,
yoga, acupuncture, and other styles of
therapy have sometimes provided either temporary or permanent relief.

Perspective and Prospects

Low back pain seems to be equally prevalent in all eras and in all countries. Despite socioeconomic improvements in the lives of physical laborers, and despite the fact that a decreasing proportion of people worldwide make their living from physical labor, no concomitant decrease in new low back pain cases has been observed. If anything, there may be a slight increase in the percentage of low back pain cases in industrialized nations since the mid-twentieth century. People with desk-bound occupations and sedentary habits are at great risk for developing low back pain, especially if they slouch in their chairs or fail to protect the natural lordosis of the lumbar spine.

Physicians no longer consider typical low back pain either an injury or a disease.
Since the late twentieth century they have understood it as a natural degenerative
condition that can usually be delayed by good posture habits and managed by
physical therapy, strength-building exercises, painkilling drugs, and lifestyle
changes.

Bibliography

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