Backache (A Simple Guide to Backache) is one of the most common complaints by patients seen in a family doctor's clinic.
The complaint may be:
1.Constant aching, pain or stiffness that occurs anywhere along your spine, from the base of the neck to the hips.
2.Sharp pain in the neck, upper back, or lower back, especially after lifting heavy objects or other strenuous activity.
4.Chronic ache in the middle or lower back, especially after sitting or standing for long period of time.
More men suffer from it than women.
Backache is most common among people in their middle age.
Backache also occurs among young people aged between 20 - 30
I usually asked for a history of:
1.back strain from the lifting of a heavy object,
2.from a fall,
3.Prolonged sitting with poor posture can also lead to chronic backache such as slouching in a couch when watching TV.
If the bad posture is prolonged, backache may occur.
4.wearing high heeled shoes also put a lot of strain on the back muscles
5.associated pain in legs or weakness and tingling in the legs or back.
6.pain increases when you cough or bend forward at the waist.
7.Back pain radiates into the legs,sciatica.
This could be a sign of a herniated disk.
8.dull pain in one area of your spine when trying to lie down or getting out of bed, especially if you are over 50 years of age. You may be suffering from osteoarthritis(A Simple Guide to Osteoarthritis)
9.pain is felt in both thighs when walking. This can be a symptom of spinal stenosis (the narrowing of the lower spinal canal).
10.persistent backache may also be an indication of an undetected cancer of the colon,ovary,bladder or prostate( A Simple Guide to Cancer).
11.gynecological problems (such as ovarian tumors( A Simple Guide to Ovarian Cancer), fibroids) and pregnancy.
I will then a full medical examination with emphasis on movement of the back:
1. Full medical examination especially of movement of the back ,any deformity of the spine, abdominal swelling, straight leg raising test
2. X-ray of the Spine: to exclude fracture, osteoarthritis, dislocation,
3. X-ray of abdomen to exclude any tumours in the abdomen pressing against the spine
4.MRI of spine for slipped disc,tumours,fracture if necessary
5.Bone density test to exclude osteoporosis
6.Blood tests for calcium, protein,kidney function,cancer markers, RA factor
7. Urine and stool tests for blood,
If no serious illness is found, the most common cause is a strained back muscle.
Treatment is directed at relief of the backache:
Symptomatic:
Painkillers and muscle relaxants
Ice packs or heat treatment
Physiotherapy to strengthen muscles
Good posture and firm mattress
Avoid aggravating factors like high heels, overstretched muscles,excessive strenuous activities
Curative:
The cause must be found and treated. Examples are fractures due to injury. Patient should sent to hospital in case he/she needs surgery
Causes like cancer and aged related illness(osteoarthritis) may not be able to cured but may improved with treatment.
Prevention of backache
1.Maintain the correct posture at all times.
When standing or sitting, ensure that your back is kept straight instead of a slouched position.
2.support your back and use a cushion when necessary.
3.Correct furniture can also help to prevent the occurrence of backache.
Use chairs of a proper height in relation to the table or desk.
4.Sleep on a firm mattress
5. Do not wear high heels
6. Keep your back straight when carrying heavy item.Keep the item close to the body.
7.Do not bend the back to carry heavy objects.
Bend the knees and keep the back straight
8.Exercise is another good way to prevent backache by strengthening the back muscles.
However, if you have had back injuries before such as a slipped disc, do be cautious when you exercise.
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