Wellness Hub

Those who suffer from it complain first and foremost about the physical discomfort and the toll it takes on their bodies. In some cases, their pain is so severe that it hinders people from performing everyday tasks or participating in the activities they love. Their second struggle, however, is the difficulty of understanding the cause of their back pain and finding treatments that actually work to alleviate this common yet frequently misunderstood and elusive condition.

Luckily, this frustration is due to an excess rather than a lack of information. The key is to pay attention to our bodies, identify the cause of our the pain, and consider the best treatment options. Exercise and physical therapy are generally the first recommendations; surgery and strong painkillers, such as opioids, should be the last resort. An increasing number of studies support alternatives for treating back pain that are less risky and in some cases, more efficient.

Where, when, and how long does it hurt?

In general, when we speak of “back pain” we are referring to the low back or lumbar pain, the most common type and the single leading cause of disability worldwide, according to a study conducted by the World Health Organization. Of course, it’s also possible to suffer from pain in the upper back (thoracic spine) pain or neck (cervical spine).

Back pain is considered chronic when it lasts more than three months or worsens over that period of time, and acute if it comes on suddenly and gets better in a couple of weeks. It’s important to note at what stage of life the pain appears, since age brings significant changes to the vertebral column and an increased risk of developing certain conditions. For example, after age thirty, the spinal discs (cartilaginous joints that separate your vertebrae) begin to degenerate and their ability to absorb shock, one of the main functions of discs, can diminish.

Older adults, especially women, have a higher risk of osteoporosis, a condition that weakens the bones and which can cause vertebrae to become fractured. Degenerative disc disease and osteoporosis, as well as other conditions associated with age like arthritis, can be the culprit of chronic or acute back pain.

Still, the most common causes of back pain are sprains and strains, injuries of the muscles or tendons that can arise after traumas as varied as a brusque motion or jerk to a car accident. Symptoms of sprains and strains include stiffness, tension and tightness, and muscle spasms, and in the vast majority of cases they will go away on their own, with time. For this reason, experts recommend waiting between 4 and 6 weeks to undergo imaging studies like magnetic resonance imaging (MRI), computed tomography scan (CT scan), or x-rays. These tests can be costly and much of the time they are not helpful in diagnosing the underlying cause of back pain.

Ouch!: Pinched nerves

Disorders affecting intervertebral discs are not limited to older age groups. In fact, a disc injury can occur at any moment due to accidents and overexertion. When a disc is injured or deteriorates, it can bulge out of place and compress the spinal cord, an essential part of the nervous system. You’ve likely heard of this disc slippage referred to as “herniated discs.” They are not always painful; in fact, experts estimate that about one in four adults will present disc herniations in an MRI or CT scan, but they will not all feel them. However, when slipped discs cause pain, the symptoms can be excruciating, characterized by what is known as sciatica (shooting pains along the extremities that cause numbness and tingling in the legs and buttocks) and by sharp and intense pain in the back.

Spinal stenosis is another condition that causes nerve compression in the spinal cord. When the bone channel of the spinal cord narrows, certain sections can press against the nerves. This condition is more common in those over 50 years old, but younger people may develop spinal stenosis if they were born with a spinal canal that is naturally narrower than what is considered normal.

“Pinched nerves” due to stenosis or herniated discs are the second most common cause of back pain, according to a Special Health Report from the Harvard Medical School.

How to find relief

Let’s just say movement is key.

In general, surgery should be reserved for extreme circumstances where one’s life is at risk—such as a spinal tumor or a serious injury, like a vertebral fracture. In most cases, the underlying causes of back pain are common and harmless issues, although this does not make it any less bothersome or debilitating. Back pain is among the musculoskeletal conditions that the World Health Organization considers disabling and detrimental to one’s quality of life, since it limits mobility and can lead to early retirement, job loss, and other situations that affect income.

What can we do to improve or cure our back pain? Treatment varies depending on the type of pain, acute or chronic:

For acute back pain, such as that caused by a lumbar injury, experts recommend applying an ice pack to the site in the immediate aftermath of the injury, but using heat after 48 hours in order to relax the muscles. When acute pain finally subsides, it’s important to focus on prevention so that we do not repeat the movement or accident that hurt us again.
On the other hand, chronic pain requires a long-term plan. The most fundamental part of this plan is exercise. Although it’s tempting to stay in bed when we don’t feel well, in the case of back pain physical activity is usually the best treatment for the majority of people. Strong muscles help maintain good posture and alignment of the vertical column, holding up the back. Low-impact aerobic exercise, such as swimming, cycling, and walking, combined with daily stretching of the muscles, is considered the gold standard.

The importance of stretching exercises for most forms of back pain cannot be overstated since it does not just alleviate discomfort but can also help prevent future injuries. Other treatments and therapies that help different people to varying degrees include yoga, Pilates, massage, and acupuncture, among others. Keep in mind that many of these, such as massage and physical therapies, are sometimes covered by health insurance.

Treatment for back pain is imperative, as there is no reason for this condition to affect our quality of life. But the price we pay for relief should not be a health risk.

Sources:

Harvard Medical School Special Reports: “Finding solutions for your aching back”
World Health Organization (WHO), “Musculokeletal Conditions”
HolaDoctor: “Tratamientos y técnicas para aliviar el dolor de espalda”
Consumer Reports, “The 3 step guide to beating back pain”