I attended a conference recently where the presenter began with a quip. He said, “You know you’re getting old when you strain your back in your sleep.” His joke highlights an unfortunately common problem that for many Americans is no joking matter.
Some surveys have shown that more than 80 percent of Americans suffer from low back pain at some point in their lives. Back pain accounts for about 3 percent of all visits to a physician – resulting in 15 million visits each year.
Risk factors for low-back pain include obesity, sedentary lifestyle, increasing age, smoking or repetitive physically strenuous work. It’s interesting to note that back-pain risk includes not enough activity as well as overdoing it. In addition, psychological risk factors for chronic low back pain include depression and anxiety.
Back pain can result from injury to structures in the back including bones, ligaments, discs or nerves. Less commonly, back pain may be the result of infection or systemic illness.
Most commonly, back pain involves the lower back and is associated with muscular strain. The anatomy of the back involves a “stack of blocks” made of bone, known as vertebrae, which surrounds a tube known as the spinal canal. At upper levels, the canal contains the spinal cord while at lower levels the canal contains nerves.
Between each vertebra is a disc made of cartilage which serves as a shock absorber. At the level of each vertebra are nerves exiting the spine and responsible for everything from sensation and muscle control to other jobs including bowel and bladder control.
Muscles on either side of the spine help maintain upright posture. Muscles in the low back are especially prone to strain injuries resulting from use of the low back as a lever such as when bending forward to lift or carry.
Muscular strain injuries of the low back can produce a wide range of symptoms from mild soreness to severe pain and spasm. Such injuries can be avoided through practice of healthy back behaviors such as using proper lifting techniques.
In general, the back should be kept straight while using leg muscles to lift. Remember to squat rather than stoop.
Maintaining a healthy weight along with regular low-impact physical activity can reduce the likelihood of low-back problems.
When strain injuries do occur, rest, stretching, moist heat and judicious use of anti-inflammatory pain medications such as ibuprofen can provide symptomatic relief.
Whenever back pain is associated with fever, abdominal discomfort, leg weakness or numbness, or alterations in urinary or bowel habits, medical evaluation is recommended.
Likewise, back pain that is severe or prolonged merits a medical assessment to exclude diseases manifesting as back pain.
Similarly, back pain that follows trauma such as a motor-vehicle accident or fall from a height should prompt a visit to the doctor to exclude serious injury.
Dr. Matthew A. Clark is a board-certified physician in internal medicine and pediatrics practicing at the Ute Mountain Ute Health Center in Towaoc.