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Dealing with lower back pain

Published:Saturday | October 15, 2011 | 12:00 AM

Dr Douglas Street, Contributor

The lower back is a very 'sacred' part of the body for us as Jamaicans, especially the men. The importance of its strength and agility during intimate activities has apparently caused us to associate many things of a sexual nature with the back.

Therefore, when the back hurts and/or doesn't function well, it may cause more than physical pain.

Back pain is very common and is second only to headache as the most common body part afflicted by pain. It can be acute (recent) or chronic (long term). It causes a significant loss of productivity, missed workdays, and impaired function on the job.

There are many causes of lower back pain, including injury, arthritis (osteoarthritis and rheumatoid arthritis), tumours, fractures, postural problems, infections (of the back or elsewhere), and mental/psychological disorders.

There are certain situations which, when associated with back pain, require a doctor's assessment. These include when it is severe, there has been significant injury, there are nerve-related symptoms (such as weakness, tingling, burning, numbness and/or spasm in the back or lower limb/s), there is unexplained weight loss or fever, history of cancer, new (onset when older than 70 years), and prolonged duration (greater than six weeks).

Injury a common cause

By far the most common cause of back pain is injury. The likelihood of this can be reduced by proper lifting techniques, use of protective gear, and regular strengthening exercises. Smoking impairs the healing ability of the back.

Once a serious cause has been ruled out, there are a number of approaches that can be taken to help relieve back pain. If the pain does not cause confinement to bed, then continued activity is important as long as it can be tolerated. Cold and warm compresses are also quite helpful.

Adequate rest is important, but prolonged inactivity should be avoided. A medium-firm mattress is usually preferable to a firm one and it is usually best to sleep on your side or back. Avoid sleeping on the abdomen.

A physical therapist can use massage, ultrasound treatment, and electrical stimulation. Guidance can also be offered with strengthening, stretching, and aerobic exercises. Spinal manipulation is somewhat controversial but some people do get relief, especially chronic cases, and it is unlikely to cause harm. Acupuncture is another controversial treatment. It does give relief to some persons but it is not usually long-lasting.

Medical treatment involves use of pain relievers, muscle relaxants and sometimes surgery.

Dr Douglas Street is a general practitioner and has private practices at Trinity Medical Centre; Trinity Mall, 3 Barnett Street, Montego Bay; and Omega Medical Centre, Plaza de Negril, Negril. Send feedback to drdougstreet@yahoo.com.