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Backache
An article by Dr. R. I. Khan

First of all let me give you some general information as follows, regarding Backache.
Backache is generally a gripping pain near the inward curve of the back above the base of the spine and it affects about 80 percent of the population at some time in their lives.

Causes:-
Strains are especially common when overworked or under exercised back muscles perform beyond their normal capacity. The muscles will then contract or go into spasm and become a tight mass of tissue. The body transmits a sharp pain signal as nearby muscles, tighten in an effort to protect strained muscle to prevent further damages. Strain of back muscle can be due to sports, sudden jerking motion or reflex actions like sneezing.Over weight is leading factor in backache. Pregnancy can produce back pain because of weight of the fetus. Menstruation may also cause back discomfort. Congenital malformation can lead to backache.Most parts of your body shrink or stiffen as your age, including the rubbery disk that cushions each vertebra. When stressed, a disk may break, it does not really slip. If a broken piece presses a nearby nerve, you suffer what is known as sciatica. Sciatica is back pain that shoots down the leg. Surgery sometimes cures a slipped disk. So see an orthopedist when sciatica is intolerable. As we age, our bones tends to become gradually thinner and more fragile, this condition is osteoporosis and is painless. When osteoporosis weaknes a vertebra to the point when it can’t support your body weight, the vertebra collapses, called a compression fracture. This condition is painful but it heals. I suspect most low back pain in the elderly is simple muscle strain.

Symptoms:-
Backache can appear abruptly after physical activity or may develop slowly. The pain may feel like a sharp jab or a dull ache. The pain some times becomes so piercing that a person who is bending over, may not be able to straighten up. Most muscular back pain disappear with in a week or two of their onset while some will last one or two months. Pain may recur unless preventive measures are taken.

Diagnosis:-

Prolong back pain (lasting for more than two weeks) should be brought to the attention of a physician, who will check for underlying disorders. An X-Ray study may reveal adverse changes in the spine.

Treatment:
If there are no apparent physical causes for the backache, physicians usually recommend an exercise program to strengthen weak muscles. Losing weight can also relieve pressure on the back.
For immediate treatment, using a heating pads or better yet, ice at the site of the pain will usually reduce soreness. Analgesic creams containing methyl salicylate or a similar ingredient produces a soothing warm sensation. Muscle relaxant and anti-inflammatory drugs may also be prescribed. When backache is the result of some deformity or damage to the disk, surgery may be necessary to correct the problem. Braces or correst. Some times improve the condition. Almost all types of musculoskeletal backache respond well to rest, which allows muscles to relax and inflammation to subside. Time is often the best healer.

Prevention:-
Walking upright is a balancing act. Good posture when awake and asleep, relieves tension on the spinal column. A semi firm mattress (neither hard nor soft) is recommended because it conforms to the arch of the back and maintains spinal alignment. Bending at the knees rather than from the waist, when lifting large, heavy objects places the stress on the legs and helps prevent back injury. One should avoid looking down for long period of time while seated at a desk and avoid watching T. V. with the chin on the chest.If the patient has been suffering from back pain since few years which has not responded to symptomatic treatment, rest and exercises, I would suggest you ask your orthopedic surgeon for C T scan or M R I, which may reveal musculoskeletal deformity, same should be treated accordingly. If scan is normal than please follow the recommended preventive measures and treatment mention above.