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From Mayo Clinic: http://www.mayoclinic.com/health/back-pain/DS00171/DSECTION=symptoms
Symptoms of back pain may include:
• • • • •
Muscle ache Shooting or stabbing pain Pain that radiates down your leg Limited flexibility or range of motion of your back Inability to stand straight
Back pain that lasts from a few days to a few weeks is considered acute. Pain that lasts for three months or longer is considered chronic. When to see a doctor Most back pain gradually improves with home treatment and self-care. Although the pain may take several weeks to disappear completely, you should notice some improvement within the first 72 hours of self-care. If not, see your doctor. In rare cases, back pain can signal a serious medical problem. Contact a doctor if your back pain:
• • • • • • •
Is constant or intense, especially at night or when you lie down Spreads down one or both legs, especially if the pain extends below your knee Causes weakness, numbness or tingling in one or both legs Causes new bowel or bladder problems Is associated with pain or throbbing (pulsation) in your abdomen, or fever Follows a fall, blow to your back or other injury Is accompanied by unexplained weight loss
Also, see your doctor if you start having back pain for the first time after age 50, or if you have a history of cancer, osteoporosis, steroid use, or drug or alcohol abuse.
Your back is an intricate structure composed of bones, muscles, ligaments, tendons and disks. Disks are the cartilage-like pads that act as cushions between the segments of your spine. Back pain can arise from problems with any of these component parts. In some people, no specific cause for their back pain can be found. Strains Back pain most often occurs:
• • •
From strained muscles and ligaments From improper or heavy lifting After a sudden awkward movement
Risk factors Factors that increase your risk of developing low back pain include: • • • • • • • • • Smoking Obesity Older age Being female Physically strenuous work Sedentary work Stressful job Anxiety Depression Preparing for your appointment If you have back pain that's lasted for at least a few days and isn't improving. Arthritis. causing back pain. back pain may be related to: • • • Cauda equina syndrome. Scoliosis. In some cases arthritis in the spine can lead to a narrowing of the space around the spinal cord. A tumor on the spine can press on a nerve. it can cause sciatica — sharp. numbness in the "saddle" or groin area. It can cause weakness in the legs. hands. Skeletal irregularities. If a fever and a tender. Sciatica. your upper back may look abnormally rounded or your lower back may arch excessively. Here's some information to help you prepare for your appointment and what to expect from your doctor. Disks act as cushions between the vertebrae in your spine. Rare but serious conditions In rare cases. Structural problems In some cases. the soft material inside a disk may bulge out of place or rupture and press on a nerve. many people who have bulging or herniated disks experience no pain from the condition. such as: • • • • • Bulging or ruptured disks. What you can do . the cause could be an infection. shooting pain through the buttock and back of the leg. But even so. a condition in which your spine curves to the side. Cancer in the spine. also may lead to back pain. This is a serious neurological problem affecting a bundle of nerve roots that serve your lower back and legs.Sometimes a muscle spasm can cause or be associated with back pain. back pain may be caused by structural problems. If a bulging or herniated disk presses on the main nerve that travels down your leg. The joints most commonly affected by osteoarthritis are the hips. If the natural curves in your spine become exaggerated. a condition called spinal stenosis. Compression fractures of your spine's vertebrae can occur if your bones become porous and brittle. Sometimes. knees and lower back. warm area accompany back pain. make an appointment with your family doctor or primary care provider. Back pain can occur if your spine curves in an abnormal way. Infection of the spine. Osteoporosis. and loss of bowel or bladder control.
Note any recent injuries that may have damaged your back.• • • • • • Write down any symptoms you've been having. don't hesitate to ask questions during your appointment at any time that you don't understand something. Write down questions to ask your doctor. Someone who accompanies you may remember something that you missed or forgot. others). such as aspirin. Creating your list of questions in advance can help you make the most of your time with your doctor. including any other conditions for which you're being treated and the names of any medications. Tests and diagnosis . Take a family member or friend along. others) or acetaminophen (Tylenol. For back pain. and for how long. if possible. ibuprofen (Advil. You may also benefit from applying heat and cold to the area that's causing you pain. Write down key personal information. What to expect from your doctor Your doctor is likely to ask you a number of questions. what are the possible side effects? For how long will I need to be treated? Are there any restrictions that I need to follow? What other self-care measures should I be taking? Is there anything else I can do to help prevent a recurrence of back pain? In addition to the questions that you've prepared to ask your doctor. some basic questions to ask your doctor include: • • • • • • • • • What is the most likely cause of my back pain? Are there any other possible causes? Do I need any diagnostic tests? What treatment approach do you recommend? If you're recommending medications. Your doctor may ask: • • • • • • • • • • • • • • • • • When did you first begin having back pain? How often do you have back pain? What do you think is causing your pain? How much is your pain limiting your ability to function? Do you have any other signs or symptoms in addition to back pain? Do you have leg pain associated with your back pain? Have you had any unexplained fevers or weight loss? Does your work or recreational activities involve any heavy physical work? Do you exercise regularly? If yes. including any mental or emotional stressors in your life. including prescription and over-the-counter drugs as well as vitamins and supplements? What you can do in the meantime While you're waiting for your appointment. you may find some relief by using over-the-counter pain relievers. vitamins or supplements you're taking. Make a list of your key medical information. with what types of activities? How often do you feel blue or depressed? How much stress or conflict do you experience on a daily basis? Do you sleep well most of the time? Do you smoke? Do you use recreational drugs? What treatments or self-care measures have you tried so far? Has anything helped? Are you currently being treated or have you recently been treated for any other medical conditions? What medications are you currently taking. Being ready to answer them may reserve time to go over any points you want to spend more time on. Motrin.
others) or nonsteroidal anti-inflammatory drugs. nerves or disks. These images show the alignment of your bones and whether you have arthritis or broken bones. Low doses of certain types of antidepressants — particularly tricyclic antidepressants. he or she will: • • Examine your back and assess your ability to sit. This test measures the electrical impulses produced by the nerves and the responses of your muscles. or EMG). Narcotics. Studies of your nerve-conduction pathways can confirm nerve compression caused by herniated disks or narrowing of your spinal canal (spinal stenosis). Nerve studies (electromyography. may be used for a short period of time with close supervision by your doctor. A regular schedule of over-the-counter pain relievers may be all that you need to improve your pain. if you do see your doctor for back pain. Medications Your doctor is likely to recommend pain relievers such as acetaminophen (Tylenol. such as ibuprofen (Advil. ice. Magnetic resonance imaging (MRI) or computerized tomography (CT) scans.Diagnostic tests aren't usually necessary to confirm the cause of your back pain. such as codeine or hydrocodone. tendons. X-ray images won't directly show problems with your spinal cord. If home treatments aren't working. In rare cases. your doctor may use a bone scan to look for bone tumors or compression fractures caused by osteoporosis. As pain improves. If mild to moderate back pain doesn't get better with over-the-counter pain relievers. ligaments and blood vessels. Bone scan. strengthen . others) or naproxen (Aleve. In this procedure. such as amitriptyline — have been shown to relieve chronic back pain. your doctor may suggest stronger medications or other therapy. fracture. The substance collects in your bones and allows your doctor to detect bone problems using a special camera. independent of their effect on depression. the therapist can teach you specific exercises to increase your flexibility. you'll receive an injection of a small amount of a radioactive substance (tracer) into one of your veins. to your back muscles and soft tissues to reduce pain. muscles. stand. but more than a couple of days actually does more harm than good. your doctor may also prescribe a muscle relaxant. muscles. Physical therapy and exercise A physical therapist can apply a variety of treatments. Your doctor may order these lab tests to determine whether an underlying disease or infection may be contributing to your back pain. These scans can generate images that may reveal herniated disks or problems with bones. infection or other specific condition that may be causing your back pain. electrical stimulation and muscle-release techniques. your doctor may order one or more tests: • • • • • Blood and urine tests. Treatments and drugs Most back pain gets better with a few weeks of home treatment and careful attention. others). nerves. ultrasound. However. They will also help rule out more serious causes of back pain. how much you can move before pain forces you to stop and whether you have muscle spasms. If there is reason to suspect that you have a tumor. such as heat. A short period of bed rest is OK. Motrin. walk and lift your legs May also test your reflexes with a rubber reflex hammer These assessments help determine where the pain comes from. X-ray. tissue.
Located on the sides. If your spine has developed bony growths that are pinching your spinal cord or nerves. This surgery involves joining two vertebrae to eliminate painful movement. Injections If other measures don't relieve your pain and if your pain radiates down your leg. which may then be splinted together with metal plates. A bone graft is inserted between the two vertebrae. you may benefit from surgical intervention. talk to your doctor about the most appropriate specialist for your type of problem. your doctor may inject numbing medication and cortisone into or near the structures believed to be causing your back pain. and improve your posture. If you have unrelenting pain associated with radiating leg pain or progressive muscle weakness caused by nerve compression. Back pain is one of the most common reasons that people see a chiropractor. In addition to chiropractors. Partial removal of disk. A drawback to the procedure is that it increases the chances of arthritis developing in adjoining vertebrae. surgeons can remove a small section of the offending vertebra. Some people with low back pain report that acupuncture helps relieve their symptoms. but the pain relief usually lasts less than a few months. some studies suggest that the following herbs may be helpful: • • • Willow bark (Salix alba). Always discuss the benefits and risks with your doctor before starting any new alternative therapy. screws or cages. taken orally Capsicum (Capsicum frutescens). Alternative medicine A number of alternative treatments are available that may help ease symptoms of back pain. surgery usually is reserved for pain related to structural anatomical problems that haven't responded to intensive conservative therapy measures. Surgery Few people ever need surgery for back pain.your back and abdominal muscles. top and bottom of each vertebra. Herbal treatments Some herbal supplements with anti-inflammatory properties may ease back pain. applied as a topical plaster Hands-on therapies • • Chiropractic care. these joints connect the vertebrae to one another and stabilize the spine while still allowing flexibility. many osteopathic doctors and some physical therapists have training in spinal manipulation. The National Institutes of Health has found that acupuncture can be an effective treatment for some . Although more research is needed to reliably determine their safety and efficacy. In some cases. your doctor may be able to remove just the portion of the disk that's causing the problem. Otherwise. to open up the passage. your doctor may inject cortisone — an anti-inflammatory medication — into the space around your spinal cord (epidural space). If you're considering chiropractic care. taken orally Devil's claw (Harpagophytum procumbens). Partial removal of a vertebra. Types of back surgery include: • • • Fusion. If disk material is pressing or squeezing a nerve. Regular use of these techniques will help prevent pain from returning. Acupuncture. A cortisone injection helps decrease inflammation around the nerve roots. such as the facet joints of the vertebrae.
the practitioner inserts sterilized stainless steel needles into the skin at specific points on the body. Use proper body mechanics: • • • Stand smart. Keep your back straight and bend only at the knees. Abdominal and back muscle exercises (core-strengthening exercises) help condition these muscles so that they work together like a natural corset for your back. Avoid lifting and twisting simultaneously. In acupuncture. Maintain a healthy weight. Being overweight puts strain on your back muscles. Evidence suggests this technique helps ease back pain. If you must stand for long periods of time. massage therapy may help loosen knotted muscles and promote relaxation. arm rests and a swivel base. Research has found that this type of therapy may significantly relieve chronic low back pain. you learn to identify and change negative thought patterns that have a damaging impact on your mental and physical health. which can hinder the healing process. If you're overweight. To keep your back healthy and strong: • • • • Exercise. Regular low-impact aerobic activities — those that don't strain or jolt your back — can increase strength and endurance in your back and allow your muscles to function better. Build muscle strength and flexibility. Smokers have diminished oxygen levels in their spinal tissues. Talk with your doctor about which activities are best for you. Choose a seat with good lower back support. This relaxation technique involves systematically tensing and relaxing different muscle groups in your body. Move straight up and down. Massage. If your back pain is caused by tense or overworked muscles. alternate placing your feet on a low footstool to take some of the load off your lower back. In addition. Mind-body techniques • • Cognitive behavioral therapy. Hold the load close to your body. Let your legs do the work. Sit smart. Nguyễn Bê sưu tầm – collected by Nguyen Be . Walking and swimming are good choices. such as depression. Quit smoking. Chronic back pain is commonly associated with emotional stress and mental health conditions. a type of yoga called Viniyoga — which emphasizes both postures and breathing exercises — may help ease back pain and reduce the need for pain medications. In cognitive behavioral therapy. Flexibility in your hips and upper legs aligns your pelvic bones to improve how your back feels. Lift smart. Maintain a neutral pelvic position. Keep your knees and hips level. trimming down can prevent back pain. Prevention You may be able to avoid back pain by improving your physical condition and learning and practicing proper body mechanics. Find a lifting partner if the object is heavy or awkward. Progressive muscle relaxation boosts your ability to recognize and counteract muscle tension as soon as it starts. Consider placing a pillow or rolled towel in the small of your back to maintain its normal curve. Progressive relaxation.• types of chronic pain.
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