The single largest cause of lost working hours, often caused by lifting, twisting, poor posture, and inadequate back support when sitting or lying down; pain is felt when back muscles are over-tense or pulled (see Fibrositis) or go into spasm to prevent further damage to overstrained ligaments (see Sprains), or when discs between vertebrae rupture, pressing on adjacent nerves (see Prolapsed Disc). Anything which puts sustained extra strain on the back - pregnancy, Obesity, having one leg shorter than the other, habitually carrying one shoulder higher than the other - can cause backache; mental and emotional overload can aggravate and sometimes cause a bad back.
Back pain may be localised, as in Lumbago (pain in middle of the back just below waist), Sciatica (pain radiates from lower back into buttock, then shoots down leg), Coccydinia (pain around coccyx, right at base of spine) or Cervical Spondylosis (pain and stiffness in neck), or more general, as in Influenza (with fever, sore throat, headache) or Osteoarthritis, especially in an older person. Where chief symptom is general stiffness or pain around sacroiliac joint (which links sacrum to pelvis) cause may be Ankylosing Spondylitis. Other ailments which can affect the spine are Tuberculosis, Shingles (knife-like pains stabbing out from one side of spine at chest level), and Paget's disease (spine tender when pressed, perhaps developing sideways curve). Extremely rarely, back pain may be due to a Spinal Cord Tumour.
If a back injury causes loss of control of bowel or bladder, or loss of movement, numbness, or tingling, contact Emergency Medical Services and give Arnica 30c every 5 minutes for up to 10 doses until help arrives; likely cause is Spinal Cord Injury.
If back pain onsets suddenly after a period of immobility, especially in someone over 60, consult your doctor if there is no improvement in 12 hours; cause may be a Fracture brought on by Osteoporosis. Back pain accompanied by Fever may be a sign of acute Pyelonephritis (back pain one-sided and radiating into groin, nausea and vomiting); again, appropriate action is consult your doctor if there is no improvement in 12 hours.
Homeopathic treatment of back trouble caused by tension and stress is mainly constitutional; for specific remedies, see Lumbago, Sciatica, Coccydinia, Fibrositis. Other remedies appear under other conditions mentioned above. Osteopathy, chiropractic, physiotherapy and acupuncture are also recommended - they bring swift relief to many thousands of back sufferers each year.
Orthodox treatment options, depending on severity of problem, include muscle relaxants, painkillers, steroid injections, traction, wearing a collar or surgical corset, physiotherapy; surgery is usually a last resort.
Self-help: Local heat - a hot-water bottle held against the small of the back, for example - can help to relax knotted muscles. Rest your back as much as possible; if you can, lie flat on your back on a fairly hard mattress with a foam pad about the thickness of two paperbacks under your head; if lying on your back is uncomfortable because you cannot let your legs go flat, lie on your side with your knees pulled up and a foam pad in the hollow of your waist.
To prevent back pain in the first place, never lift things with a bent or twisted back; bend your knees instead and keep your back straight. Don't try to lift and twist at the same time. Wear low-heeled shoes. Sit as upright as possible; if you spend a lot of time sitting down, have a stretch and a walk around every half hour or so, and use a chair which supports the small of your back or a back support cushion. Special back chairs which have a seat which tilts forward oblige one to sit up straight, allowing the back to assume its natural inward curve at the waist. Make sure your mattress is fairly hard, but not uncomfortably so; if it has a dip in the middle, put a board or a door underneath it. Losing weight also takes some of strain off the spine.
Shoulder bags, especially if worn on the same shoulder all the time, do untold damage to backs. Wherever possible, split the loads you carry - carry a bag in each hand rather than one heavy bag in one hand. Make a habit of carrying things in alternate hands.
Your medical doctor or physiotherapist may recommend special exercises to strengthen your back. If not, try the following exercises twice a day. Do not try 2 until you can do 1, or 3 until you can do 2, and go very gently to start with
- Lie on the floor, on your back with your knees bent; tighten the muscles around the anus and raise your hips three centimetres (an inch or so) off the floor, then relax. Repeat 10 times.
- Lie on the floor, on your back with your knees bent; breathe in and arch your back as strongly as possible, then breath out and flatten your back against the floor. Repeat 10 times.
- Kneel on all fours, supporting yourself on straight arms, with your hands flat; arch your back upwards as far as possible and tuck your chin as close to your chest as you can; now let your back sink slowly down raise your face to the ceiling; now arch your back up again, and so on. Repeat 10 times, holding each posture for a few seconds. Try to breathe out as you arch up and in as you sink down. This is a yoga exercise known as The Cat.
Swimming is also beneficial.