Take Care of your Back

Back pain is caused by injury, mechanical or inflammatory back problems. The mechanical or inflammatory problem must be fixed before the pain will go away for good. Treatment must go beyond pain control to include restoring strength, flexibility and safe work skills. The following is a list of treatment strategies for managing back problems.

Recovery from a back problem has three stages namely:
1. Controlling pain
2. Restoring function
3. Preventing re-injury

Rest:

The best immediate care of a back injury is rest to allow the back to heal. However bed rest must be limited to a few days only to allow for injury and inflammation enough time to heal. Two/three days of bed rest can be effective but can also produce severe weakness, stiffness and poor circulation to back structures. Muscles become weak and lose flexibility. Joints get stiff and become over-sensitive. Discs become starved of oxygen and nutrients. Prolonged bed rest can also produce emotional problems. These changes can prevent recovery. Treatment by bed rest should include early return to walking, exercise and other activities within few days. Strength and mobility must be restored quickly.

Medication:

Medication can reduce pain, inflammation and muscle spasm. They can speed up recovery and help you tolerate return to work or activities. Like bed rest, medication reduces symptoms only. They do not restore spinal function.

Physical Modalities:

Heat, ice, ultrasound and electrical stimulation can improve circulation and reduce pain. These modalities stimulate nerves that assist in decreasing pain, open blood vessels and relax muscle tension. However, they help restore spinal function.

Massage can be very healthy for muscles and connective tissue. It can reduce spasm and improve circulation but, does not restore strength.

Mobilisation is when a physiotherapist moves the joints of the spine with their hands. This is usually a gentle procedure.
A more intense, sudden force referred to as a manipulation can also be used. The purpose of manipulation is to restore mobility to the joints and to stimulate their nerves in ways that can reduce pain and spasm. Manipulation is usually accompanied by exercises that build strength and flexibility.

Surgery:

Surgery does not fix a “bad” back. It may help some people with certain severe back problems. It should be viewed as an option of last resort.
One of the most important parts of surgery is the rehabilitation post operatively.

Physiotherapy:

Physical therapy is a physical, mechanical and educational approach to correcting the causes of back problem. Specially trained medical professionals i.e. physiotherapists use a combination of treatment strategies including:
 

Exercise is a key to recovery. Movement must be started as soon as pain will allow some activity. Movement, strength and flexibility are necessary to restore circulation, healing and back function for long - term recovery. Certain exercise may also help damaged discs improve their circulation and reduce disc bulging.

Taking care of your back problem:

For a new/ new re-injury:
Stop, rest and apply ice. Immediately rest your injured back. A good rest position is to lie on your back on a hard surface such as the floor. Place your legs on a chair, so that your hips and knees are bent at right angles. Support your lower back with a rolled towel.

Place ice rather than heat for 10-15 min at a time. Pain should improve significantly in a day or two. You should start activity as soon as you can tolerate it e.g. walking, back exercises etc. Do not quit exercises when the pain goes away. You need to do preventative exercises for life, to avoid re-injury.

Back Exercises:

Back protection and recovery exercises:
Long- term recovery and protection come only from restoring strength, flexibility and endurance. These are restored only through exercises.
Flexibility is vital to the working spine. You must be able to comfortably maintain postures, move freely within those postures and move out of the postures. You also need adequate strength to stabilize and protect your spine during work activity.

Exercises start with gentle movement and stretches, progressing to more vigorous strengthening. One should not do any back exercises that cause pain. The very best overall exercise is walking. Walking brings rhythmic movements of the spine in its proper patterns of motion. This increases circulation, mobility, strength and endurance of all the structures of the spine working together.

Stages of exercises:

Ergonomics

“Ergonomics” is designing your job to reduce work effort. This means avoiding bad postures and stressful movements to reduce fatigue, discomfort and damage.
Two things determine how much work your back does on the job: The design of your job and your work habits. Following the rules of proper lifting is vital to protecting your back from fatigue and injury. The design of your job, however, is also important. Job design factors include the following:

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