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.
Pysiotherapy:
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:
- Physical modalities to control pain and inflammation
- Massage to reduce pain and restore tissue mobility
- Traction and joint mobilization
- Exercises to build flexibility, strength and endurance
- Education to make people aware of their back problem, to stay in
shape and avoid re-injury.
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:
- Gentle stretching
- Gaining full mobility
- Back strength and protection
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:
- How much weight you lift
- How often you lift
- How low you bend to lift the load
- How high you lift the load
- How far you carry the load
- How far you twist with the load
- How far you reach with the load
- How you use the your body to move the load
- How long you sit at your job
- Design of seating for sitting jobs
- Sustained or repeated bending, twisting or reaching
- The physical environment of your job
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HEALTH KWAZULU-NATAL
