The 2nd - 6th September 2017 is the National Back and Physiotherapy awareness week. The KwaZulu-Natal Department of Health and the South African Society of Physiotherapists dedicate this week to educate and make aware health workers and members of public in the Province on the problems of back pain, common causes /risks, complications, management and prevention of common causes /risks of low back pain. Physiotherapists from both public and private sectors will be at hand to offer advice and necessary intervention
Pain in the lower back or low back pain is a common concern, affecting up to 30 – 40 % of South Africans at some point in their lifetime. Low back pain is not a specific disease but rather, a symptom that may occur from a variety of different processes. In some cases, people with low back pain despite a thorough medical examination, no specific cause of the pain can be identified.
Back pain is only a symptom of an actual problem. Pain arising from other organs may be felt in the back. This is called referred pain. Many intra-abdominal disorders-such as appendicitis, aneurysms, kidney diseases, bladder infections, pelvic infections, and ovarian disorders, etc. can cause pain referred to the back. Your doctor will have this in mind when evaluating your pain.
Back pain may be caused by injury, mechanical or inflammatory conditions of the spine. The mechanical or inflammatory problem must be fixed before the pain will go away for good. Nerve root syndromes are those that produce symptoms of nerve impingement (a nerve is touched/compressed), often due to a hernia (or bulging) of the disc between the spinal bones. Sciatica is an example of nerve root impingement. Impingement pain tends to be sharp, in one spot, and associated with numbness in the area of the leg that the affected nerve supplies.
Musculoskeletal pain syndromes that produce low back pain include myofascial pain syndromes and fibromyalgia. Other skeletal causes of low back pain include osteomyelitis or sacroiliitis (infections of the bones of the spine). This pain is usually worse at night and is worse when sitting or standing for a long time. Tumors, possibly cancerous, can be a source of skeletal pain
Self-Care at Home
General recommendations are to resume normal, or near normal, activity as soon as possible. The best immediate care of a back injury is rest in order to allow the back to heal. However bed rest must be limited to a few days only to allow for the 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. However, stretching or activities that place additional strain on the back are discouraged.
Medication
Medication can reduce pain, inflammation and muscle spasm. They can speed recovery and help you tolerate return to 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 do not 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.
Mobilization 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 and it should be viewed as an option of last resort.
One of the most important parts of surgery is the rehabilitation post operatively.
Physiotherapy
Physiotherapy 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.
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 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:
Using your back properly is essential to a happy and healthy life. There are simple rules to safe lifting.
Pushing is safer than pulling, if you have a choice. Whether you push / pull , you must follow safe back work rules:Wide stance, tuck chin and arch back slightly, push/pull close to body, do not use sudden high – speed efforts.
Hold the load close to your body. Keep your chin tucked and lower back slightly arched. Try to stand an inch taller than usual as you carry the load.
Analyse the work task to decide how best to do it. Lift properly. Do not try to lift too heavy a load. Get help. Use equipment. DO not do something unsafe to your back.
For more information on back care, contact a physiotherapist at any nearest public hospital or the Disability and Rehabilitation Programme on tel. 033 846 7247 or email:
This page last edited on
12 May, 2023
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