Bewildered by your back pain

You’re probably reading this blog post because your back hurts. Maybe you’ve had back pain for a matter of weeks; maybe you’re a longtime sufferer; or maybe you’re wondering about surgery. Another possibility is that you previously had a bout of back pain and made a full recovery. Then suddenly, for no apparent reason, you wake in the morning, prepared to spring into your day, and you’re in agony. If you recognize yourself in any of these scenarios, go reading further.

Whether you’re having recurring bouts of back pain or you’ve one of those unfortunate people who have endured persistent back pain for more than six months, chances are you’ve already made the rounds of doctors and may even have heard several different opinions about how to treat your back problem. In addition, well meaning family members and friends may have proffered all sorts of helpful suggestions. Unfortunately, these suggestions may have been confusingly contradictory. One person may have told you to stay in bed, while another advised against staying in bed. Someone may have told you to exercise your way back to a pain-free life, the “no pain, no gain” approach to your situation. Somebody else, on the other hand, might have recommended doing absolutely nothing physical until you feel better and thereafter doing next to nothing – to guard against a relapse. You may also have heard a wide range of advice about surgery, with advocates advising surgery as soon as possible and naysayers warning you that surgery should be your last resort when everything else has failed. Not surprisingly, you come away from these conversations with not only a painful back but also a spinning head!

A bewildering condition

If you’re feeling bewildered about how to manage your back pain, you’re in good company. Many of the patients are similarly confused and this story shares with you a fairly common patient story that illustrates just how frustrating getting a diagnosis and a recommended treatment plan can be. Theresa is a woman in her forties who developed back pain without provocation. With three very active young children to take care of, back pain was not good news. By the time she walked into my office, Theresa was feeling decidedly frazzled. One doctor had told her she had a disk problem; another told her that her disks were fine and the problem was the ligaments in her back. Yet another doctor said there didn’t seem to be anything wrong with her back at all – despite the fact that Theresa was in pain. To make matters worse, she’d received a range of different treatment recommendations, from steroid injections to medications to exercises. Needless to say, she was confused and frustrated, with no idea whom she should listen to or what advice she should follow. Theresa was helped to make decisions that were right for her and that she is now engaged in many of the family and community activities she enjoys.

If Theresa’s experience of going from doctor to doctor and coming away no wiser matches yours, you might think back-pain doctors are not up to snuff. But that’s not true. It’s important to appreciate that your doctor may well be feeling as frustrated as you. A major stumbling block for doctors and patients alike is that in the US there have been no recent national guidelines for the diagnosis and treatment of back pain. Although the Agency for Health Care Policy and Research published low-back-pain guidelines in 1992, these have not been updated. And 14 years is a long time to the history of a medical condition. There has been a lot of new research in that period. Another consideration relates to doctors who specialize in back pain. While specialists can be invaluable, seeing a medical specialist at the start of your back-pain episode is sometmes not as helpful as you might wish. This sounds contrary, but it’s a matter of focus. A specialist tends to look for anomalies that explain the problem in terms of his or her specialty. So a doctor who specializes in orthopedics may see an orthopedic abnomality, for example, a slight problem in alignment of the vertebrae, and be convinced the problem is orthopedic in nature. Similarly, a neurologist who specializes in problem of the nervous system see a nerve problem. This explains some of the diagnostic discrepancies and mixed-message treatment recommendations back-pain sufferers receive.

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Back smart lifting
Whenever you need to lift even a moderately heavy object:

1. Face the object and position yourself close to it.
2. Bend at your knees, not your waist, and squat down as far as you comfortably can.
3. Tighten your stomach and keep your buttocks tucked in.
4. Lift with your legs, not your back muscles.
5. Don’t try to lift the object too high, Don’t raise a heavy load any higher than your waist; keep a light load below shoulder level.
6. Keep the object close to you as you lift it.
7. If you need to turn to set something down, don’t twist your upper body. Instead, turn your entire body, moving your shoulder, hips, and feet at the same time.
8. Ask for help with lifting anything that’s too heavy.

Back belts: Not a panacea
Back belts have gained in popularity among workers who must often lift goods – from grocery store clerks to nurses’ aids to airline baggage handlers. With back problems accounting for nearly 20 percent of all workplace injuries in the United States and costing anywhere from $20-$50 billion a year (costs are high in other countries, too), it’s no surprise that some companies require their workers to use these belts.

But most studies cast doubt on whether back belts can protect workers’ backs or reduce sick time and workers’ compensation claims. And although a few studies have found them to be protective, the consensus is that back belts do not reduce back injuries. The US National Institute of Occupational Safety and Health (NIOSH) has expressed concern that these belts may even do harm by giving workers a false sense of security. According to NIOSH, there is evidence that workers think they can lift heavier items when wearing the belts. NIOSH also points out that there is no scientific evidence to back up claims that these belts decrease the force exerted on the spine, that they remind wearers to lift properly, or that they reduce workplace injuries. As a result, the agency doesn’t recommend that employers insist that their workers use back belts to prevent back injuries.

Worker wearing a backbelt

Seen above is a worker wearing a ergonomic backbelt by Back-A-Line that costs around US$ 60 and gives your relief from backaches.