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PENNY RICKHOFF remembers exactly when her pain started. "I was on the tennis court finishing a set. The next thing I knew, I was in hospital." The 55-year-old interior designer has had two operations in the 15 years since that first episode, but she still faces daily pain.
She's not alone. Most of us will experience back pain at some point. "The people who never have pain are the unusual ones," says psychologist Dennis Turk, who's on renowned team of pain researchers at the University of Washington.
Luckily,things are looking up for the aching millions. The last decade has brought a revolution in back care, says physician Richard Deyo, also at the University of Washington. This shift has changed how experts diagnose and treat this vexing problem.
Back when Rickhoff had her front court collapse, the standard advice was to stay in bed, "We now know that's the worst thing you can do," says Deyo. In fact, he argues, lying around actually boosts your risk of developing chronic back pain.
Doctors are also less likely to offer a diagnosis than they used to be. "There are many different diagnostic labels for back pain, but often they just cover up the fact that we don't what's causing it," explains Michael Von Korff, a back researcher at Group Health Cooperative in Seattle, Washington. "In the end, as long as you've excluded serious disease, the treatment is the same."
Unfortunately , sophisticated image techniques are often little help in diagnosing the cause of common back pain. Eugene Carragee, an orthopaedic surgeoun at Stanford University, analysed the MRIs of 96 people who had risk factors for disc degenaration. Those with damaged discs were only slightly more likely to report pain during activity than those without them.
Yet the sufferes in Carragee's study had one surprising thing in common. "When we looked at who hurt the most, the best predictor was increased emotional distress like depression," he says.
No-one denies that the pai is real. But people's attitudes about the discomfort play a major role in how they cope - and how fast they heal. "People get back pain and become anxious," says Deyo. "Then they limit their activities, and that makes it worse. It can be a downward spiral."
So what do experts suggest you do about backache? Not much. "Virtually all episodes of back pain go away on their own," says University of Washington neurosurgeon John Loeser.
The key is to drop the expectation of a simple diagnosis and an easy cure and instead find ways to manage your pain and prevent flare-ups. The vast majority of people can get relief with one or two of the most common treatments. Here are eight pain-busters worth trying.
Self-Care
You spent the morning lifting boxes, and your back has you begging for mercy. Doctors call these intense attacks acute pain. When misery strikes, they say, it's best to take immediate action. Try an over-the-counter pain medication like
ibuprofen, aspirin or acetaminophen.
If you have recurrent back pain, you may want to get a prescription pain medication to have on hand for your next bout with acute pain. Since such agony usually subsides quickly, the risk of addiction is not very high.
Doctors suggest icing the area that is experiencing pain for 15 minutes at a time, three to five times per day. A bag of frozen peas makes a great ice pack. If the pain persists for more than a few days, substitute a heating pad for those 15-minute periods. Meanwhile, remain as active as you can.
To prevent further flare-ups, sleep on a firm mattress and curl up on your side with a pillow between your knees. Choose chairs that support your lower back. Rethink behaviours that exacerbate your woes.
Kim Hedberg, a 42 year-old business consultant, avoids sitting still for extended periods, lifting heavy objects and stressing herself out -- all of which can bring on an attack of back pain. "Every little thing helps," she says.
Back when Rickhoff had her front court collapse, the standard advice was to stay in bed, "We now know that's the worst thing you can do," says Deyo. In fact, he argues, lying around actually boosts your risk of developing chronic back pain.
Doctors are also less likely to offer a diagnosis than they used to be. "There are many different diagnostic labels for back pain, but often they just cover up the fact that we don't what's causing it," explains Michael Von Korff, a back researcher at Group Health Cooperative in Seattle, Washington. "In the end, as long as you've excluded serious disease, the treatment is the same."
Unfortunately , sophisticated image techniques are often little help in diagnosing the cause of common back pain. Eugene Carragee, an orthopaedic surgeoun at Stanford University, analysed the MRIs of 96 people who had risk factors for disc degenaration. Those with damaged discs were only slightly more likely to report pain during activity than those without them.
Yet the sufferes in Carragee's study had one surprising thing in common. "When we looked at who hurt the most, the best predictor was increased emotional distress like depression," he says.
No-one denies that the pai is real. But people's attitudes about the discomfort play a major role in how they cope - and how fast they heal. "People get back pain and become anxious," says Deyo. "Then they limit their activities, and that makes it worse. It can be a downward spiral."
So what do experts suggest you do about backache? Not much. "Virtually all episodes of back pain go away on their own," says University of Washington neurosurgeon John Loeser.
The key is to drop the expectation of a simple diagnosis and an easy cure and instead find ways to manage your pain and prevent flare-ups. The vast majority of people can get relief with one or two of the most common treatments. Here are eight pain-busters worth trying.
Self-Care
You spent the morning lifting boxes, and your back has you begging for mercy. Doctors call these intense attacks acute pain. When misery strikes, they say, it's best to take immediate action. Try an over-the-counter pain medication like
ibuprofen, aspirin or acetaminophen.
If you have recurrent back pain, you may want to get a prescription pain medication to have on hand for your next bout with acute pain. Since such agony usually subsides quickly, the risk of addiction is not very high.
Doctors suggest icing the area that is experiencing pain for 15 minutes at a time, three to five times per day. A bag of frozen peas makes a great ice pack. If the pain persists for more than a few days, substitute a heating pad for those 15-minute periods. Meanwhile, remain as active as you can.
To prevent further flare-ups, sleep on a firm mattress and curl up on your side with a pillow between your knees. Choose chairs that support your lower back. Rethink behaviours that exacerbate your woes.
Kim Hedberg, a 42 year-old business consultant, avoids sitting still for extended periods, lifting heavy objects and stressing herself out -- all of which can bring on an attack of back pain. "Every little thing helps," she says.
Exercise
Though you might feel more inclined to moan in bed, regular exercise may be the best thing you can do for back pain. The only time you should avoid intense workouts is during the first few days of an acute attack. "Studies show that people who do as many active things as they can are the ones who recover best," says Carragee.
Experts agree that no single work out will erase your pain, but they say two categories are important: aerobic activities such as brisk walking, and exercises such as crunches and back extensions that strengthen your back and stomach muscles. A trainer at any gym can show you moves that will be right for you.
Relaxation Techniques
Stress can cause your body to tense up, worsening your back pain, says Deyo. Relaxation techniques like meditation may help you let go of tensions that might be triggering your pain.
In a landmark 1995 report, a panel of experts assembled by America's National Institutes of Health concluded that techniques like meditation and hypnosis can ease any chronic pain. Scientists say that these activities seem to mellow out your nervous system. This appears to blunt your body's sensitivity to pain. Some relaxation techniques such as yoga and tai chi have the added benefit of including exercise.
Physiotherapy
Blair Hurst, 53, went to a pain clinic in desperate shape. "My back was so bad I could barely stand up," she recalls. A physiotherapist showed her stretching and strengthening exercises that helped diminish her pain -- and taught her how to move without injuring herself.
A physical therapist can teach your exercise to eliminate postural problems or muscle weaknesses and imbalances that might cause or aggravate pain. The therapist can also show you correct ways to lift and bend.
Recent research suggests that the combination of stretching and strengthening with endurance exercises and proper body mechanics speeds up people's return to work after sustaining a back injury.
Chiropractic
Chiropractors were long perceived as back-cracking hacks, but those days are over. Studies have demonstrated that chiropractic manipulations can truly bring relief to an aching back.
The theory behind the manipulations is simple. Chiropractors say that swelling, joint irregularities or muscle spasms can immobilise your back joints, causing chronic pain. By moving these joints with their hands, they say, they can relieve tension and allow them to move again. "It's like a concentrated exercise in the joints with their hands, they say, they can relieve tension and allow them to move again. "It's like a concentrated exercise in the joint," says chiropractor Daniel Hansen of The Texas Back Institute.
Massage
A massage therapist can target both the back and surrounding areas. For some, the results are immediate and long-lasting. The rubbing, pushing, and kneading increases blood circulation to the back and relaxes tense muscles.
Massage comes in many flavours. There is evidence to show that neuro muscular massage therapy -- which targets specific pressure points -- is especially effective for low back pain. If the technique is going to help you, you should notice a response by the sixth treatment, says physician Robert Schulman of the American Academy of Medical Acupuncture.
Acupuncture
A 1997 US National Institutes of Health panel concluded that acupuncture is indeed helpful for treating low back pain. Researchers think acupuncture spurs the release of endorphins, your body's natural painkillers.
In one study, medical acupuncturists reported that about two-thirds of their patients said that they were pleased with the results. Many people feel at least some benefit after the first visit.
Surgery
Only about two per cent of all back-pain patients require surgery. In fact, Deyo says, there are only four reasons to consider surgery: a herniated disc that's been causing sciatic pain below your knee for a month; a spinal stenosis (narrowing of the spinal canal); a displaced vertebra; or a tumour or other life-threatening or disabling problem.
Despite the cautionary approach of most researchers, surgeons are still performing a slew of procedures, and new methods are being toutedin journals. Deyo and other experts urge people with back pain to be wary.
"Many patients rush into the latest thing, and then five years later we discover that it's worthless --- or worse," says Deyo. If, after getting a second oponion, you've decided that the scalpel offers you best chance at relief, look for an experienced surgeon. And be sure you're clear on what kind of long-term outcome you can expect.
Though you might feel more inclined to moan in bed, regular exercise may be the best thing you can do for back pain. The only time you should avoid intense workouts is during the first few days of an acute attack. "Studies show that people who do as many active things as they can are the ones who recover best," says Carragee.
Experts agree that no single work out will erase your pain, but they say two categories are important: aerobic activities such as brisk walking, and exercises such as crunches and back extensions that strengthen your back and stomach muscles. A trainer at any gym can show you moves that will be right for you.
Relaxation Techniques
In a landmark 1995 report, a panel of experts assembled by America's National Institutes of Health concluded that techniques like meditation and hypnosis can ease any chronic pain. Scientists say that these activities seem to mellow out your nervous system. This appears to blunt your body's sensitivity to pain. Some relaxation techniques such as yoga and tai chi have the added benefit of including exercise.
Physiotherapy
Blair Hurst, 53, went to a pain clinic in desperate shape. "My back was so bad I could barely stand up," she recalls. A physiotherapist showed her stretching and strengthening exercises that helped diminish her pain -- and taught her how to move without injuring herself.
A physical therapist can teach your exercise to eliminate postural problems or muscle weaknesses and imbalances that might cause or aggravate pain. The therapist can also show you correct ways to lift and bend.
Recent research suggests that the combination of stretching and strengthening with endurance exercises and proper body mechanics speeds up people's return to work after sustaining a back injury.
Chiropractic
Chiropractors were long perceived as back-cracking hacks, but those days are over. Studies have demonstrated that chiropractic manipulations can truly bring relief to an aching back.
The theory behind the manipulations is simple. Chiropractors say that swelling, joint irregularities or muscle spasms can immobilise your back joints, causing chronic pain. By moving these joints with their hands, they say, they can relieve tension and allow them to move again. "It's like a concentrated exercise in the joints with their hands, they say, they can relieve tension and allow them to move again. "It's like a concentrated exercise in the joint," says chiropractor Daniel Hansen of The Texas Back Institute.
Massage
A massage therapist can target both the back and surrounding areas. For some, the results are immediate and long-lasting. The rubbing, pushing, and kneading increases blood circulation to the back and relaxes tense muscles.
Massage comes in many flavours. There is evidence to show that neuro muscular massage therapy -- which targets specific pressure points -- is especially effective for low back pain. If the technique is going to help you, you should notice a response by the sixth treatment, says physician Robert Schulman of the American Academy of Medical Acupuncture.
Acupuncture
A 1997 US National Institutes of Health panel concluded that acupuncture is indeed helpful for treating low back pain. Researchers think acupuncture spurs the release of endorphins, your body's natural painkillers.
In one study, medical acupuncturists reported that about two-thirds of their patients said that they were pleased with the results. Many people feel at least some benefit after the first visit.
Surgery
Only about two per cent of all back-pain patients require surgery. In fact, Deyo says, there are only four reasons to consider surgery: a herniated disc that's been causing sciatic pain below your knee for a month; a spinal stenosis (narrowing of the spinal canal); a displaced vertebra; or a tumour or other life-threatening or disabling problem.
Despite the cautionary approach of most researchers, surgeons are still performing a slew of procedures, and new methods are being toutedin journals. Deyo and other experts urge people with back pain to be wary.
"Many patients rush into the latest thing, and then five years later we discover that it's worthless --- or worse," says Deyo. If, after getting a second oponion, you've decided that the scalpel offers you best chance at relief, look for an experienced surgeon. And be sure you're clear on what kind of long-term outcome you can expect.
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1 comments:
Yeah.. I got the problem too.. Back pain ain't easy to handle..
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