The back is an intricate structure of bones muscles and other tissues that form the back or
posterior part of the body trunk, from the neck to the pelvis, while pain is physical discomfort
ranging from mild to severe, usually caused by injury, illness or a nerve condition.
Backpain is physical discomfort occurring anywhere on the spine or back ranging from mild to
disabling. It occurs when problems develop in the spine, discs, muscles, ligaments or tendons in the
back. Backpain is one of the most common medical problems worldwide. Anyone can have
backpain, and almost everyone will experience backpain at some point in their life.
Factors that contribute to backpain includes the following:
Fitness level – backpain is likely to occur if you exercise strenuously after being inactive for
a while or when you are not physically fit.
Weight gain – high calories diet combined with an inactive lifestyle can lead to obesity and
this can put stress on the back causing it pain.
Job-related risk factor – jobs that requires heavy lifting, pushing, pulling or twisting can
cause back pain as well as poor posture or sitting all day in an uncomfortable manner.
Stress level – people with poor sleep, depression or anxiety are prone to back pain.
Age – back pain is prevalent in ageing population especially after 45 years.
Hereditary – genetics plays a role in some disorder that causes back pain.
TYPES OF BACK PAIN
1. Acute back pain is the pain extending from the lowest rib to the buttocks and sometimes the
lower limbs. The pain is generally felt suddenly on either side of the midline and last for few
days or weeks. It affects every 8 out of 10 adults. It is usually non-specific, where no causes or
structures can be identified to account for the perceived pain. The source of pain may be in the
spinal joint, discs, vertebrae or soft tissues.
Causes of acute back pain:
Strain
Sprain
Sciatica
Pregnancy
Menstrual cramp
Herniated discs
2. Chronic back pain is the pain lasting longer than 12 weeks, even after an initial injury or
underlying cause of acute back pain has been treated. It is common among the ageing
population with higher prevalence in females especially the ones from lower economic status. It
can be caused by muscle strains, problems with discs in the spine, narrowing of the spine or
arthritis.
Causes of chronic back pain:
Compression fractures
Spinal stenosis
Curvature of the spine
Medical problems such as fibromyalgia or rheumatoid arthritis
Piriformis syndrome
Spondylolisthesis
Degenerative diseases
Spinal deformities (Scoliosis)
Infections
Cancer
Psychosomatic factors
SYMPTOMS OF BACK PAIN
1. Increasing pain with lifting and bending
2. Worsening pain when resting, sitting or standing
3. Stiffness
4. Weakness in the legs
5. Numbness and tingling
6. Posture problem
7. Muscle spasms
DIAGNOSIS OF BACK PAIN
(a) Physical exam which may include:
Ability to stand and walk
Spine’s range of motion
Reflexes
Leg strength
Ability to detect sensation in the leg
(b) Imaging test such as:
X-rays of the spine to show alignment of the patient bone
CT scan or MRI scan to assess the discs, muscles, ligaments nerves and blood vessels.
Bone scan to look for abnormalities in the bone tissues.
Electromyography (EMG) to test nerve signals.
Blood and urine test to check underlying conditions.
TREATMENT FOR BACK PAIN
1. Home treatment for sprains and strain includes:
Rest
Gentle movement or stretching
Applying a hot or ice pack compress
Exercise
2. Medications such as:
Over the counter pain medication
Topical rubs an ointments
Muscle relaxants
Anti-depressants
3. Physiotherapy for posture-related pain, or a curved spine to strengthen the back muscles, and
improve flexibility.
4. Injections
5. Spinal manipulation or traction.
6. Alternative medicine such as:
Acupuncture
Massage
Chiropractic adjustment
Cognitive behavioral therapy
Relaxation techniques
7. Surgery such as:
Bone grafting
Spinal fusion for treating scoliosis and herniated disc
Laser surgery
Disc replacement surgery, etc.
WAYS TO PREVENT BACK PAIN
(a) Improve your posture while sitting and standing
(b) Avoid lifting heavy loads
(c) Weight management
(d) Exercise regularly
(e) Use of supplements like Calcium
(f) Eating healthy
(g) Maintain a strong core
(h) Stress management
(i) Have a good sleep
(j) Stop smoking
IMPACT OF BACK PAIN
1. Physical impacts
Restriction in movement and performance of daily activities
Poor posture my occur making it difficult to sit or stand upright
Pain may radiate to the legs making walking difficult and painful
It may lead to tiredness and lack of stamina which can result to difficulty in performing
daily activities
2. Impact on daily activities
Back pain can limit productivity at work
It can lead to social isolation making it difficult to maintain healthy relationships.
It can prevent one from participating in activities like exercise, sports, etc.
Lack of independence
Difficulty in sleeping may occur
3. Mental and emotional impacts
Fear and depression may set in
Low self-esteem
It can lead to irritation and frustration
It can cause one to be afraid to move around
It can lead to lack of intimacy in relationship.
HOW TO MANAGE BACK PAIN
Regular exercise e.g: walking, swimming or yoga
Do not overwork the body.
Stress management
Maintaining good posture
Have enough rest and sleep.
Take medications.
SOURCES:
(1) Ashby et al. 2012. The impact of chronic low back pain on leisure participation; implication
for occupational therapy.
(2) Improving the pharmacologic management of back pain in older adults.
