Five things you should know about back pain

In developed societies, back pain has become an epidemic and is considered one of the most pressing health problems. It affects over 80% of the population at some point in their lives.

To better understand this concept, we must first make the appropriate distinctions, as this type of discomfort gets different names depending on the part of the back where it is felt. Terms are formed by adding a suffix – algia (meaning pain) to each of the spinal regions. Thus, we have cervicalgia when the cervical region (neck) is affected; dorsalgia, if the spinal region hurts; and pain in the lower back, in the lower part.

These words often appear in many clinical reports, but in fact they do not correspond to the diagnosis: we simply indicate the presence of pain in a certain area.

1. When do you need to worry about us?

Although almost all people experience back pain at some point in their lives, fortunately, in most cases it is not serious. In a large percentage, it decreases a month after the start.

Physiotherapists and doctors use the expression “red flags” (translated from English. red flags) for those signs and symptoms that may indicate a serious disease of the spine or other part of the body. Some warning signs are sensory and muscle changes (tingling in the limbs, loss of strength, urinary incontinence…), unreasonable weight loss, stroke, chest pain or fever.

For this reason, although back pain is usually benign, a healthcare professional should be consulted when in doubt. As long as there are no alarms, we must remain calm, because there are no signs of serious pathology.

2. Does how you deal with it affect your evolution?

Psychosocial factors, called “yellow flags”, are necessary for pain to persist for a long time. That is, it becomes chronic.

Some examples of yellow flags are: negative attitude (we must remember that severe pain is not synonymous with serious injury or disability); stop exercising for fear of discomfort or making the problem worse (called kinesiophobia); thinking that passive treatment is better than exercise; and also face social, family or financial problems.

3. If my back hurts, do I need an x-ray?

This decision must be made by the doctor, because the x-ray is not harmless. After the age of 50, it is normal to suffer from degenerative processes in the spine or changes in the intervertebral discs, but people without discomfort also suffer from this.

Ultimately, diagnosing these diseases with imaging tests contributes to over-medication of patients and prolongation of sick days. The International Association for the Study of Pain indicates that pain is non-specific (cannot be associated with a specific problem) in 85% of cases. For this reason, x-rays are often used when there are red flags.

4. What are the best exercises to fight it, according to science?

With all the options available, from zone-specific exercises to full-body exercises, it’s hard to sum up without missing important information. The physiotherapist will prescribe it based on the needs and pathology of each patient.

The Cochrane Collaboration International Network of Experts points out in long-term low back pain that exercise therapy is more effective than other interventions or treatments, but no program shows a clear advantage over others.

However, some recent publications have ventured to suggest Pilates and Mackenzie exercises (which focus on back extension movements) as known to relieve low back pain.

In our studies, we also observed that exercise therapy and proper patient counseling enhance the effect of manual therapy.

Thus, there are many alternatives offered by physiotherapy. Many exercises focus on improving spinal mobility and stretching shortened muscles (eg, spinal extensor muscles, hamstrings, and iliopsoas). Others strive for strengthening and adequate control of the muscles, especially in the central region (the so-called calf muscles). basic), as well as postural hygiene for preventive purposes.

But any activity, from the simplest, is beneficial. Science shows that walking reduces pain and improves quality of life, and prevents movement avoidance in chronic low back pain. Plus, it’s one of the easiest and most affordable ways to stay active.

It is important to do activities that the patient enjoys: the worst exercise is one that is never done.

5. Can I exercise after my transfer?

A sedentary lifestyle, a great enemy of our overall health, contributes to the lengthening of the back and increased disability. Therefore, rest must be properly justified and limited to the minimum possible time.

It has not been proven that playing sports (in free time or in competition) causes the recurrence of back pain. Rather, it ensures that the benefits of physiotherapy treatment are maintained as long as the intensity and duration are adjusted.

In any case, we must choose the appropriate discipline and consult with a specialist. This is a case of swimming that should be practiced if we choose the butterfly style. When riding a bicycle, we must adjust our position in the saddle to maintain the correct posture.

If we choose a team sport (football, basketball…), it is important to take into account the contact between the participants and sudden and intense movements. And in tennis, the serve or serve is particularly stressful because of the movement it requires from the back.

In terms of running activity, it causes repetitive impact and stress on the lumbar spine during the heel strike phase as it maintains a compression that oscillates 2.7 to 5.7 times body weight. Intense running can be a risk factor for lower back pain, but moderate running even reduces any back discomfort.

In short, the best way to cure back pain is to reassure the patient, insist that he avoid unnecessary rest, control over-medication, and give up a sedentary lifestyle.

Lorenzo Antonio Justo Cuzinho, professor at the Faculty of Physiotherapy. Physiotherapist, Doctor of Neurological Sciences, University of Vigo

This article was originally published on The Conversation. Read the original.