Back Pain

Risk Factors of Back Pain
Upper body weight is more or less 2/3 of the total body weight. Upper body weight is transmitted by vertebras. Vertebrae has anterior and posterior segment.

• Anterior segment is vertebral body and disk.
• Posterior segment is facet joint.
• Disk is the softer component of the weight bearing structure. Disruption of the weight bearing system can lead to moderate to severe pain. Pain could be secondary to fracture of vertebrae or injury to disk. Disk injury may set off bulge, herniation or degeneration.
• Trauma or disease of posterior component of the vertebrae may lead to pain secondary to fracture of facet joint or facet joint disease. Back Pain is common in the lower back among all patients. But upper back (neck) and middle back (thorax) also are common complaints in the younger age group.
• Chronic Back Pain could also be secondary to muscle injury or spasm. Paravertebral muscle is predominantly situated on side of vertebral body and facet joint.
• Muscle disease such as Fibromyalgia, myofascial syndrome or myositis can cause severe back pain.
• Muscle spasm may be protective when anterior or posterior segment of vertebral system has a pathological reason to convey pain.
• Paravertebral muscle spasm may disappear once the illness causing pain from vertebrae, disk and facet joint is treated.

Diagnosis Depends on history, clinical examination and outcome of investigations.

Demographic Risk Factors – Gender- Common in female Age- Older age Weight - Obesity Tissue hypoxia- Smoking Obesity Pregnancy- Lordosis posture
Physical Risk Factors- Activities- Stressful job, Physical strenuous work Laborious physical effort Carrying a heavy purse, briefcase or backpack
Chronic Disease as risk factors- Disease- Osteoporosis Cognitive symptoms- Anxiety, Depression

Prevention of Back Pain
Back pain predominantly occurs in low back and neck. Prevention involves preclusion of origin of cause of pain. If any of the following cause of pain is eliminated or minimize, the occurrence of pain will be less severe or abolish. Back pain prevented by eliminating abnormal posture, scrutinize weight distribution and avoid execution of actions beyond limitation. One must know the limitation.
 

• Prevent- Inappropriate lifting- in erroneous posture
• Laborious physical effort- when not trained
• Sports injury or fall- unaware of posture or imbalance
• Work injury- unaware of posture, object weight or imbalance Auto accident- speed, acceleration and whiplash injury
• Poor sitting or standing posture- improper weight distribution Bending forward too long- strain on muscle and ligaments Carrying a heavy purse, briefcase or backpack
• Stress and muscle tension- prolong muscle spasm Working at a desk with poorly designed seats Lack of muscle tone- inadequate exercise Sleeping position and/or pillow positioning- overextended or flex neck
• Excess weight- obesity, excessive strain on skeletal system
• Pregnancy- Lordosis posture Foot problems/improper shoes
  Safety measures-
• Posture- Maintain proper posture at work and while lifting or carrying heavy object. Decent posture maintains the weight distribution in properly aligned musculoskeletal system. Proper posture balances the bilateral muscle tightening and reduces stress on tendons and ligaments. Properly aligned bones and joints during activities eases the contraction of muscles involved in maintaining posture. In return the spasm of muscle is least and residual pain is also minimal.
• Regular exercise- Exercise is performed either to build the physique or improve cardiovascular fitness. Exercise could be outdoor or indoor. Outdoor cardio exercises are walking, swimming and bicycling. Indoor cardio exercise are walking or running on treadmill, steps ladder, elliptical trainer and stationary bicycle.
• Weight lifting could be either use of free weights such as dumbbells or cable weights. Weight lifting is strenuous and could be harmful if not done right. Proper posture and positioning of body is essential while lifting heavy weights to prevent any injury to joint and muscles. Lifting of incremental weights during exercise depends on body weight and muscle strength as well as muscle mass.