In developed societies, back pain has acquired the characteristics of an epidemic and is considered one of the most relevant health problems.
It affects
more than 80% of the population at some point in their lives
.
To better understand this concept, we must first make the appropriate distinctions, since this type of discomfort receives a different name depending on the part of the back where it is experienced.
The terms are formed by joining the suffix –algia (meaning pain) to each of the vertebral regions.
Thus, we have
cervicalgia
, when it affects the cervical area (neck);
dorsalgia
, if the dorsal region hurts
;
and low
back pain
, in the lower part.
It is common to find these words in a multitude of clinical reports, but they do not really correspond to a diagnosis: we are simply indicating that
there is pain in a specific region
.
When the pain affects the neck area it is called cervicalgia.
Photo Shutterstock.
1. When should we worry about back pain?
Although almost everyone will experience back pain at some point in their lives, fortunately
it is not serious in most cases
.
In a large percentage, it decreases a month after starting.
Physiotherapists and doctors use the expression
"red flags"
(translation from English red flags) for those signs and symptoms that could reveal a serious disease in the spine or another part of the body.
Some warning signs are experiencing
sensory and muscular alterations
(tingling in the limbs, loss of strength, urinary incontinence...), losing weight without justification, having suffered a blow, feeling pain in the thoracic region or having a fever.
For this reason, although back pain is usually benign, a health professional should be consulted whenever there are doubts.
As long as there are no red flags, we must
remain calm
, because there are no signs of serious pathology.
2. Does the way you deal with it influence your evolution?
Psychosocial factors, called
"yellow flags"
, are essential for pain to last for a long time.
That is, it becomes chronic.
Some examples of yellow flags are: adopting a negative attitude (we must keep in mind that a lot of pain is not synonymous with serious injury or disability);
stop doing physical activity for fear of discomfort or that the problem will worsen (the so-called
kinesiophobia
);
thinking that passive treatments are better than exercise;
and also face social, family or financial problems.
3. If my back hurts, should I get an X-ray?
It is a decision that must be made by the doctor, because X-rays are not innocuous.
After the age of 50 it is normal to suffer from
degenerative processes
in the spine or alterations in the intervertebral discs, but people without discomfort also suffer from it.
In the end, the diagnosis of these ailments through imaging tests contributes to
over-medicalizing patients
and increasing absenteeism from work.
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 treat back pain, according to science?
Considering all the options available, from zone-specific activities to full-body exercises, it's hard to summarize without leaving out relevant information.
The physiotherapist will indicate it according to the needs and pathology of each patient.
In long-term low back pain, the international network of experts
Cochrane Collaboration
indicates that therapeutic exercise is more effective than other interventions or treatments, but no program demonstrates a clear advantage over others.
However, some recent publications do venture to propose Pilates and the
McKenzie method
exercises (which focus on back extension movements) as notable for relieving low back pain.
In our research we also observed that
therapeutic exercise
and correct patient counseling increase the effect of manual therapy.
Therefore, there are multiple alternatives offered from physiotherapy.
Many exercises are aimed at
improving the mobility of the spine
and stretching shortened muscles (for example, the extensor muscles of the spine, the hamstrings and the iliopsoas).
Others seek the strengthening and adequate control of the muscles, especially in
the central area
(the so-called core muscles), as well as postural hygiene as a preventive measure.
But any activity, from the simplest, is beneficial.
Science indicates that walking reduces pain and improves quality of life, as well as preventing
movement
avoidance behaviors in chronic low back pain.
Plus, it's one of the easiest and most affordable ways to stay active.
The important thing is to carry out an activity that is to the patient's liking: the worst exercise is the one that is never done.
They recommend avoiding unnecessary rest.
Photo Shutterstock.
5. Can I do sports after having back pain?
A sedentary lifestyle, a great enemy of our health in general, favors
back pain to lengthen
and generate greater disability.
Therefore, rest must be duly justified and limited to the minimum possible time.
It has not been shown that practicing sports (leisure or competitive) causes back pain to reappear.
Rather, it favors that the benefits of physiotherapy treatment are maintained, as long as
the intensity and duration are regulated
.
In any case, we must choose the appropriate discipline and have the advice of a professional.
This is the case of swimming, whose practice must be supervised if we opt for the butterfly style.
While in cycling we must adjust the position of the seat to maintain a proper posture.
If we choose a team sport (soccer, basketball), the important thing is to take into account the contact
between the participants and sudden and intense movements.
And in tennis,
serving or serving
is especially stressful because of the movements it requires of the back.
As for the activity of running, it generates repeated impacts and stress on the lumbar spine in the heel strike phase, since it supports a compression that oscillates between 2.7 and 5.7 times the body weight.
Running vigorously could be a risk factor for low back pain, but running moderately even
improves any type of
back discomfort.
In short, the best way to treat back pain is to reassure the patient, insist on
avoiding unnecessary rest
, control overmedication, and break a sedentary lifestyle.
*Lorenzo Antonio Justo Cousiño is a professor at the Faculty of Physiotherapy, physiotherapist and doctor in neuroscience at the University of Vigo, Spain. The original article was published on The Conversation.
***
Do you feel pain?
These notes may interest you:
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➪A surprisingly simple way to relieve knee pain
And to get you moving:
➪ "Wake up" and pre Pilates: exercises to relieve neck pain
➪3 exercises to work the "core" or middle area
➪Three strength exercises for people over 50
***
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