Common Injuries
The Epidemiology of Neck Pain
Backaches
Most backaches come
from strained muscles in the lower back. Other causes include back injuries such
as a slipped or herniated disc, arthritis, osteoporosis and urinary tract
infection. The goals of treatment are to treat the cause of the backache,
relieve the pain, promote healing and avoid re -injury.
How to Avoid Back Pain
Lifting causes a lot of backaches. Here are some lifting Do's
and Don'ts to help you avoid straining your back.
Do's:
- Wear good shoes with low heels, not sandals or high heels.
- Stand close to the thing you want to lift.
- Plant your feet squarely, shoulder width apart.
- Bend at the knees, not at the waist. Keep your knees bent as you lift.
- Pull in your stomach and buttocks.
- Keep your back as straight as you can.
- Hold the object close to your body.
- Lift slowly.
- Let your legs carry the weight.
- Get help or use a dolly to move something very heavy.
Don'ts:
- Don't lift if your back hurts.
- Don't lift if you have a history of back trouble.
- Don't lift something that's too heavy.
- Don't lift heavy things over your head.
- Don't lift anything heavy if you're not steady on your feet.
- Don't bend at the waist to pick something up.
- Don't arch your back when you lift or carry.
- Don't lift too fast or with a jerk.
- Don't twist your back when you are holding something. Turn your whole
body, from head to toe.
- Don't lift something heavy with one hand and something light with the
other. Balance the load.
- Don't try to lift one thing while you hold something else. For example,
don't try to pick up a child while you are holding a grocery bag. Put the
bag down, or lift the bag and the child at the same time.
Questions to Ask
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YES
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NO
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Is the back pain extreme and felt across the upper back (not just on
one side) and did it come on suddenly (within about 15 minutes) with no
apparent reason such as an injury or back strain? (Note: These may be
symptoms of a dissecting aortic aneurysm.)
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Seek emergency care
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Go to next question
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Did the pain start inside your chest and move to the upper back?
(Note: You may be having a heart attack. The pain can be dull, and you
may not feel it in the chest at all.)
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Seek emergency care
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Go to next question
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Was the back pain sudden with a cracking sound?
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Seek emergency care
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Go to next question
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Did the pain come after a recent fall, injury or violent movement to
the back, and are you having a hard time moving your arm or leg? Do you
also have numbness or tingling in your legs, feet, toes, arms or hands
and/or loss of bladder or bowel control?
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Seek emergency care
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Go to next question
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Did the pain come on all of a sudden after being in a wheelchair or
after a long stay in bed, or are you over 60 years old?
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See doctor
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Go to next question
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Is the pain severe (but not a result of a fall or injury to the
back), and has it lasted for more than five to seven days, or is there
also a sense of weakness, numbness or tingling in the feet or toes?
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See doctor
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Go to next question
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Does the pain travel down the legs below the knee?
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See doctor
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Go to next question
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Does it hurt more when you move, cough, sneeze, lift or strain? Have
you lost control of your bladder or bowel movements?
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See doctor
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Go to next question
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Does it hurt, burn or itch when you pass urine? Do you have fever or
vomiting with the pain? Do you have to go to the bathroom more often?
Does your urine smell or have blood in it?
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See doctor
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Go to next question
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Is the pain felt on one side of the small of your back, just above
the waist, and do you feel sick and have a fever of 101 degrees
Fahrenheit or higher?
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See doctor
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Go to next question
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Do you also have any of the following:
Joint stiffness and pain
Redness, heat or swelling in affected joints
Cracking or grating sounds with joint movement
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See doctor
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Provide self-care
(see below)
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Self-Care Procedures
Rest -- Resting the back can help
treat the pain and avoid re-injury. Resting doesn't have to be in bed, but lying
down takes pressure off your back so it can heal faster. Up to three days of bed
rest is usually recommended. Your back muscles can get weak if you stay in bed
longer than that. To make the most of rest:
- When you need to get up from bed, move slowly, roll on your side and swing
your legs to the floor. Push off the bed with your arms.
- Get comfortable when you are lying, standing and sitting. For example,
when you lie on your back, keep your upper back flat but your hips and knees
bent. Keep your feet flat on the bed. Tip your hips down and up until you
find the best spot.
- Take pressure off your lower back. Put a pillow under your knees or lie on
your side with your knees bent.
Cold treatment -- Cold helps with bruises and swelling.
You can make a cold pack by wrapping ice in a towel. Use the cold pack for 20
minutes, then take it off for 20 minutes. Do this over and over for two to three
hours a day. Lie on your back with your knees bent and put the ice pack under
your lower back. Start as soon as you hurt your back. Keep doing it for three to
four days.
Heat treatment -- Heat makes blood flow, which helps
healing. But don't use heat on a back strain until three to four days after you
get hurt. If you use heat sooner, it can make the pain and swelling worse. Use a
moist heating pad, a hot-water bottle, hot compresses, a heat lamp, a hot tub,
hot baths or hot showers. Use heat for 20 minutes, then take the heat off for 20
minutes. Do this up to three hours a day. Be careful not to burn yourself.
Massage -- Massage won't cure a backache, but it can
loosen tight muscles.
Braces or corsets -- Braces and corsets support your back
and keep you from moving it too much. They do what strong back muscles do, but
they won't make your back stronger.
Pain relief -- Take aspirin, ibuprofen or naproxen sodium
for pain. Note: Do not give aspirin or any medication containing salicylates to
anyone 19 years of age or younger, unless directed by a physician, due to its
association with Reye's syndrome, a potentially fatal condition. Acetaminophen
will help the pain but not the swelling.
Don't overdo it after taking a painkiller. You can hurt your
back more and then it will take longer to heal.
More tips:
- After two to three days of resting your back, try some mild stretching
exercises to make stomach and back muscles stronger. Exercise in the morning
and afternoon. (Always ask your doctor before starting an exercise program.)
- Don't sit in one place longer than you need to. It strains your lower
back.
- Sleep on a firm mattress.
- Never sleep on your stomach. Sleep on your back or side, with your knees
bent.
- If your back pain is chronic or doesn't get better on its own, see your
doctor. He or she can evaluate your needs. A referral may be given to a
physical therapist, a physiatrist (a doctor schooled in physical therapy) or
a chiropractor.
Copyright © 1996 Don R. Powell, Ph.D. From The American Institute for
Preventive Medicine's Self-Care: Your Family Guide to Symptoms and How to
Treat Them, by arrangement with People's Medical Society.
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