Counseling Sheet

Agatha M. Thrash, M.D.
Preventive Medicine‍

Causes‍

The most common cause of backache is overweight. Carrying excess poundage puts a strain on the back, on both the bones and the soft tissue (muscles, ligaments, and joint tissues). The excess weight in front of the spine, on the abdomen and chest, leads to pulling the body forward, causing the back muscles to be under a strain to hold the body erect.

A weakening of these structures by fat that grows into the tiny spaces around blood vessels and along the borders between muscles and around joints causes these soft tissues to be less able to protect themselves from minor injury.

Overeating is another major cause of backache. In a thin person, even eating too large a meal can result in overbalancing the body in the forward position from the extra weight of the food and digestive juices. The reflexive effort to hold the shoulders and ribs off the overloaded intestinal tract adds to the strain on the back.

A slipped or ruptured disc causes rather severe back pain, often with radiation down the thigh and leg, sometimes with "hot spots" somewhere along the course of the pain. Diseased discs come on over a period of years caused by excessive strain on the joints of the back, such as by poor posture, occupational stresses, or competitive sports. It is rarely a sudden event in a person having no previous symptoms.

Chronic back strain may be caused by maintaining one position for a long period of time, such as in typing or bending over at work. Learn to sit and bend without strain.

Weakness of muscles from lack of exercise is another important cause of backache. Vigorous outdoor exercise that brings into use all the powers and movements of the back can gradually correct certain chronic backaches. Be certain to start an exercise slowly, as exercise of weak muscles can cause a flare-up of pain.

Spondylolisthesis is a slipping forward of one vertebra over its neighbor with erosion of a part of one vertebra. Sitting on the floor with the legs straight out in front can cause this type of backache. Low seated bucket seats give a similar position.

A transitional vertebra is a birth defect in which one vertebra in the low back is doing double duty both as a part of the spine above, and as a part of the pelvis below.

Psychological factors are, in some people, a very potent cause of pain in the back. Take away the unhappiness or prescribe long walks in nature to neutralize tension or mental anguish and the backache disappears. The resulting overwork leads to pain. Back-strengthening exercises can help this type of pain.

Constitutional factors cause backache, such as constipation, hypoglycemia, pregnancy, menstruation, and pelvic tumors in both men and women.‍

Treatments‍

Specific remedies for backache include removing all of the causes already known and strengthening the back by walking, purposeful labor, or well-directed exercises as follows:

Stand with back against a wall, heels four inches from the wall. Tilt the pelvis in such a way as to tuck the buttocks under and flatten the curve of the low back. While in this position contract the muscles of the abdomen and the buttocks and hold for thirty seconds. Relax for five seconds and repeat.

Stand facing a wall with toes on a line drawn two feet from the wall. Place hands on the wall at a little lower than shoulder level and lean into the wall. Keep heels on the floor at all times. Hold for ten seconds. Push up for three seconds. Repeat three times. The stretching helps low back pain in some people. It should be done daily for thirty days.

Sit in chair. Hug one knee to chest. Raise other leg to the level of the chair seat, keeping knee straight and toes pointed up. Hold for a few seconds and alternate.

Another back exercise is called winging. While lying on the floor face down, raise the arms and legs off the floor above the back, and hold the head and shoulders off the floor, causing the entire body to be supported just on the abdomen. Hold for several seconds and build up time to two minutes.

You may also try bridging. Lie on the floor on your back. Arch back and support body weight on the heels and shoulders, keeping the head off the floor. Maintain this position for several seconds, building up gradually to two minutes.