EULALEE THOMPSONIT APPEARS that back pain is the price human beings pay for being upright, for if we were still on all fours this might not be a major medical concern for orthopaedic surgeons. In fact, consultant orthopaedic surgeon, Dr. Kenneth Vaughan says that 75 per cent of the adult population will, at some time, experience some amount of back pain. For the majority it may be a single episode but he said that about 10 to 15 per cent of the population will suffer chronic lower back pain.
"It is a significant problem because of the impact on the well-being of individuals, society, the demands on healthcare, the cost of investigation, time loss from work and litigation due to injury on the job. The latter is a fairly large area, we haven't got figures locally but elsewhere, a fairly large chunk of litigation is due to back pain," he said.
Back pain can be very excruciating. Usually the pain is concentrated in the lower back, but Dr. Vaughan said that the pain may be localised or it can radiate down the thighs, legs and feet.
The lower back is a complex structure of vertebrae, discs, spinal cord and nerves. The vertebrae are stacked one upon the other, connecting the upper spine to the pelvis and the discs act very much like shock absorbers or cushions to protect the lumbar vertebrae. The spinal cord and nerves travel through a central canal in the vertebrae, connecting the brain to the muscles in the legs.
It is the malfunctioning of any part of this complex structure that will result in serious back pain. Dr. Vaughan said that by far the majority of the cases of back pain are caused by the degeneration of the discs or infection in the spine. He also said that some people will develop a tumour in the spine or some degenerative changes such as arthritis and this will result in back pain.
The treatment is dependent on the cause. Dr. Vaughan said that if the disc is pressing on nerve causing significant symptom, then the surgeon would usually remove the disc. Life will continue without the disc and once it is removed, the symptoms should disappear.
If the cause of back pain is an infection, then it would be treated with a course of antibiotics. Infections in the back are usually caused by bacteria sometimes from an infection from the urinary tract or as a result of generalised septicema. One of the specific infections in the back, Dr. Vaughan said, is TB. A tumour would be treated by removing the bone or with radiation and chemotherapy. When the bone is removed, Dr. Vaughan said that it can be replaced with a bone from elsewhere such as the hips, ribs and legs.
Dr. Vaughan said that although treatment is available, individuals should try as far as possible to prevent injury to the back. People should for instance take care when they bend and when they lift heavy things. He said that it is better to bend, not by bending the back, but by bending the knees (keep the back straight) and lift objects in a similar way. If the object is too heavy then two persons should lift it. He also pointed out that there are "industrial back supports" that will give external support to the back.
Dr. Vaughan also advises people to take care of the back by controlling weight gain and keeping our bodies in shape since exercise, especially of the abdomen, strengthens the muscles of the back.
The Jamaican Orthopaedic Association
will hold its sixth annual symposium on
the spine, January 20-21, 2001 at the
Crowne Plaza Hotel, Kingston.
If you have back pain...
The American Academy of Orthopaedic Surgeons advises that there are some exercises that you can do to lessen the pain but discuss them with your doctor before kicking off. These exercises work the muscles of the back, stomach, hips and thighs.
THE WALL SLIDE
Stand with your back against a wall and feet and shoulder-width apart. Slide down into a crouch with knees bent to about 90 degrees. Count to five and slide back up the wall. Repeat five times. This exercise strengthens the back, hip and leg muscles.
THE LEG RAISE
Lie on your stomach and then tighten the muscles in one leg and raise it from the floor. Hold your leg for a count of 10 and return it to the floor. Do the same with the other leg. Repeat five times with each leg.
