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From the New Straits Times, a lot of Americans, and the rest of us, suffer from Back Pain.

The bane of BACK PAIN
Rajen M.

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While back pain is a complex subject, its causes can be identified and, in many cases, relief can be attained.

ONE-HALF of all working Americans admit having back pain symptoms each year. Back pain is one of the most common reasons for staying away from work. In fact, back pain is the second most common reason for visiting the doctor, outnumbered only by upper-respiratory infections.

Most cases of back pain are mechanical or non-organic -- meaning they are not caused by serious conditions, such as inflammatory arthritis, infection, fracture or cancer.

When the body is not seen as a whole, simple things are missed. That is why current technologies have done little to ease the pain of lower back ache sufferers. While back pain is a complex subject, its causes can be identified and, in many cases, relief can be attained.

The cause of lower back pain can be broken down into five primary problems. These five causes are interconnected. This breakdown is adapted from the St John Neuromuscular Therapy training -- a method of postural analysis and clinical massage therapy.

Except for pain caused by trauma or by cancer or rheumatoid arthritis, almost all lower back pain can be traced to one or a combination of these causes.

-Ischemia

In everyday language, this means "lack of blood flow". Tissues such as muscles cannot function properly. Without adequate blood to provide food and oxygen, soft tissues such as muscles, tendons and ligaments can build up lactic and other breakdown products of metabolism. This can become painful over time. Ischemia occurs when muscles are chronically contracted over a period of time.

- Trigger points

A "trigger point" is an area of the soft tissue which, after chronic contraction and reduced blood flow, becomes an area of high nerve activity.

For example, certain fibres in an ischemic muscle (a muscle with low blood) can become an unduly active trigger point in response to biochemical changes in the tissue.

Active trigger points cause referred sensation to other parts of the body. That sensation can be pain, tingling, numbness, thermal sensations (hot or cold), weakness, a general ache quality, or the feeling that "it just doesn't feel right".

For example, you might have a trigger point in a muscle of your lower back which refers sensation down into your buttocks, or even down the leg.

- Nerve compression and entrapment

This is pressure put on a nerve by a bone or an inter-vertebral disc. Nerve compression occurs when the spine becomes misaligned and one of the discs between the vertebrae gets squeezed on one side, causing it to bulge out on the other side. This "bulge" can put pressure on a spinal nerve causing pain.

Nerve entrapment is when a nerve is caught or pinched by the soft tissues. For example, the sciatic nerve (the largest nerve in the body) runs down through the buttocks and can become entrapped by the piriformis muscle when that muscle is very tight. This can result in pain flowing down the back of the leg.

- Structural imbalance

In a sense, this issue is the most significant of all. Structural imbalance is often the root problem responsible for ischemia, trigger points, and nerve compression or entrapment.

If the body is distorted off its centre line of gravity, compensating muscular patterns can result.

- Dysfunctional biomechanics

This is often a secondary result of structural imbalance and is caused by faulty movement patterns. Someone having a nagging lower back pain might hold her body in a restricted way and walk differently, showing a limited range of movement.

It is logical to do that. It is not recommended to fight against your body's self-imposed limitations. It is trying to protect you from pain.

However, "restrictions" are imposed on your body to prevent further damage to the injured areas. The structural imbalance needs to be addressed to relieve pain.

However, repetitive movements while you were injured can become patterned such that, even after the problem has been settled, you still move in a limited, protective way. That is why even a minimum regime of daily stretches can be vital to full recovery.

As you can see, there is quite a bit that you can do naturally in terms of stretching and exercise. There is also quite a bit that an occupational therapist can do as well. Similarly, chiropractors and osteopaths can do a lot in terms of treatment of trigger points and ischemia.

Datuk Dr Rajen M. is a pharmacist with a doctorate in holistic medicine. Email him at health@po.jaring.my


If you would like further information about back pain, please go to http://.www.backpainloss.com
Have a happy Christmass, and may all your wishes come true in the new year.
Paul