Watch Your Back!

When is pain in this body part a passing nuisance, and when does it need medical attention? A spine specialist explains.

Back pain is one of the most common complaints for which patients visit doctors. In fact, experts estimate that nearly 80 percent of people will experience back pain at some point in their lives. Though it can happen at any time of year, here in the Northeast it’s especially frequent during winter, when a sedentary lifestyle may make muscles stiffen. Also, of course, it’s the time when many of us overwork our backs while clearing snow from dri[1]veways and sidewalks. BERGEN sought insights on the subject from Dante A. Implicito, M.D., section chief of spine surgery at Hackensack University Medical Center.

• What causes back pain. Your back is made of many different moving pieces that connect to aid stability and movement. Bones, joints, ligaments and muscles are all intertwined, and injury or damage to any one of them can result in back pain. You can irritate joints, sprain ligaments or rupture discs, sometimes with just a simple movement. Bending over to tie your shoes? Reaching for a book on the top shelf? Back muscles can tighten up, leading to pain and stiffness, doing those activities. “Inflammation can occur from everyday activities like playing basketball, raking leaves or shoveling snow,” Dr. Implicito says. “Any injury to the structure of the back is perceived as pain.”

Back pain also can be caused by problems and diseases of internal organs, such as kidney stones, blood infections, scoliosis (an abnormal curvature of the spine), arthritis and some types of cancer. “Any back pain that’s not the result of a physical activity is suspicious,” Dr. Implicito says. “Back pain that’s accompanied by fever or cough can also be a red flag, and that should be checked by a doctor.”

• How to find relief. If you experience back pain, one to two days of rest can help, but resist the urge to stay in bed. “In general, you should be moving around after even a few hours of rest,” our doctor says. Over-the-counter pain relievers can help alleviate stiffness, improve mobility and aid recovery. Applying heat to a sore back can increase blood flow and speed recovery from acute or chronic back pain. Treating with ice can reduce inflammation and ease pain. Sometimes alternating between the two is the best remedy. If pain exists while you’re trying to sleep, try supportive positions such as placing a pillow under your pelvis, says Dr. Implicito. Trial-and-error can be a useful approach when figuring out what eases your particular symptoms most effectively.

Though exercise is not advised for treatment of acute back pain, stretching, yoga and core strengthening can help relieve chronic back pain. For instance, Dr. Implicito often recommends that patients perform McKenzie exercises (Google them) as well as “quadruped rocking” to help reduce inflammation. “Another simple stretch is to lie on your back and bring your knees to your chest,” he says.

• When to see a doctor. Most of the time, back pain will subside on its own with or without treatment. However, it’s a good idea to see a doctor if you have tingling or numbness, if the pain is the result of a fall or injury, or if the pain is severe and doesn’t improve with rest and anti-inflammatory medication, Dr. Implicito says.

It’s also important to be evaluated by a doctor if you have pain together with trouble urinating, numbness or weakness in your legs, fever or unintentional weight loss. These could be signs of a more serious problem.

BACK PAIN’S A BIG DEAL

No statistic speaks as eloquently as the wince[1]inducing discomfort that emanates from your back when it’s your turn for this almost ubiquitous malady. But when you look at back pain in terms of numbers, they are monster numbers indeed:

• 65 million: The number of Americans who experience chronic back pain.
• $12 billion: Annual healthcare cost in the U.S. due to back pain.
• 83 million: The estimated number of work days lost in the U.S. annually due to back pain.Source: Georgetown University Health Policy Institute