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Talking back: Coping with back pain

The fact that a majority of Americans experience back pain at some point in their lives is small consolation when the statistic with back pain is you.

Back pain typically begins with a movement in your torso that doesn’t go quite right: lifting a child into the car seat, bending over to pick something up, twisting to deliver a powerful forehand during tennis play. For some reason, your back protests, and there you are, lying on the ground in pain.

Should you see a doctor?
Consult a physician about your back pain if:

1) It is accompanied by high fever, which may indicate an infection;

2) You have numbness in your pelvis, extreme weakness in your leg, or problems controlling your bladder or bowel-signs of a severely pinched nerve;

3) You are experiencing rapid weight loss — a sign of a tumor; and/or

4) Back pain persists for more than four weeks.

Treat yourself
For most cases of acute back pain that is probably due to muscle spasm, health professionals advise the following:

1) Ice the affected area five to 10 minutes several times a day for the first few days. After that, use either ice or heat, whatever seems to help.

2) Take over-the-counter pain medication. Try to avoid any muscle relaxants you may have hanging around the medicine cabinet, as these have unpleasant side effects and can lead to further injury by helping you ignore the pain.

3) Rest as little as possible, and resume daily activities as much as you can, allowing the pain to serve as a guideline for what you should ask your back to do. That means if it hurts, don’t do it. Especially hard on your back is sitting for extended periods, or moving heavy objects.

When to exercise
The most common cause of back pain is muscle strain. The most common cause of muscle strain is weak back muscles which lack the strength to support the torso, especially when extra force is required, such as during bending or twisting. When back muscles are not strong enough to do their job, they may stretch and then contract in painful spasm.

Since exercise is so good for so many ills, many people mistakenly believe that exercise is good for everything. Not so for muscle spasms. Trying to stretch a spasming muscle may only add insult to injury. Exercise is more important for preventing future recurrences of back pain, rather than fixing an acute back pain episode.

Once acute pain has subsided, exercise to stretch and strengthen postural muscles is recommended. Regular aerobic exercise such as walking, swimming (use a variety of strokes) and cycling improves general fitness, as well as back health. Education about correct body mechanics is essential. Learning to maintain good posture can greatly reduce back stress.

Coping with chronic pain
Some people find that back pain continues to return despite their best efforts to exercise regularly and practice good body mechanics. Most of these folks succeed in finding ways to eliminate or at least significantly reduce their back pain, but their paths to success require perseverance, self-observation, positive thinking and a willingness to try a variety of treatment options. Treatment options that have helped many back pain patients include stress management and relaxation techniques, chiropractic manipulation, physical therapy, acupuncture and acupressure, and yoga. Back care programs, videos and books can be beneficial.

Perseverance can be hard to come by. Persistent pain wears you down, but giving up is not an option; giving up only leads to more pain.

When to rest
Bed rest, once the most popular treatment for back pain, is now discouraged. While sometimes back pain is so incapacitating that you have no other option, you will be urged to get up as soon as you can. Bed rest further weakens those muscle, joints and bones whose weaknesses may be causing pain in the first place.

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