Most sudden back pain is due to a sprain or a small tear in a muscle or ligament. You may have a niggling ache in your lower back or a sharp, localized pain and stiffness due to muscle spasm in the area. Sciatica is pain that travels through one buttock to the leg and foot, sometimes with numbness, tingling, and weakness in the leg. It is caused by trapping or irritation of the sciatic nerve, often due to a “slipped disc” between the bones of the spine. The usual causes of back pain and sciatica include lifting awkwardly or sudden twisting, but factors such as poor posture, pregnancy, and being inactive or unfit may make the back more vulnerable.
WARNING
Seek immediate medical help if:
* You have difficulty controlling your bowels or bladder; tingling and/or numbness in the anal or genital area; or muscle weakness
* Back pain follows an injury
Make an appointment to see your doctor if:
* You have symptoms of sciatica
* Back pain has been developing slowly and is gradually getting worse
* You are losing weight or have a fever
PRACTICAL TECHNIQUE
Moving without pain Getting out of bed awkwardly can cause sudden, painful twinges when you have back pain. This sequence of movements will get you on your feet with the minimum strain on your spine, so continue to use them even when your back is no longer painful.
* Lying flat on your back, bring your knees up to hip level and roll yourself slowly on to your side, facing the edge of the bed.
* Swing your legs to the edge of the bed and lower your feet to the floor. Use your arms to push yourself into a sitting position.
* Using your arms and your leg muscles to push yourself up, slowly rise to a standing position. Reverse the procedure when you get back into bed.
What you can do yourself
An episode of back pain usually gets better within a few weeks. Take these steps to ease pain, staying as active as possible rather than resting in bed.
* If the pain is tolerable, try to continue normal activities as much as possible. Gradually increase what you do each day, but don’t overdo things. Stop any activity that makes the pain worse.
* If the pain is so severe that you cannot move, rest in bed for a day or two. As soon as you feel able to do so, get out of bed and start moving, even if it causes some discomfort.
* Your mattress needs to be firm, but not too hard. If you have an old, sagging mattress that does not support our back, put a board under it. You will probably find that lying on your side is more comfortable than lying on your back.
* While your back is painful, try to move in ways that are less likely to bring on or worsen the pain (see PRACTICAL TECHNIQUE)
* Take painkillers to relieve pain and stiffness (see DRUG REMEDIES).
* Rub ibuprofen gel or cream into the area to ease pain and inflammation (see DRUG REMEDIES).
* Rubbing the sore area with a counter-irritant cream or gel may help to soothe the pain for a short while (see DRUG REMEDIES).
* Holding a wrapped hot-water bottle or heating pad against your back may help to relieve pain, particularly if there is muscle spasm. You can also direct warm water on to the small of your back when in the shower.
Arrange to see your doctor if:
* The back pain is getting worse or is not easing within 48 hours
* You develop any of the symptoms listed in the Warning box
PREVENTION
Avoiding back pain If you prone to back pain, you may be able to prevent further episodes by taking particular care of your back.
* Wear comfortable shoes with a low heel.
* If you are overweight, lose weight – it will help to take pressure off your back.
* Walking, swimming, or a course of Pilates or yoga exercises will help to strengthen your back muscles. Your doctor or physiotherapist can also recommend back-strengthening exercises.
* Try to improve your posture when you walk, stand, and sit, both while you have back pain and afterwards (see PRACTICAL TECHNIQUE). You should also practice safe ways of lifting and moving heavy objects to reduce the risk of straining your back.
DRUG REMEDIES
Painkillers include paracetamol and ibuprofen. Ibuprofen also has an anti-inflammatory effect, which will reduce stiffness, making it easier for you to try some gentle movement. If pain persists, try a stronger painkiller containing paracetamol and codeine.
Ibuprofen gel, cream, or spray has an anti-inflammatory effect and reduces pain when you apply it directly to the affected area.
Counter-irritants , available as creams, gels, or sprays, produce a tingling sensation in the skin that soothes pain temporarily. Some warm the area; others have a cooling effect.
PRACTICAL TECHNIQUES
Standing and walking When you are standing or walking, pull your shoulders slightly back and down, holding you trunk straight. Try to balance your weight evenly over both feet.
Driving Angle the driver’s seat backwards very slightly and position it so you can reach the hand and foot controls easily. While you are driving, check from time to time that your arms are relaxed and your shoulders are not hunched.
Sitting Sit with your back straight, your bottom pushed into the back of a chair, and your feet flat on the floor. Choose a chair that is the right height to allow you to do this, with an upright back that supports the small of your back. The seat should support the full length of your thighs but should not put too much pressure on the backs of your thighs. When using a computer, the top of the screen should be at eye level.
Good posture
Sit well back in the chair, with your back straight and your lower back supported by the backrest. Keep both feet flat on the floor.
Reflexology alleviate muscle tension and stress
