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addictions to osteoporosis,
also obesity and insomnia |
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beyond health, wellness
at
work, nutrition |
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a-z physical
health :
back pain
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Back pain (also known "dorsalgia")
is pain felt in the back that usually originates from the muscles,
nerves, bones, joints or other structures in the spine. |
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The pain may have a sudden onset
or can be a chronic pain; it can be constant or intermittent,
stay in one place or radiate to other areas. It may be a dull
ache, or a sharp or piercing or burning sensation. The pain
may be felt in the neck (and might radiate into the arm and
hand), in the upper back, or in the low back, (and might radiate
into the leg or foot), and may include symptoms other than pain,
such as weakness, numbness or tingling. |
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About nine out of ten adults experience
back pain at some point in their life, and five out of ten working
adults have back pain every year.The spine is a complex interconnecting
network of nerves, joints, muscles, tendons and ligaments, and
all are capable of producing pain. Large nerves that originate
in the spine and go to the legs and arms can make pain radiate
to the extremities. |
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Associated
conditions |
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Back pain can be a sign of a serious
medical problem, although this is not most frequently the underlying
cause: |
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Typical warning
signs of a potentially life-threatening problem are bowel
and/or bladder incontinence or progressive weakness in
the legs. |
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Severe back pain such as
pain that is bad enough to interrupt sleep that occurs
with other signs of severe illness (e.g. fever, unexplained
weight loss) may also indicate a serious underlying medical
condition. |
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Back pain that occurs after
a trauma, such as a car accident or fall may indicate
a bone fracture or other injury. |
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Back pain in individuals
with medical conditions that put them at high risk for
a spinal fracture, such as osteoporosis or multiple myeloma,
also warrants prompt medical attention. |
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Back pain in individuals
with a history of cancer (especially cancers known to
spread to the spine like breast, lung and prostate cancer)
should be evaluated to rule out metastatic disease of
the spine. |
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Back pain does not usually require
immediate medical intervention. The vast majority of episodes
of back pain are self-limiting and non-progressive. Most back
pain syndromes are due to inflammation, especially in the acute
phase, which typically lasts for two weeks to three months. |
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A few observational studies suggest
that two conditions to which back pain is often attributed,
lumbar disc herniation and degenerative disc disease may not
be more prevalent among those in pain than among the general
population, and that the mechanisms by which these conditions
might cause pain are not known. |
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Underlying
causes |
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Muscle strains (pulled muscles)
are commonly identified as the cause of back pain, as are muscle
imbalances. Pain from such an injury often remains as long as
the muscle imbalances persist. The muscle imbalances cause a
mechanical problem with the skeleton, building up pressure at
points along the spine, which causes the pain. |
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Another cause of acute low back
pain is a meniscoid occlusion. The more mobile regions of the
spine, such as the facet joints, have invaginations of their
synovial membranes that act as a cushion to help the bones move
over each other smoothly. The synovial membrane is well supplied
with blood and nerves. When these become pinched or trapped
sudden severe pain may result. The pinching causes the membrane
to become inflamed, causing greater pressure and ongoing pain.
Symptoms include severe low back pain that may be accompanied
by muscle spasm, pain with walking, concentration of pain to
one side, but no radiculopathy (radiating pain down buttock
and leg). Relief should be felt with flexion (bending forward),and
exacerbated with extension (bending backward). |
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When back pain lasts more than
three months, or if there is more radicular pain (sciatica)
than back pain, a more specific diagnosis can usually be made.
There are several common causes of back pain: for adults under
age 50, these include spinal disc herniation and degenerative
disc disease or isthmic spondylolisthesis; in adults over age
50, common causes also include osteoarthritis (degenerative
joint disease) and spinal stenosis,trauma, cancer, infection,
fractures, and inflammatory disease.Non-anatomical factors can
also contribute to or cause back pain, such as stress, repressed
anger, or depression. Even if there is an anatomical cause for
the pain, if depression is present it should also be treated
concurrently. |
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Treatment |
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The management goals when treating
back pain are to achieve maximal reduction in pain intensity
as rapidly as possible; to restore the individual's ability
to function in everyday activities; to help the patient cope
with residual pain; to assess for side-effects of therapy; and
to facilitate the patient's passage through the legal and socioeconomic
impediments to recovery. For many, the goal is to keep the pain
to a manageable level to progress with rehabilitation, which
then can lead to long term pain relief. Also, for some people
the goal is to use non-surgical therapies to manage the pain
and avoid major surgery, while for others surgery may be the
quickest way to feel better. |
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Not all treatments work for all
conditions or for all individuals with the same condition, and
many find that they need to try several treatment options to
determine what works best for them. The present stage of the
condition (acute or chronic) is also a determining factor in
the choice of treatment. |
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