What is back pain?
Back pain is not a disease in itself but rather a symptom of many other medical diseases and disorders. According to the American Chiropractic Association (ACA), back pain is one of the most common reasons for missing work. In fact, it accounts for up to 264 million lost workdays in a year. Furthermore, Americans are estimated to spend upwards of fifty billion dollars annually due to lower back pain.
The human back is a complex structure composed of bones, ligaments, muscles, and several joints. Injury or manipulation of any of these structures can cause back pain, especially in the field of sports. However, it is comforting to know that most of the back pain cases are mechanical or non-organic in origin as they are not associated with complicated medical conditions.
Although many methods are present for the prevention or rapid treatment of back pain, it is one of the leading causes of disability worldwide.
Risk Factors for back pain
Certain risk factors can significantly increase the chances of a person developing back pain, such as:
- Age: From the age of 30 to 40 years, the risk of developing back pain increases
- No physical activity: Lack of physical exercise can cause weakness in the unused muscles of the back, and abdomen, resulting in back pain.
- Obesity: Extra weight puts extra pressure on the back and the knees, resulting in back and joint pain.
- Arthritis and certain other pathological conditions can increase the risk of developing back pain.
- Mental illnesses: Certain conditions like anxiety and depression are known to cause back pain, however, the exact mechanism is not known.
- Weights and Lifting: Lifting heavy weights with improper lifting techniques can cause severe back pain.
- Smoking: Smoking can cause osteoporosis as it reduces the blood flow to the spine and can result in back pain. Furthermore, smokers usually present with herniated disks which can be due to excessive coughing seen in smokers.
- Improper sleeping positions or bad mattresses
- Bad posture
Etiology of back pain
Back pain can arise due to multiple reasons ranging from serious sports injuries to arthritis, from stress to overdoing of simple movements. The major reasons are listed below:
- Muscle or ligament strain: Repeated heavy lifting or a sudden awkward movement can negatively impact the muscles and ligaments of the back, causing severe, cramping back pain that may be accompanied by muscle spasms.
- Bulging or ruptured disks: Although they do not always present with back pain, when they do, it can be extremely painful and uncomfortable.
- Arthritis: It is the inflammation and tenderness of the joints which can affect the lower back causing severe back pain.
- Osteoporosis: The bones in the spine become brittle and porous which can result in increased pathological fractures and incidence of back pain.
When should you see a doctor?
Back pain can be a symptom of a complicated disease or it can be simply due to bad posture. It is important to be able to differentiate between them and seeking medical attention when needed. If the following features occur alongside your back pain, it might be beneficial to visit your physician:
- Persisting back pain over a few weeks.
- Severe, not improving with rest.
- Radiates to both lower limbs, especially below the knee.
- Weakness, numbness, or tingling in the lower limbs.
- Unexplained weight loss.
- Furthermore, if the pain presents with bowel or urinary problems, it is important to seek immediate medical help.
How to prevent back pain?
- Eat a well-balanced, healthy diet.
- Participate in daily physical activities, under the supervision of your physician
- Avoid a sedentary lifestyle.
- Warm up or stretch before exercising or even everyday physical activities.
- Correct your posture.
- Wearing comfortable, low-heeled shoes can ease the pressure on the back.
- Sleep on a mattress of medium firmness
- Lift with your knees and do not twist when lifting heavy objects.
- Quit smoking
- For working people, it is best to ensure that your working chair is properly aligned and not the reason for your back pain. Correcting your workstation can help prevent back pain.
What is the treatment of back pain?
Back pain can be treated using medications, surgery, massage, chiropractic manipulations, and yoga. Medication for the treatment of back pain includes over-the-counter NSAIDs, certain topical rubs, ointments, muscle relaxants especially in the presence of muscle spasms along with pain, and in some cases, opioids.
Surgical treatment of back pain is limited for severe cases like those that result in unremitting pain or nerve compressions, eventually weakening the back muscles.
The surgery, Spinal fusion, fuses two vertebrae into one, solid bone that limits the painful motion of the bone and reduces back pain significantly.
However, sometimes the pain can be due to non-medical conditions, and a change in lifestyle alone can alleviate the pain easily.
How to know if your bed may be the reason for your back pain?
Back pain can vary in intensity and nature, but the one thing that remains stable is that 8 out of 10 people will experience back pain at some point in their life. It is a very common symptom as the risk factors and causes for it are very common.
Although back pain can present as sharp, stabbing pain, more often than not it is due to a non-urgent medical condition such as poor posture or sleeping habits. The following tips can help you determine if your back pain is related to your mattress quality:
- Time of pain: If your back pain arises early in the morning, right after you wake up, and is relieved by fifteen to thirty minutes of stretching, it is probably due to your mattress;
- Quality of sleep: If you spend the entire night tossing and turning, unable to find a good sleeping position, then it can result in chronic lower back pain. This is because the mattress doesn’t allow for your spine to be in a neutral position, making you uncomfortable and causing pain.
- Age of the mattress: If you have had the same mattress over a long period of time, 8 years to be exact, there is a chance that the mattress can no longer provide accurate support to your back and shoulders. This can cause chronic back pain.
How to choose the perfect mattress?
Mattresses can be very expensive but it is important to view them as a financial investment rather than a burden. A good mattress can help you get a good night’s sleep, allowing you to be more fresh, active, and productive the next day. Furthermore, a good mattress will prevent back pain and any medical bills that may pile up due to the consequences of a bad back.
While buying a new mattress, it is important to choose one that is not too firm but not too soft either. According to a study conducted in Spain, people who used a mildly firm mattress (5.6 on a firmness scale) experienced less back pain than those who used a soft or a firm mattress.
The reason behind the pain experienced when sleeping on a firm or a soft mattress is that these mattresses do not allow for equal distribution of pressure and proper alignment of the back. Gerard Varlotta, director of sports rehabilitation at the Rusk Institute of Rehabilitation Medicine at New York University Medical Center, agreed with the findings of the study conducted in Spain, saying, ‘Too firm of a mattress is not good. It doesn’t provide enough contour to our bodies. Too soft is going to bend and cause problems as well.
Agreeing with Varlotta and speaking further on the issue with regards to body alignment, Dr. Arya Nick Shamie, associate professor of orthopedic surgery and neurosurgery at Santa Monica UCLA Medical Center said this, ‘If the mattress is too firm, it will push on those main pressure points and take you out of alignment. If it’s too soft, those pressure points won’t be properly supported, so your whole body flops back. Either way, one would wake up with back pain in the morning.
Apart from the firmness or softness of the mattress, the material of the mattress also contributes to the quality of sleep and the risk of developing back pain. Dr. Michael Breus, Ph.D., a sleep expert analyzed different types of mattresses like innerspring mattresses, memory foam, latex, and even sofa beds. In his expert opinion, latex mattresses are the best option amongst all and can be very important in preventing back pain.
It is a firm mattress and comfortable just like memory foam. However, unlike memory foam, it is very supportive as it pushes back at the spine, reducing the pressure. He also notes the cons of using a latex mattress which is simply the firmness of it.
Overall, it is important to invest in a proper mattress with appropriate firmness level and quality so as to prevent chronic back pain which can act as a gateway for other medical conditions.
Goodman D, et al. Acute Low Back Problems in Adults. U.S. Department of Health and Human Services, December 1994.