Back and neck pain: taking the "ouch!" out of your pocket

“Ouch! My back hurts… again!”

It is said that 80% of people will experience back pain at some point during their lives.  Back and neck pain is a common cause for many employees to be absent from work. The result being thousands spent each year by medical aids, compensation funds and patients themselves.  This pain can often go away within a short time by itself, but if it lasts longer than 3 days or is a result of an injury, rather see a medical practitioner or physiotherapist.  Pain that lasts longer than 3 months is described as chronic and severe: chronic pain can make you depressed, feel useless and tired.

We are taught in schools how to prepare for our future jobs, our elders teach us the basics of life skills, but very few of us know how to take care of our spines and move in the correct way.  Therefore many people end up with back or neck pain, sometimes to such an extent where surgery is necessary to relieve pain…… again and again. During Back Awareness Week from 2-6 September 2015, South African physiotherapists aim to make people more aware of back injuries, treatment and prevention by means of the correct care.

With initial back pain, try to use ice, heat and over the counter medication. If this does not take the pain away, contact your general practitioner or physiotherapist. With conservative treatment your doctor will aim to get rid of the pain with muscle relaxants, anti-inflammatories and pain medication.   After assessing your pain, the physiotherapist will aim to reduce the pain with different modalities for example taping, electrotherapeutic intervention, soft tissue treatment and vertebral mobilisation or manipulation and in some cases, dry needling.   If you do not react appropriately to the treatment, they will refer you for X-rays, if not earlier.

Many people experience terrible pain although their x-rays do not show any pathology.  Other people’s x-rays show severe looking conditions, but do not experience any pain.  Certain problems cannot be identified on X-rays and they might need to have other specialized diagnostic tests done.  MRI and CT-scans show conditions like prolapsed discs or narrowing of the spinal canal.  Some conditions are not picked up by any of these tests, for example local segmental weakness of stabilising muscle groups.  Your pain may be caused by stiffness of different specific areas of your spine that can again result in too much movement at another level of your spine.  In one person, different conditions may cause different kinds of pain with different movements.  Many people might have the same pain in the same area, but it might not be due to the same pathology.  Therefore the same kind of treatment may cause similar pain in different people to become worse.

With proper assessment, physiotherapists who completed a post-graduate specialized course in spinal problems will often be able to identify the cause of your pain.  X-rays, MRI and CT-scans may support that diagnosis.  Although these tests sometimes show specific pathology, the pathology might not necessarily be the reason for a patient’s pain at that specific moment in time. It is crucial that this proper assessment is done for the therapist to be able to give the correct advice, treatment and exercises.  Remember that you can sometimes feel worse after a physio session.  The feedback from you, the patient, is very important for the physio to explain the result of the treatment and to adjust the treatment accordingly.

The physiotherapist and biokineticist will work together to prevent the pain from recurring by teaching the patient correct ergonomics, movement patterns and exercises.  It is important to know that you can exercise yourself into pain, or out of it.  The principle of “no pain, no gain” mostly does not apply to your spine. If you experience pain during or after your gym or home exercise session, a few small adjustments to the exercises will help you to become pain free.

Knowledge of ergonomics regarding how to sit, stand and even sleep correctly can play a huge part in becoming painfree during night and day.  Picking up your children, washing the dog and understanding how to carry your backpack the correct way can mean pain or no pain during your leisure times.  Adapting your computer workstation and many other working habits may lead to more productivity at work and less hours off to seek medical help.

If you apply the principles of ergonomics, movement patterns and correct exercises, you can stay pain free.  If we apply those same principles before surgery, you might prevent pain from ever starting or even prevent surgery.

Stress can aggravate any underlying pathology’s symptoms from the spine.  If you go through stressful periods, you might experience that even a small lesion in the spine can wreak havoc on your muscles.  Therefore, seeing a psychologist to help you handle stress in your situation or learning how to relax in spite of circumstances will give you much better results while being treated by the other medical professionals.

If you know that you can benefit from losing a few extra kilograms, also realise that it will benefit your back and that in the process of losing weight, the chances are that you might “lose” your back pain.  Consult a dietician if you need help with this matter.

Even with the best medical intervention, whether it is exercises prescribed by a biokineticist, physiotherapy or even surgery, the result can only be as good as the patient-practitioner teamwork.  If underlying pathology is present and the patient stops applying what they are taught, the pain often comes back. With good treatment, the medical team aims to get you pain free and helps you to stay pain free.

All these medical processes can become very costly.  To have some more insight in your spinal pain, you might consider visiting a physiotherapist who can spend time on a proper evaluation and teach you how to take care of the condition in order to live as pain free as possible, even without spending a lot of money on different kinds of treatments.  Some conditions, however, might need you to go for physiotherapy from time to time or will end in surgery regardless.

At Woodhill Intercare, Pretoria, the presentation of The Spine School may give you insight into your pain and how you can become the controller of your pain, instead of the pain controlling your life.  This presentation consists of a once-off lecture on the basic anatomy, possible pathologies, the symptoms thereof, possible medical treatment as well as ergonomic tips for home, office and leisure times on how to take care of your spine.  If you empower yourself with knowledge on taking care of your spine, staying painfree need not cost you an arm and a leg.  The Spine School doesn’t teach you to live with your pain, but to live painfree in spite of the problem.  This lecture can also be presented at your company.

Bookings for the Spine School can be made at the Woodhill Intercare Physiotherapy department on 012-9980425.

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