At Home with Dr Christian Jessen - 115

| BACK PAIN|

N

agging ache.
Uncomfortable
stiffness.
Sudden, sharp
spasms. Back
pain comes in
a variety of
guises and with
an enormous range of severity.
According to the Office for National
Statistics (ONS), back pain is the
most common cause of long-term
sickness in the UK. In fact, ONS
figures indicate that the main cause
of working days lost in the UK in
2013 was musculoskeletal conditions
- namely, back and neck pain.
A whopping 31 million days were
lost to it - that's 4.4 days per worker.
The main causes of back pain
are strained muscles or ligaments,
wear and tear, bad posture and
stress. For most people, back pain
isn't serious and only lasts for a short
period of time. This is known as
'acute' pain and usually persists
for less than six weeks.
However, for others, back pain
can be an ongoing and debilitating
problem. Known as 'chronic' pain,

injury or strain. Similarly, if you're
sitting wrongly day in, day out, at a
desk job, you're likely to experience
back pain in the long-term.
SMOKING - Not only can smoking
prevent enough nutrients getting to
the discs in your back, a smoker's
cough can also cause back pain.
Healing also takes longer in
smokers, so your pain may last
longer than a non-smoker.
YOUR GENES - Some conditions
that lead to back pain are genetically
inherited - for example, ankylosing
spondylitis, a form of arthritis
that specifically affects the spine.
OTHER DISEASES - Back pain can
sometimes be the result of another
underlying disease, such as cancer.

Before you consider
having surgery

Who's at risk?

Almost everyone will experience
some form of back pain in their
lives, but there are certain factors
that increase your risk:
YOUR AGE - Back pain becomes
more common the older you get.
YOUR WEIGHT - Being overweight
puts added stress on your back.
YOUR FITNESS - Back pain is
more common in people who
aren't physically active.
YOUR CAREER - A job that
involves pushing, pulling and lifting
on a regular basis may cause a back

Most back surgery is performed
on the lower back - known as the
lumbar spine (as opposed to the
cervical spine, which is at the
back of the neck). Some conditions
or injuries may not respond
to other pain relief treatments
and surgery may be considered the
best solution. These include:

A SLIPPED DISC OR SCIATICA

This is where a disc is damaged
and pressing on a nerve. The pain
is not always felt in the back, but
may affect one or both legs.

SPINAL STENOSIS

This occurs when part of your spinal
column narrows, placing pressure
on the nerves in that area.

Surgery for back pain is usually
regarded as a last resort, due to
its serious and often invasive nature.
According to Mr Rath Sundaram,
who is a spinal specialist based at
Nuffield Hospital, Cheltenham,
'Often lower back pain settles
with a short period of bed rest,

SPINAL INJURIES

If the spine is fractured and the
tissue around your spinal cord swells.

METASTATIC SPINAL
CORD COMPRESSION

'A WHOPPING 31 MILLION DAYS WERE LOST
TO MUSCULOSKELETAL CONDITIONS
- THAT'S 4.4 DAYS PER WORKER'
this can last for three months or
significantly longer for some people.
It's this type of back pain that
may ultimately require a surgical
procedure, although this is only if
no other treatment proves successful.

WHEN SURGERY IS
THE ONLY OPTION

analgesia, physiotherapy and
other activities such as Pilates
and seeing an osteopath or
chiropractor for treatment.'
Your doctor is likely to consider
surgery only if other treatments
have failed to work, including:
PAIN MANAGEMENT For
long-term back pain, there are
several options. If a trapped or
inflamed nerve in your spinal
column is the cause of your back
pain, a nerve root block can offer
relief. A steroid or anaesthetic is
injected into your back. This has to
be in exactly the right place in your
spine to be effective, so the procedure
is done under X-ray or computerised
tomography (CT) scan guidance.
Another option is 'facet joint
injections', which also use steroid
or anaesthetic injections. The facet

This is where cancer elsewhere in
the body, such as the lungs, spreads
to the spine and presses on the
spinal cord or nerves.

joints connect one vertebra to
another in order to keep your
spine aligned, and these joints can
be affected by arthritis, leading to
pain. However, this procedure is
not effective for everyone.
PHYSIOTHERAPY According to a
study cited by the Chartered Society
of Physiotherapy, 80% of patients
who had physiotherapy treatment
for back pain were able to carry on
working, rather than taking time off.
Treatments may be manual or may
involve acupuncture sessions. Your
physiotherapist will advise you on
exercises to do at home.
OSTEOPATHY Another form of
manual therapy used to treat lower
back pain. Techniques include soft
tissue manipulation, stretches and
high velocity thrust (HVT), where
joints are clicked to ease movement. >

www.athomemagazine.co.uk MARCH 2015 | 115
http://www.athomemagazine.co.uk
At Home with Dr Christian Jessen

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