Backache can occur in a variety of conditions. It is a fairly common complaint during “flu,” menstruation, acute kidney inflammations, arthritis; in some elderly individuals it is caused by shrinkage and collapse of the vertebrae due to loss of calcium. By far and away, however, the most common cause is acute and chronic stress-and-strain on the muscles and ligaments supporting the spine. Pain is most commonly experienced low in the back, either in the small of the back or in the bony region just below it (the sacroiliac region). In acute low backache severe pain may come on in seconds. The sufferer often states that he reached over to pick up something, experienced a stabbing pain in the back region, and found himself so doubled up by pain as to be unable to straighten up. A backache of this sort may be utterly incapacitating and require narcotics for relief of pain. The patient may have to be helped into bed and kept there for several days. Attempts to turn in bed may be most painful. The victim usually finds a comfortable position by trial and error. This is frequently flat on the back with a pillow underneath the knees.
Treatment: Heat from a heating pad, aspirin, and similar pain-killers-and occasionally cortisone-type drugs-may help to relieve the pain. (There are some patients who experience a few such attacks of acute sacroiliac pain at widely spread intervals throughout their lifetime.)
0. Chronic Low Backaches These may come on after a bout of acute sacroiliac strain, or may develop in a slow and progressive fashion until finally the person realizes he is having backaches a good deal of the time. Such backache is usually described as dull. persistent, and made worse under such circumstances as prolonged standing, driving, slumping in a chair, or (at times) on arising in the morning. Occasionally a single factor. such as a sagging mattress or a strain or position at work. can be identified as the cause; with correction of such a factor the backache disappears. More often, however, the patient finds that the backaches are frequent and recurrent, and that special efforts seem to be needed to help them. Among the measures that are useful are:
l. A firm mattress is generally desirable. Particularly if the pain comes on in the morning on arising, an inadequate bed should be suspected as a major contributing factor. It may be necessary to put a bed board between mattress and box spring.
2. Attention should be directed to avoiding positions which strain the back. Chairs should have a good back support; most chairs are too deep and the victim of backache will need a pillow for adequate support. A sitting position in which the knees are at a somewhat higher level than the lower back or hips may be the most relaxing. This may be achieved by having low footstools available both at home and at work. The basic principle is to avoid positions which accentuate arching of the back.
3. Systematic daily exercises.
Exercises for Backache Victims of chronic low backache find that exercise is the most effective therapy for their condition. Exercises should be done once or twice a day, either on a firm bed or on the floor. Among useful exercises are:
1. Lying flat on the back, raise both legs off the floor to a vertical position and slowly return to starting point.
2. In the same position, bring the legs up and over as far as possible (which will require lifting the lower back off the supporting surface).
3. Starting flat on the back, raise up the trunk, bringing arms forward until the fingertips reach the ankles.
4. “Kissing the knees:” Starting flat on the back, come up to a sitting position. at the same time drawing up the knees, thus bringing the face up to the knees.
5. From a standing position-with knees slightly bent, not with straight knees-bend the trunk, bringing arms down to ankles or toes, then return to starting position.
6. With the hands supported by top of a table or bureau and knees slightly bent-slowly do a few knee bends, then return to original position.
All these exercises can be done in sequence, with brief rest periods between them. The average sedentary person may be able to do only a few to begin with, but should be able to work up to ten to fifteen each within a period of a few weeks. In addition to their tonic and trimming effect, exercises may cause mild backaches to disappear. Although some backaches may be relieved by special belts and girdles, such devices in some cases may weaken rather than strengthen the important supporting muscles of the back and abdomen. Properly exercised and developed muscles are a better support.