Strangely, one of the most difficult of all the diagnoses that a doctor has to make concerns the cause of a pain in the back. Excluding the pain that comes with breaking the bones of the spine or twisting the spine completely out of line, a number of different conditions may be responsible for different kinds of pains in the back.
Infections may attack the tissues of the back as they do other parts of the body. Rheumatoid arthritis may select the many joints of the backbone as a place in which to locate. The little cartilages or discs that act as cushions between the bones may be crushed or slip out of place. The ligaments which attach to the bones of the spine may be pulled to the point where they are painful with every movement.
Careful study by an experienced physician reveals the cause of pain in the back and indicates the type of treatment to be followed.
This may vary from changing the shoes and wearing a specially designed brace or corset, to instructions for reducing weight, improving the posture or even a surgical operation. A recent postural instruction sheet designed by Dr. Paul C. Williams says:
- When standing or walking, toe straight ahead and take most of your weight on the heels.
- Sit with the buttocks tucked under so that the hollow in the low back is eradicated.
- When possible elevate the knees higher than the hips while sitting.
- Sleep on your back with your knees propped up or on your side with one or both knees drawn up. Bed should be firm.
- Never bend backwards.
- Avoid standing as much as possible.
- Learn to live 24 hours a day without a hollow in the lower part of your back.
- Avoid sleeping on the abdomen.