Don’t let back pain cripple you

Back pain? There is a lot you can do to help yourself. Scientific evidence shows the best treatment is to stay active, try simple pain relief and if you need it, get advice. Evidence also shows:

* The shorter you are off work, the less risk there is of developing chronic pain

* You do not have to be completely pain free to return to work

* Employees, employers and health professionals working together can support you at work.

If you have severe pain, which gets worse over several weeks instead of better you should see your doctor.

You should see a doctor straightway if you have:

* Difficulty in passing or controlling urine

* Numbness around your back passage or genitals

* Numbness, pins and needles or weakness in both legs

* Unsteadiness when on your feet

Back facts

* Back pain affects nearly everyone at some point in his or her life but is rarely serious.

* Back pain or ache is usually not due to any serious disease.

* Often back pain settles quickly, at least enough to get on with your normal routine.

* About half the people who develop backache will have it again within a couple of years. This does not mean that it is serious. Between attacks most people return to normal activities with few if any symptoms.

* It can be very painful and you may need to reduce some activities for a time, but rest for more than a day or two usually does not help and may do more harm than good. So keep moving.

* Your back is designed for movement. The sooner you get back to normal activity the sooner your back will feel better.

* The people who cope best are those who stay active and get on with their life despite the pain.

Causes of back pain

Your spine is one of the strongest parts of your body. It is made of solid bony blocks joined by discs to give it strength and flexibility. It is reinforced by strong ligaments. It is surrounded by large and powerful muscles, which protect it. It is surprisingly difficult to damage your spine.

Most x-ray findings in your back are normal changes with age - as normal as gray hair.

In most people it is not possible to pinpoint the exact source of the trouble. It can be frustrating not to know exactly what is wrong. But it is also good news - you do not have any serious disease or any serious damage in your back.

Most back pain comes from the muscles, ligaments and joints in your back. They may be simply not moving and working as they should. You can think of your back as "out of condition".

So what you need to do is get your back working properly again.

Stress can increase the amount of pain you feel. Tension can cause muscle spasm and the muscles themselves can become painful.

People who are physically fit generally get less back pain, and recover faster if they do get it.

So the cure for backache is to get your back moving and working properly again.
Get back into condition and physically fit.

It's your back - get going!


The old fashioned treatment for back pain was prolonged rest. But bed rest for more than a day or two is not good because:

* Bones get weaker

* Muscles get weaker

* You get stiff

* You lose physical fitness

* Depression sets in

* The pain feels worse

* It is harder and harder to get going again

No wonder it didn't work! No longer is bed rest used to treat any other common condition. It is time to stop bed rest for backache. The message is clear: bed rest is bad for backs.

Of course, you might need to do a bit less when the pain is bad.

You might be forced to have a day or two in bed at the start. But the most important thing is to get moving again as soon as you can.

Exercise is good for you

Your body must stay active to stay healthy. It thrives on use. Use it or lose it!

Regular exercise:

* Gives you stronger bones

* Develops fit, active muscles

* Keeps you supple

* Makes you fit

* Makes you feel good

* Releases natural chemicals, which reduce pain, so that even when your back is sore, you can make a start without putting too much stress on your back.

Dealing with an acute


What you do depends on how bad your back feels.

Remember, your back isn't badly damaged. You can usually:

* Use something to control the pain

* Modify your actualities

* Stay active and at work

You may have good days and bad days - that's normal.

Control of pain

There are many treatments which help back pain. They may not remove the pain completely, but they should control it enough for you to be active. These treatments help to control the pain, but they do not cure your back pain.


Your GP will provide you with adequate analgesics, anti-inflammatory tablets, and muscle relaxants.

Heat or cold

In the first 48 hours you can try a cold pack on your back for 5 -10 minutes at a time - a bag of frozen peas wrapped in a towel. Other people prefer heat; a hot water bottle, a bath or a shower.

Spinal manipulations

Most doctors now agree that manipulation can help pain and activity levels and higher patient satisfaction. It is best within the first six weeks. Osteopaths, chiropractors and some physiotherapists with special training carry out manipulation. It is safe if a qualified professional does it.

Other treatments

Many other treatments are used, e.g.. Acupuncture which some feel helps. It is up to you to find out what helps you.

Stress and muscle tension

If stress is a problem, you need to recognize it at an early stage and try to do something about it. It is not always possible to remove the cause of stress, but it is quite easy to learn to reduce its effects by breathing control, muscle relaxation and mental calming techniques.

Prevention and pain alleviationLifting

Lift what you can handle. Always lift and carry close to your body. Bend your knees and make your legs do the work. Don't twist your back - turn with your feet. Deep car boots can be dangerous in this respect.


Use an upright chair. Try a rolled towel or cushion in the small of your back. Get up and stretch every 20-30 minutes.


Try putting one foot on a low box or stool to vary your weight allocation. Have your working surface at a comfortable height


20-30 minutes walking, cycling or swimming every day.


Some people prefer a firm mattress - or try boards beneath the mattress. Choose a position which provides the most comfort, e.g. on your back with a pillow under your knees or on your side with your knees bent and a pillow between them.


Take care getting in and out of the bed without twisting your back. When getting in - sit on the side of the bed, lower the body onto the elbow and shoulder, draw knees up until the feet are on the bed. Then roll the body over to face the ceiling and straighten the knees. When getting out - reverse the procedure. Bend both knees, and then turn over to the side. Push the trunk up with the top hand lowering the knees at the same time to the sitting position.

Wearing socks and shoes

Use a straight back chair. Try to bend one knee and place the ankle above the opposite knee. Put your sock and shoe on. Repeat the procedure on the opposite foot. To remove them adopt a similar posture.

Getting in and out of a car

Getting in - open the door, first sit and gently lift both feet in with the help of your hands, placed underneath the knees close the door.

Getting out - open the door, lift both feet out, stand with the help of the door and walk away closing the door without twisting your back.


Adjust your seat from time to time. Try a rolled towel or cushion in the small of your back. Take a break on long drives.


Learn to relax. Use relaxation techniques.

Remember, you have to run your own life and do the things you want to do. Don't let your back take over - you really can help yourself.


Couch potato syndrome

By Katharine Arney
Scientists have come up with proof that watching television can be bad for your health.
A team from the Harvard School of Public Health studied 50,000 women over a six-year period to determine whether changes in their patterns of television watching or sitting around at work led to an increased likelihood of obesity or type 2 diabetes.

The researchers, led by Dr Frank Hu, an expert in nutrition, found that watching television for an extra two hours a day increased the rate of obesity by 25%, and diabetes by 14%.

This was even after factors such as smoking and diet had been taken into consideration.

There was also bad news for office workers. The risks of obesity and diabetes also increased with every additional two hours spent sitting down at work - though these were much smaller than the risks from watching the box for the same length of time.

Dr Hu said he was not surprised that watching television seemed to have such a powerful effect. "Compared with other sedentary behaviours, TV watching is associated with a lower resting metabolic rate. "Also, people tend to eat junk foods while watching TV, due to constant exposure to food commercials."

The researchers also found that basic exercise had a significant positive effect on obesity and diabetes rates.

Every additional two hours per day spent walking or standing at home cuts the risk of obesity by 9%, and the risk of diabetes by 12%.

Brisk walking for an hour per day was enough to drop the risk of obesity 24%, and diabetes by 34%.

The researchers have calculated that adopting a relatively active lifestyle can prevent nearly a third of new cases of obesity and over 40% of new cases of diabetes. They define this healthy lifestyle as no more than 10 hours television per week, and at least 30 minutes of brisk walking per day.

Dr Hu said: "We should not only promote increasing physical activity levels but also target a decrease in sedentary behaviours, especially prolonged TV watching. "Personally, I have a treadmill in front of a TV so that I can do some exercise while watching the news."

The research is published in the Journal of the American Medical Association.

Do you have vertigo?

Vertigo is described as the illusion of movement. It's the feeling that our surroundings are spinning around us whilst we remain still, or that we are spinning within our surroundings, rather like the gyroscope ride at the fun fair. The spinning is usually felt as rotation, moving round and round.

It's different to dizziness, which is usually a feeling of unpleasant fuzziness in the head. Vertigo, however, is horrible, and often confines people to their home, even their bed. Trying to move is difficult because of the loss of balance that occurs, and the nausea and vomiting that often accompanies episodes of vertigo.

Possible causes

Middle ear infection

Middle ear inflammation

Benign Positional Vertigo

Meniere's disease

Circulation problems

Head injury

After ear surgery

Side effects of medication

Recreational drugs


Neurological disease

What's behind vertigo?

Vertigo occurs most often when there is a problem with the middle ear balance mechanisms. It can also be caused by a problem in the brain itself, or with the nerve connections between the brain and the middle ear.

Infections, circulatory problems, migraine, injury, or inflammation, can all be responsible. In particular, the side effects of some medicines, recreational drugs, and of course alcohol may also be the guilty party.

One of the most common causes of vertigo is motion sickness, which many of us have experienced and know just how unpleasant it can be.

Benign positional
vertigo For some people the bouts of vertigo may be short-lived but recurrent. When this is the case the most likely cause is a condition called benign positional vertigo. This tends to affect older people and any sudden movement of the head (usually head turning) brings on an episode of acute vertigo without warning.

Although it tends to last less than a minute it can be very unpleasant and disabling. As with other causes of vertigo this type usually follows a viral infection or is a result of inflammation or damage to the middle ear. Fortunately it tends to settle after a few months without treatment. Specialist physiotherapy can be of benefit for some sufferers if the symptoms persist.

Meniere's disease
This is an altogether more disabling condition that is caused by problems affecting the middle ear. It is believed that an increased amount of fluid collects and puts pressure on the balance mechanisms.

The bouts of vertigo can last anywhere from only a few minutes to as long as twelve hours usually leaving an affected person vomiting and prostrate. As if this isn't enough for someone to cope with, Meniere's disease brings with it other problems. Tinnitus (ringing in the ears), and difficulty with hearing complete the triad of symptoms that are diagnostic of this unpleasant condition.

When the attacks are sporadic then treatment to calm symptoms down are used when they're needed. If, however, attacks are occurring regularly and preventing someone from living an enjoyable life then medication is taken daily to prevent the attacks. On occasion, surgery to remove the additional fluid in the middle ear may be performed.

Establishing the diagnosis
It's very important that vertigo is taken seriously. Most people will see a specialist and have tests performed to establish the precise cause of the vertigo. Once this is known then the best treatment can be provided.

SARS: Warnings of mutant strains

The virus thought to cause SARS (Severe Acute Respiratory Syndrome) is constantly changing form, say scientists - which will make developing a vaccine difficult.

The Beijing Genomics Institute reported last week that the virus is "expected to mutate very fast and very easily".

Other experts have warned that, once established, it could be particularly hard to stop the SARS virus causing problems. SARS appears to be caused by a new strain of the corona virus, which may have "jumped" from animals to humans in the southern Chinese province of Guangdong.

So far the strain has killed more than 200 people, mainly in China, Hong Kong, Canada and Singapore. The number of new cases in China continues to rise, with the authorities admitting over the weekend that the virus is more widespread than previously acknowledged.

Teams of inspectors are now being sent into remote regions to aid prevention efforts. Chinese authorities are installing thermal imaging equipment to check the temperatures of travellers moving across the southern border between Shenzhen and Hong Kong.

There have now been almost 4,000 probable cases of SARS worldwide, according to the World Health Organization (WHO). Scientific teams are racing to produce a vaccine against the new strain, but have warned that this may take years. Experts say that a vaccine may only offer limited - and temporary protection. Other strains of the corona virus can cause "common cold"-like infections in humans.

They are also a significant cause of illness in various types of animals, particularly poultry.

Dangerous changes
Every virus is capable of mutating. Although the virus contains a large amount of genetic information, every time it is "replicated" inside a cell, tiny genetic "mistakes" are made. Some of these may harm the success of a virus, leave it unchanged - or make it better at infecting and replicating in humans.

Natural selection means that "mistakes" that end up benefiting the virus will lead to the creation of strains that are more virulent, or more easily transmitted from human to human. Dr. Adrian Mockett, who has helped develop the corona virus vaccines for use in veterinary medicine, said the virus had particular characteristics that could prove a problem in humans. "The ability of the virus to mutate has been a real problem in poultry vaccines. "The virus has the ability to change quite quickly - a vaccine might be suitable for a while, but not forever."

He said that because it was likely the new strain of the corona virus had only just "jumped" to humans, newer versions better suited to living in humans were possible. He said that other corona viruses in animals had mutated so that the infection could be spread not only through coughs and sneezes, but also through faeces - raising the possibility that a future outbreak could be transmitted through tainted water supplies or contaminated food.

Scientists believe that the current strain is transmitted through droplets coughed out of the lungs, but are still not certain about other possible routes of transmission. Even if a vaccine works at first, said Dr Mockett, he said that the "duration of immunity" had yet to be determined. He added: "You only get one chance to eradicate something like this - once it's established, you've got a real problem."

The characteristics of the corona virus and the way it infected humans meant that future vaccines were likely to work in the same way as flu vaccines - with different components needed to tackle a variety of common strains.

However, he said that if different strains evolved in North America and the Far East, a jab that worked in one place would offer no protection in the other.

WHO defence
Meanwhile, the WHO has dismissed criticism that it has exaggerated the threat posed by SARS. Last month it took the unusual decision to issue a worldwide warning about the disease. Spokesman Dick Thompson said: "The personal risk to any particular individual is minimal, but the risk to the public health system from this disease is enormous. "We needed people to be aware of the signs and symptoms of this disease. We did not want them to walk into a health clinic and not alert physicians that they had travelled from one of the outbreak sites."
BBC News


Back to Top  Back to Plus  

Copyright © 2001 Wijeya Newspapers Ltd. All rights reserved.