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26 Cheshvan 5765 - November 10, 2004 | Mordecai Plaut, director Published Weekly
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Home and Family

Mind Your Back
by S. Bender

Back pain can hit anyone at any age and at any time.

The spine is composed of a very sophisticated set of bones and nerves. The spinal cord is the main pathway of communication between the brain and the rest of the body. This soft tubelike structure of nerves which extends from the base of the brain is protected by the bones of the spinal column, the vertebrae. These bones are separated from one another by discs made of cartilage. Each disc has a strong outer layer and a soft inner part that acts as a shock absorber to cushion the vertebrae during movement.

Nerve roots project from the spinal cord between the vertebrae, delivering and receiving signals from almost all parts of the body. The nerve roots are organized in pairs. The motor nerves emerge from the front of the spinal cord and stimulate the muscles, and the sensory nerves emerge from the back of the spinal cord and bring sensory information to the brain.

Anyone can look up this information in most encyclopedias and one does not have to be qualified in medicine or even in alternative medicine to become quite an expert on back pain, its prevention and if possible, cure. Any new member of the sufferers club will be inundated with advice, yet on the whole, 90% of acute back pain will get better within a month, more frequently within a week.

Whether one consults an osteopath, chiropractor, a normal GP or cures oneself by taking to bed (because one can't move anyway), the pain will subside, leaving no trace of ever having been there. Unfortunately, there is every chance that it will recur, but this time, the sufferer will know what is coming. Moreover, the ten percent of sufferers who do not recover spontaneously from this acute pain may remain chronic sufferers. These people become experts, at least as far as their own backs are concerned.

What causes back pain? Is it hereditary? Has it anything to do with one's occupation? Do white collar workers suffer less than laborers? How can one prevent it?

There is little evidence of hereditary factors in back pain. Yeshiva men are at least as prone as dock workers to lower back pain. Sitting for prolonged periods in one position puts a heavy strain on the discs in the spine. On the other hand, lifting heavy weights is also a strain on the back. Occupations involving vibration, such as taxi drivers, are also prone to lower back pain. So maybe, long bed rest is one way of preventing back pain? Not really, because the muscles become weakened through disuse.

The Germans call it something like a `witches shot,' this sudden awful pain in the lower back when you can't get up from a stooping position. You can't think of anything except your back and are prepared to take any amount of pain-killer just to try and numb the pain. Sometimes the pain continues shooting down the leg and sometimes through the shoulders into an arm. If the sufferer remembers that 90% of those suffering from this acute pain will recover spontaneously, it is a great help.

If your body demands complete bed rest, follow its dictates; there is no point fighting it. If a hot-water bottle helps, use one. If an ice pack seems to be the answer, try that. Rubbing with any of the wonderful creams on the market might also help. However, if after a few days you are not better, you will have to go to a professional.

Unfortunately, some really acute cases of back trouble can be aggravated if one does not see a really qualified back specialist. There are many charlatans out there (not all, of course. Reputable practitioners would know when they mustn't attempt manipulation), and people going to a chiropractor because they heard that he was good, might, G-d forbid, suffer irreparable damage. It all depends on which part of the back is affected and how it is affected.

Back pain does not have to originate in the back. Doctors may diagnose ailments ranging from a stomach infection to an infected gall bladder. There are stories of other more serious illnesses which were first detected because the patient had a back pain. There is also psychosomatic back pain which can come from stress of any kind.

Before Pesach, when I get severe pain in my upper back, I know that there is nothing the matter with me, but that my body is telling me to take a break. Different people suffer from different pains when they are stressed. Some are prone to headaches, others to stomachaches and still others to back pain.

A slipped disc can be caused either by a ruptured cartilage between two vertebrae or by general deterioration, in older people, of the spaces between the vertebrae. It is often difficult for doctors to pinpoint the exact cause of the pain, especially if there is a torn tendon or sprained muscle, and much of the examination is done by a process of elimination.

Computed tomography (CT) is a computer-enhanced scanning technique used for analyzing X-ray pictures. Alternatively, MRI (magnetic resonance imagining) can help doctors determine the site of the pain with great pecision. Some doctors are very quick to offer surgery, and indeed, back surgery nowadays has a 90% chance of success.

However, other specialists feel that surgery is a last resort, and offer a course of cortisone coupled with analgesic injections epidurally. These are usually very effective for the lower back. Anti-inflamatory drugs are often prescribed for acute back pain. Physiotherapy can be quite effective for all areas of the back, starting with the neck, shoulders, upper and lower back. They may use ultrasound deep heat treatment and also teach you various muscle strengthening exercises which have to be done about ten times, three times a day. Water aerobics are also recommended for some types of pain. A neck collar and a firm girdle for the back are used to `remind' the patient not to move too suddenly or too much till the pain is stabilized.

When a person is perfectly healthy again, the Alexander technique and others like it can teach him how to move, stand and sit correctly at all times. It really does help if one has the self discipline to abide by the rules. We mistreat our backs shamefully and someone of thirty does not think of the future. We should all sleep on hard mattresses, or a thin mattress over a board.

Some years ago, I was a guest somewhere and they gave me a beautifully soft mattress. As soon as I felt myself sink into it, I knew that I would not be able to move by the morning. I dragged that mattress onto the floor and slept well all night. So if you are a potential sufferer and know which particular circumstance is going to trigger off an attack, avoid that circumstnace.

Money cannot buy good health, but sincere prayer for others and for ourselves may be rewarded by this most precious of all commodities.

 

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