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.
