My mother’s chicken delivery man grimaced in pain as he got down from his bike last week.
Clutching a plastic bag full of goodies in one hand, the other supported his lower back.
Normally cheery, anguish was written all over his face and he complained, “Aiyo, belakang banyak sakit. Apa mau buat? (My back is hurting. What can I do?)”
He must have done too much spring cleaning to usher in the Year of the Pig and threw out his back.
We all experience back pain at some point in life, which most commonly comes from poor posture, weak muscles and bad lifting habits.
It can also occur from a sudden jolt such as a car accident, fall, degenerative condition, or other stresses on spinal bones and tissues.
Too much or too little exercise, combined with the ageing process also contributes to back pain, especially in the lumbar or lower back area.
Causes of back pain
Ever heard your grandmother saying that as you age, everything starts to fall apart? There’s plenty of truth to this.
Unless you’re religiously exercising, you will start losing bone strength and muscle elasticity as you age.
The intervertebral discs between the vertebrae, which is filled with a gel-like substance, begins to lose its fluid and flexibility, which decreases its ability to cushion the vertebrae. So, any small strain can lead to pain.
However, in the majority of cases, lower back pain is caused by muscle weaknesses and imbalances, including a tight hamstring, tight butt muscles, tight lower back muscle groups, tight hip flexor muscles and weak abdominal muscles.
Normally, when you exercise too hard or lift heavy objects, it can cause a bit of back pain.
Often caused by muscle strain, the pain should go off within a few days.
But sometimes, back pain can be related to a disc that bulges or ruptures.
If a bulging or ruptured disc presses on the sciatic nerve, it irritates the nerve and pain may shoot from the buttocks down one leg.
This condition is called sciatica, which causes additional symptoms such as numbness, weakness or a tingling sensation.
Overdoing it at the gym or golf course is one of the most common causes of overextended muscles leading to low back pain.
You’re especially vulnerable if you tend to be inactive during the work week and then become a weekend warrior by spending hours at the gym or futsal court.
If you’ve got your back checked and the doctor says it’s a muscle strain, rest is not necessarily the best treatment. Stretching is a better option.
Lying flat in bed or too much rest actually prolongs recovery time.
Studies suggest that any more than a day or two of bed rest can actually worsen the pain and may reduce muscle tone and flexibility.
For short term relief, use hot or cold compression packs.
When there is inflammation, cold packs are recommended, but for the back, some people find it more soothing to use a hot pack.
If you don’t have a hot water bottle, an easy way to make a hot pack is to use an old sock, put a few fistfuls of uncooked rice inside, knot the top and microwave it for a minute (or according to how warm you want it). Apply to the affected area for 20 minutes.
Considered a moist heat pack, the rice pack is less dehydrating to the skin than dry heat, and it allows heat to absorb better into the skin, which may relieve pain faster.
While several studies suggest massage can be effective in managing back pain, do ensure the problem is nothing serious before you head to the masseur.
Pick someone who is knowledgeable enough to know what is wrong with the back or you’ll end up with worse pain after a massage.
There are so many easy stretches you can do to lessen the pain. If you’re unable to stand up, you can do them while lying down.
Try this: lie flat in bed or on the floor, bend both knees and place the feet on the floor.
Lift one knee and pull it close to your chest. Hold for 30 seconds or thereabouts before switching legs.
Once you get better, straighten the leg that is on the floor and pull the opposite knee into the chest.
After you get better, try pulling both knees into your chest. Then twist them down to the opposite side (spinal twist).
If your pain is not debilitating, try the yoga child’s pose or balasana (below).
Not only is this gentle stretch good for the back muscles, it is also very relaxing as it helps reduce stress and fatigue.
If you have difficulty sitting on your heels in this pose, place a cushion or thickly folded blanket between your back thighs and calves.
Or if you have bad knees, put a blanket or towel underneath your knees for added support.
While you’re having pain, do not attempt any strengthening exercises until the pain has completely subsided.
When you’ve recovered and feel ready to start working the muscle, begin with lying on your stomach (prone position) with the forehead on the floor, arms at the side, and lift one leg off (keep it straight) the floor.
Again, hold for 30 seconds and switch legs. Do each side three or four times.
As you get stronger, lie in the same position, keep the legs on the floor and hands by your side, but this time, lift the upper body off the floor, without straining your neck. You’ll feel your back muscles engaging.
When it gets serious
When it comes to the spine, surgery should always be the last resort. If the pain is interfering with your daily life and other treatments have not provided relief, then you’re left with no choice.
Depending on the cause of your pain, a surgeon may remove a herniated disc, widen the space around the spinal cord, and/or fuse two spinal vertebrae together (spinal fusion).
Spinal fusion surgery involves identifying the painful vertebrae in the spine and fusing them together.
Essentially, the process involves bonding two painful bones into one stronger, pain-free, but less mobile vertebrae.
The idea is that by restricting the movement of the individual bones, you should be able to eliminate the pain.
If you recall, golf pro Tiger Woods suffered tremendous back spasms a few years ago, leaving him crippled with pain.
He had two discectomies (surgical removal of the whole or a part of a degenerative intervertebral disc) and a third operation that failed to remedy his sciatica, so left with no alternatives, he opted for spinal fusion.
Since then, he has made a remarkable comeback to golf.
Experts recommend you seek immediate medical help if you experience back pain and numbness or tingling around your genitals or buttocks, difficulty peeing, loss of bladder or bowel control, chest pain, a high fever, unexplained weight loss, or a swelling or a deformity in your back; or if doesn’t improve after days of resting.
These problems could indicate something more serious.