SCRIPT NUMBER 140
LOW BACK PAIN - 2
(TWO SPEAKERS)
PROGRAM NAME: HEALTH NUGGETS
PROGRAM TITLE:
LOW BACK PAIN - 2
PROGRAM NUMBER:
140
SUBJECT: CAUSES, RISK FACTORS, SYMPTOMS, TREATMENT,
SURGERY, PREVENTION OF LOW BACK PAIN
KEY WORDS:
RADIATING PAIN, DEGENERATION, PHYSICAL
THERAPIST, FUSE, BONE GRAFTING, POSTURE
DATE OF SCRIPT:
NOVEMBER 29, 2013
AUTHOR: RICHARD YUKL, MD, FACS
SPEAKER 1:
Anna is an instructor in a nursing school. She was in the
hospital teaching her nursing students when she tripped over the leg of some
medical equipment, falling hard onto her right knee. The fall caused considerable
pain in her right knee for several days, but as time went on, she developed more
and more pain in her lower back and down the back of her right leg to her ankle.
A doctor friend told her that she had probably strained her back muscles. He
suggested that she apply a heating pad to her lower back, and he gave her pain
pills, telling her that her pain should go away within a few weeks. Instead, her low
back pain progressively worsened for one and one-half years, even though she
tried many types of conservative treatments.
SPEAKER 2:
Low back pain is one of the most common reasons for
people to be absent from work and to see a doctor. Most adults experience pain
their low back at least once. The good news is that one can take simple
measures to prevent or lessen the severity of most episodes. Home treatments
will often heal the pain within a few weeks. Surgery is rarely required.
SPEAKER 1:
Why is low back pain so common?
SPEAKER 2:
We were created with backs that are a delicate, interwoven
network of parts working together to allow us to stand upright. Pain most often
occurs either because we strained our muscles by improper or heavy lifting, or
because a sudden awkward movement has unbalanced the forces acting on our
back. Less frequently, the pain is caused by damage to the pads between the
backbones, the bones themselves, or to nerve injury. As an example, the pads
located between the bones of our spine contain a soft material in their center,
and, if the pad breaks and bulges out of place, it will irritate the nerves, causing
pain.
SPEAKER 1:
back pain?
What are the factors that increase my risk of developing low
SPEAKER 2:
Factors include hard physical work, aging and being
overweight. Less obvious risk factors include smoking, stress, anxiety and
depression. Also, working long hours every day at a desk will weaken the
muscles that support our back, increasing our risk of developing low back pain.
SPEAKER 1:
What are the most common symptoms of a low back injury?
SPEAKER 2:
They include such discomforts as muscle aches, stabbing
pain in the low back, pain that spreads down the back of the leg, and the inability
to stand up straight.
SPEAKER 1:
If I develop low back pain, how should I treat it?
SPEAKER 2:
Most low back pain improves with a few weeks of home
treatment. Short periods of bed rest help, and you can buy medicines without a
prescription to help relieve the pain. Because low back pain can signal a more
serious medical problem, however, you should see your doctor if your pain is
constant or severe, especially if it worsens at night when you lie down. Also, be
evaluated by a doctor if the pain causes weakness, numbness or tingling in your
legs, or if you develop bowel or bladder control problems.
SPEAKER 1:
What treatment will the doctor prescribe?
SPEAKER 2:
The doctor can treat back pain more aggressively than you
can at home. He can put medicines directly into the space surrounding your
spine to lessen the pain and possible irritation of your nerves. He will instruct a
physical therapist to apply helpful treatments to your back. And, as the pain
improves, the therapist will teach you exercises to strengthen your back and
stomach muscles, and to improve your posture to prevent the pain from
returning.
SPEAKER 1:
When is surgery necessary?
SPEAKER 2:
Surgery may be needed if the pain doesn’t respond to the
doctor’s intensive treatments. In that event, a surgeon may fuse the bones of
your low back together using metal rods and screws or by bone grafting. The
surgeon will also remove the portions of bone that are pressing against nerves.
Anna eventually consulted a back pain specialist, who did the testing needed to
make a proper diagnosis. Her original fall injury had damaged the space between
two bones in her low back. Nerves in her back were being pinched, causing the
pain. She required an operation to successfully repair the damage.
SPEAKER 1:
So, what can I do to prevent low back pain?
SPEAKER 2:
First, get physically fit. Stomach and back muscles function
as natural support for your back. Regular exercises such as walking and
swimming won’t strain or jolt your back, but they will strengthen these muscles,
allowing them to function more efficiently. Next, if you stand for long periods of
time, learn to stand straight so that the bones of your low back are in line,
allowing more room for your nerves as they exit the spine. When you sit, choose
a chair with good lower back support. Consider placing a pillow or rolled towel in
the small of your back to maintain its normal curve, and don’t twist your body in
the chair. Finally, when you lift, let your legs do the work. Move straight up and
down, keeping your back straight, and bend only at the knees, holding the load
close to your body.
SPEAKER 1:
Are there yet other things I can do to help limit low back
pain?
SPEAKER 2:
Smokers have a lowered oxygen level in their tissues, which
slows the healing process, so if you smoke, stop. Being overweight puts extra
strain on your back muscles, so, if you are overweight, losing weight can be
helpful.
SPEAKER 1:
Health Nuggets is written by Dr. Richard Yukl, a medical
doctor working in the United States. The medical views expressed in this
program are his and may differ for your particular health needs. If you need
medical advice, please consult a medical professional in your area.