Ouch! my back hurts
Almost everyone has low back pain at one time or another. The lower
back is the connection between your upper and lower body, and it bears
most of your body's weight. Because of these roles, it is easily injured
when you lift, reach, or twist.
 The good news is that most low back pain will go away in a few weeks
with some basic self-care. However, if your pain is severe or lasts more
than a couple of weeks, see your doctor.
What causes low back pain?
Low back pain is often caused by overuse, strain, or injury. For
instance, you may hurt your back by playing sports or working in your
yard, taking a jolt in a car accident, or lifting something too heavy
for you.
Aging plays a part too. Your bones and muscles tend to lose strength
as you age, which increases your risk of injury. The spongy discs
between the bones of the spine (vertebrae) may suffer from wear and tear
and may no longer provide enough cushion between the bones. A disc that
bulges too much or that breaks open (herniated disc) can press on
nerves, causing back pain.
Less often, low back pain is the result of arthritis, compression
fractures caused by bone loss (osteoporosis), illness, or a spine
problem that you may have had since you were born.
Your state of mind has an effect on your level of pain and whether it
becomes long-lasting (chronic). People who are depressed, under stress,
or unhappy in their work are more likely to have chronic back pain.
Often we don't really know the cause of low back pain.
What are the symptoms?
The term "low back pain" is used to describe a range of symptoms.
Depending on the cause, low back pain may be dull, burning, or sharp,
and it may be felt at a single point or over a broad area. It can come
on gradually or suddenly and may occur with muscle spasms or stiffness.
Leg symptoms can be caused by lower spine problems that place
pressure on a nerve that leads to the leg. The symptoms can occur on
their own or along with low back pain. Leg symptoms can include pain,
numbness, or tingling, often extending below the knee.
Weakness and/or numbness in both legs, along with loss of bladder
and/or bowel control, are symptoms of cauda equina syndrome, which
requires immediate medical attention.
Back pain can be:
* Acute (short-term), which lasts less than 3 months. Most people
gain relief after 4 to 6 weeks of home treatment.
* Recurrent, which is a repeat episode of acute symptoms. Most people
have at least one episode of recurrent low back pain.
* Chronic, which lasts longer than 3 months.
How is low back pain diagnosed?
Your doctor will begin by asking questions about your medical
history, your symptoms, and your work and physical activities. He or she
will also do a physical exam.
The questions and the exam can help him or her rule out a serious
cause for your pain. For most people with low back pain, the doctor will
be able to recommend treatment after the first exam.
Imaging tests such as X-rays, CT scans, and MRIs are not helpful for
diagnosing most episodes of low back pain. They are usually limited to
cases in which the doctor suspects a serious problem such as a broken
bone, cancer, or infection, or if surgery is being considered or
planned. You might also have imaging tests if workers' compensation or a
lawsuit is involved.
How is it treated?
Most low back pain will improve if you take the following steps:
* Apply ice for 5 to 15 minutes every 2 or 3 hours. You can use an
ice pack or a bag of frozen vegetables wrapped in a thin towel. After a
few days of ice, switch to heat for 15 to 20 minutes every 2 or 3 hours.
You can take a hot shower or use a heating pad or hot water bottle.
* Take pain medicine, such as ibuprofen (Advil or Motrin, for
example), aspirin, or acetaminophen (Tylenol, for example). These
medicines usually work best if you take them on a regular schedule
instead of waiting until the pain is severe.
* For the first day or two, rest in a comfortable position. Try lying
on your side with a pillow between your knees. Or lie on your back on
the floor with a pillow under your knees.
* As soon as possible, get back to your normal activities. Movement
helps your muscles stay strong. Staying in bed for more than 1 or 2 days
can actually make your problem worse.
Walking is the simplest and perhaps the best exercise for the lower
back. Your doctor or a physical therapist can recommend more specific
exercises to help your back muscles get stronger. These may include a
series of simple exercises called core stabilization.
The muscles of your trunk, or core, support your spine. Strengthening
these muscles can improve your posture, keep your body in better
balance, and lower your chance of injury.
If your symptoms are severe or you still have them after 2 weeks of
self-care, see your doctor. You may need stronger pain medicines, or you
might benefit from physical therapy.
Some people find relief from pain by using massage, chiropractic,
acupuncture, pain management techniques, or another type of treatment.
Certain treatments work for some people but not for others. You may need
to try different things to see which works best for you.
Only a few people with low back pain need surgery. Surgery may help
if you have a herniated disc or back pain along with symptoms of nerve
damage, such as numbness in your legs. Even in these cases, most people
will improve without surgery.
Having surgery does not guarantee that all your pain will go away.
Before you have surgery, it is a good idea to get a second opinion.
How can I prevent low back pain from returning?
Once you have had low back pain, you are likely to have it again. To
help keep your back healthy and avoid further back pain:
* Practice good posture when you sit, stand, and walk.
* Get regular, low-impact exercise. Walk, swim, or ride a stationary
bike. Stretch before you exercise.
* Wear low-heeled shoes with good support.
* Sleep on your side. A medium-firm mattress may be easiest on your
back.
* Don't try to lift things that are too heavy for you. When you must
lift, bend your knees and keep your back straight, keep the object you
are lifting close to your belly button, and avoid lifting and twisting
at the same time.
* Watch your weight. Being too heavy, especially around your waist,
puts extra stress on your back.
* If you smoke, quit. Smoking decreases blood flow and prevents
healing. If you sit or stand for long periods at work:
* Pay attention to your posture. Sit or stand up straight, with your
shoulders back.
* Make sure your chair has good back support.
* Take regular breaks to walk around. If your work involves a lot of
bending, reaching, or lifting:
* Talk to your human resources department to see if there are other
ways you can do your work.
* Don't depend on a 'back belt' to protect your back. Studies have
not shown these belts to be effective in reducing back injuries. The
most they can do is to help remind you to use good techniques for
lifting. Mouth is dry all the time.
New York Times
***
Damp, mouldy homes may cause depression
 People who live in damp, mouldy homes may be prone to depression, a
new study suggests.
The possible link was uncovered in an analysis of mould and health
conditions in several cities in eastern and western Europe. And it could
one day lead to the addition of emotional problems to the list of health
woes caused by mould, the study authors said.
But, the researchers cautioned, it's still too soon to tell if
exposure to mould is directly related to depression, or whether an
already depressed person might simply relinquish control of their
surroundings to the degree that mould may develop.
"There is some preliminary evidence which suggests that high levels
of exposure to mould may lead to depression," said study lead author
Edmond D. Shenassa, an assistant professor of community health at Brown
University School of Medicine.
"But it's not a certainty," he stressed. "We have found an
association between mould and risk of depression, but we have more work
to do to see if this is causal situation." The study results are
published in the October issue of the American Journal of Public Health.
Moulds are ubiquitous and toxic microscopic organisms called fungi
that come in a variety of species numbering in the tens - or even
hundreds - or thousands.
Mould spores - spread through air, water or insects - are found
year-round both indoors and out, and survive and multiply most readily
in warm, damp, shady, and humid conditions, according to the U.S.
Centers for Disease Control and Prevention.
Typically, routine cleaning with soap, water and bleach can prevent
mould from accumulating in the most susceptible areas, such as the seal
of a refrigerator door, showers, windows, and air conditioners.
But, a serious mould problem - easily evidenced by either the smell
of a musty odour or the sighting of slimy, furry and discoloured patches
on walls or ceilings - can develop and fester after excessive and
continuous water damage.
The U.S. government has not established general guidelines for
acceptable levels of residential mould. And no study has conclusively
linked mould exposure to mental health problems.
However, the CDC cautions that inhaling living or even dead mould
spores can provoke an allergic respiratory reaction among sensitive
individuals. Wheezing, shortness of breath, and even lung infections can
ensue, as can the onset of a stuffy nose, cough, headaches, and skin,
throat, or eye irritations.
Those most at risk include men and women suffering from allergies,
asthma, or the immune suppression that accompanies HIV infection,
chemotherapy treatment for cancer, and organ transplants.
To explore the possible link between mould and mental health
problems, Shenassa and his colleagues reviewed World Health Organization
data collected between 2002 and 2003 in eight European cities: Angers,
France; Bonn, Germany; Bratislava, Slovakia; Budapest, Hungary; Ferreira
do Alentejo, Portugal; Forli, Italy; Geneva, Switzerland; and Vilnius,
Lithuania.Almost 6,000 men and women in almost 3,000 households were
questioned in person about their health, including whether they had been
clinically diagnosed as depressed in the prior 12 months.
The participants, who ranged in age from 18 to 104, were divided
equally between men and women and were chosen by random.
They were asked if they had experienced any of four symptoms of
depression in the previous two weeks, such as problems sleeping, low
self-esteem, poor appetite, and/or a decreased interest in activities.
Those with three or more symptoms were deemed to be depressed.
Residents were also asked to assess their living conditions, while,
at the same time, the researchers conducted visual inspections to
calculate the levels and location of any dampness and mould in each
home.
Finally, each study participant was asked whether or not they felt in
control of their home environment, as well as whether they had any of
six conditions that can be associated with exposure to mould, including:
cold or throat problems; wheezing; asthmatic attacks or other
respiratory problems, fatigue; or headaches.
Housing characteristics - such as light, ventilation, size, crowding
and heating conditions - were also noted, as were basic demographic
information such as employment status. The researchers pointed out that
such factors, as well as general health, are sometimes associated with
depression.
Shenassa and his colleagues found that 57 percent of all the
residents lived in homes that were free of dampness or mould, although
the prevalence of mould varied greatly depending on region - ranging
from more than 80 percent in Portugal to a little more than 25 percent
in Slovakia.
Meanwhile, nine percent of all residents were determined to be
depressed. Women, the elderly and the unemployed were most likely to
have depressive symptoms, while those living in crowded conditions also
appeared to run a higher risk for depression.
But, even after accounting for such key mitigating factors, the
researchers connected the dots and found that having mould in the home
appeared to be associated with depression.
"Basically, the risk for depression went up about 40 percent among
people who lived in mouldy homes," said Shenassa. "And to the extent
that there are the same types of mould in Europe as they are in the
U.S., the results should also apply to U.S. households."
"But although we saw that there is more depression among people who
live in mouldy homes, we don't know which came first," Shenassa
cautioned. "We think there are multiple pathways to depression. So, we
need to do more work."
Kelly A. Reynolds, a research microbiologist in the University of
Arizona, described the study as "very interesting" but agreed that
further research is needed."Knowing that the mould-health effects are
long-term and chronic and sometimes cumulative means they (the study
authors) might be very far from determining which is the chicken and the
egg," she said.
"So, although there's a lot of speculation, it's difficult to prove a
mental health connection. But what we always tell people is that if you
can smell or see mould in your house, there's really no reason to not
get rid of it."
MayoClinic.com
|
