Back pain is second only to the common cold in terms of frequency of visits to the doctor and is caused by a variety of factors. These include a sedentary lifestyle, poor diet, incorrect body posture during office work, obesity or aging. Today, it is estimated that at least 8 out of 10 people experience back pain at some point in their lives that requires a visit to the doctor.
Therapeutic massage and physiotherapy for back pain
Causes of back pain
Back pain can manifest itself as a spasm of the spinal muscles, with a cramping or cramping character, or it can be felt as a continuous burning sensation. In some situations, the pain may radiate to the lower limbs and may be accentuated by movements of the trunk or prolonged walking.
Acute back pain comes on suddenly and usually subsides within a few days of onset. Chronic back pain may persist for more than 3 months after onset and is due to extensive pathological processes of the spine.
The main cause of back pain is muscle tension which contributes to reduced blood flow to the paravertebral muscles, depriving them of oxygen and nutrients necessary for proper function. Muscular tension is particularly favored by the adoption of vicious postures during the performance of various sedentary professional activities, such as sitting in a chair at a desk, couching for long periods and prolonged orthostatism (hairdressers, dentists, and surgeons).
Office work is the most common cause of back pain and is due to the failure to adapt working conditions to the individual needs of each person:
- Maintaining a seated position throughout the day
- Inadequate height of chairs and furniture
- Lack of adequate lumbar support.
- Excessive use of mobile phones by the young population favors the appearance of back pain, especially at cervical and thoracic levels and is due to the vicious position that causes over time, deformations of the spine.
Restrictions during the pandemic period meant that many people spent an increased number of hours in bed in front of the TV or with the laptop on their lap if it was possible to substitute office duties, but these activities led in most cases to the maintenance of a vicious posture of the spine and favored the appearance of back pain.
Back pain can also be caused by improper sleeping conditions: sleeping on mattresses that do not respect the physiology of the spine and incorrect use of support pillows.
Treatments commonly given to patients with back pain include non-steroidal anti-inflammatory drugs, opioids and cortisone infiltration, along with exercise therapy and remedial gymnastics.
Low back pain
Low back pain is the most common form of back pain because this segment of the spine supports and takes up a large part of the body’s weight. Low back pain can sometimes be accompanied by symptoms such as muscle stiffness and difficulty walking. The causes commonly involved in the occurrence of low back pain are:
- Compression fractures due to osteoporosis
- Tumor processes of the spine
- Lumbar spine fracture
- Muscle spasm
- Disc herniation
- Sciatica
- Spinal canal stenosis
- Lumbar lordosis
- Other less common causes of low back pain are caused by rupture of an abdominal aortic aneurysm, arthritis (rheumatoid, psoriatic, osteoarthritis), spinal infections (osteomyelitis, discitis, abscesses), kidney infections and female-associated medical conditions (endometriosis, ovarian cysts, ovarian cancer, uterine fibroids)
Back pain in the chest area
Back pain in the thoracic area can sometimes be difficult to diagnose because of the similarity to other pain syndromes that occur as a result of cardiac (myocardial infarction) and pulmonary pathologies. The muscular and bony causes of back pain in the thoracic area are represented by:
- rib fractures
- Costochondritis
- Myalgia
- Compression of the intercostal nerves between the intervertebral discs of the thoracic spine
- Vertebral tumors.
Back pain in the coccyx area
Coccygeal pain or coccydynia occurs in the last portion of the spine and affects females more frequently, in a ratio of 5:1 to males. Coccyx pain can be felt both when resting in a seated position and when walking due to movements made by the coccyx and sacrum, via the sacrococcygeal joint, during walking.
Pain in the coccyx area is accentuated when moving from the sitting position to orthostatism (standing upright), during defecation, sexual contact or sitting on hard surfaces without a pillow. Factors that favor the development of coccydynia are the wider female pelvic structure, pregnancy, childbirth, obesity and menstrual cycle pain that may radiate to the last part of the spine.
Exercises for back pain
Whether it’s moderate exercise, stretching or targeted physical therapy, movement is a good remedy for back pain. Exercises have the effect of strengthening the paravertebral muscles affected by sedentary lifestyles.
Exercise can be used to relieve moderate back pain. An effective method of improving the stability of the lumbar spine and toning the muscles of the hips and shoulders is the Superman exercise. This type of exercise involves extending the spine by contracting the paravertebral and gluteal muscles. The Superman exercise is performed by placing the body in a prone position (on the stomach), followed by simultaneously raising and lowering the outstretched limbs and keeping the neck in a neutral position, keeping the gaze down at ground level.
Stretching exercises are another method of treatment for low back pain and can be performed in the privacy of your own home without the need for special equipment. Stretching exercises include gentle mobilizations of the spine by adopting the supine position (lying on your back) and performing successive bending movements of the knees for each lower limb.
Therapeutic massage and physiotherapy for back pain
Kinesiotherapy uses movement as therapy and aims to regain muscle strength and relieve back pain through various exercises and therapeutic massage techniques.
The physiotherapist assesses the patient from a motor and muscular point of view, and then establishes an exercise plan adapted to each individual. The exercises are aimed at:
- Increasing the capacity for muscular effort with improved endurance
- Improving the mobility of the spine
- Regain control and a sense of balance
- Correction of posture and body alignment
- Preventive measures such as medical consultation, physiotherapy sessions and therapeutic massage can limit the impact of back pain on daily activities, including work
References:
- Back pain, George E Ehrlich, The Journal of Rheumatology
- Back pain – Symptoms & causes, Diagnosis & treatment, Mayo Clinic
- Diagnosis and treatment of low back pain – Clinical Review
- The Epidemiology of low back pain, D. Hoy, P. Brooks, F. Blyth, R. Buchbinder
