Backache

Backache is a pain in the lower back. Back pain is pain felt in the back that usually originates from the muscles, nerves, bones, joints or other structures in the spine.



The spine is a complex interconnecting network of nerves, joints, muscles, tendons and ligaments, all of which are capable of producing pain.




Causes


There are several potential sources and causes of back pain.However, the diagnosis of specific tissues of the spine as the cause of pain presents problems. This is because symptoms arising from different spinal tissues can feel very similar and is difficult to differentiate without the use of invasive diagnostic intervention procedures, such as localanesthetic blocks.


Diagnosis


In most cases of low back pain medical consensus advises not seeking an exact diagnosis but instead beginning to treat the pain. This assumes that there is no reason to expect that the person has an underlying problem. In most cases, the pain goes away naturally after a few weeks. Typical people who do seek diagnosis through imaging are not likely to have a better outcome than those who wait for the condition to resolve.In cases in which the back pain has a persistent underlying cause, such as a specific disease or spinal abnormality, then it is necessary for the physician to differentiate the source of the pain and advise specific courses of treatment.
Pain
Heat therapy is useful for back spasms or other conditions. A meta-analysis of studies by the Cochrane Collaboration concluded that heat therapy can reduce symptoms of acute and sub-acute low-back pain. Some patients find that moist heat works best (e.g. a hot bath or whirlpool) or continuous low-level heat (e.g. a heat wrap that stays warm for 4 to 6 hours). Cold compression therapy (e.g. ice or cold pack application) may be effective at relieving back pain in some cases.
Use of medications in chronic back pain is controversial. The short term use of muscle relaxants is effective in the relief of acute back pain.Opioids have not been shown to be better than placebo for chronic back pain when the risks and benefits are considered.[26] Non-steroidal anti-inflammatory drugs (NSAIDs/NSAIAs)have been shown to be more effective than placebo, and are usually more effective than paracetamol (acetaminophen). There is insufficient clinical trials to determine if injection therapy, usually with corticosteroids, helps in cases of low back pain.
Back schools appear to improve pain as compared to standard treatments.
Massage may help for those who have had a relatively long period of low back pain.
Acupressure or pressure point massage may be more beneficial than classic (Swedish) massage.


Depending on the particular cause of the condition, posture training courses and physical exercises might help with relieving the pain.
Exercises can be an effective approach to reducing pain, but should be done under supervision of a licensed health professional. Generally, some form of consistent stretching and exercise is believed to be an essential component of most back treatment programs. However, one study found that exercise is also effective for chronic back pain, but not for acute pain. Another study found that back-mobilizing exercises in acute settings are less effective than continuation of ordinary activities as tolerated.
Studies of manipulation suggest that this approach has a benefit similar to other therapies and superior to placebo.
Acupuncture has some proven benefit for back pain, however, a recent randomized controlled trial suggested insignificant difference between real and sham acupuncture.
Education, and attitude adjustment to focus on psychological or emotional causes - respondent-cognitive therapy and progressive relaxation therapy can reduce chronic pain


                                                        

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