Low back pain

Sumitra is in pain. She lifted a large bucket of water and immediately felt a catch in her back. Now her back feels stiff as a board and she has pain in the lower back. What can she do to relieve the pain and how can she prevent it from happening again?

Common causes

Most people will first feel back pain just after lifting a heavy object, moving suddenly, sitting in one position for a long time, or having an injury or accident. It is important to remember that years of poor posture and neglect of the back can precipitate low back pain when the back is strained in an acute situation. The commonest causes of low back pain are:

•  Muscle spasm (very tense muscles that remain contracted)
• Ruptured or herniated disc
• Degeneration of the discs
• Poor alignment of the vertebrae
• Small fractures to the spine from osteoporosis
• Narrowing of the spinal canal
• Strain or tears to the muscles or ligaments supporting the back

Low back pain from any cause usually involves spasm of the large muscles on both sides of the spine. The spasm and stiffness accompanying back pain are what make the pain hard to bear and prolong the problem.

Relieving pain

The best position for relief of low back ache is to lie on the back with pillows under the knees, with hips and knees bent. This takes the pressure and weight off the back. You can also sleep on your side, curled up in the fetal position, with a pillow between your knees. Avoid sleeping on your stomach because this increases the curvature of the low back and can worsen the pain. One to two days of this sort of rest may be required for a hurt back. Remember that resting longer than this can cause the muscles to weaken, which can slow your recovery. Even if it hurts, it is important to walk around for a few minutes every hour.

Hot water bags or heating pads can help to relax painful muscle spasms. Use heat for 20 to 30 minutes at a time. Ice packs and massages may also give relief.