Back Pain

Dear Reader,

Back pain is not a disease, but an alarm signal. It indicates that somewhere something is wrong. From the base of the skull to the coccyx (tail bone), back pain occurs for a variety of reasons. Everyone will experience back pain during their lifetime.

Back pain exceeding the normal and explicable muscle aches should be taken seriously, because in every case, the spinal column with its numerous connected moving segments are integrated with central nerve pathways and muscles. Back pain always causes movement restriction and is reflective of a transferred loading to compensate for problems, therefore setting up more severe future problems.

Spine orthopedics has made powerful progress in recent years. Nevertheless, a defective spinal column never can be restored to what it once was, so prevention of spinal disorders should be practiced.

This book gives the reader important information and management tools for preventing problems and changes of the spinal column. It also describes the connected muscle and nerve structures to give the reader a better understanding of the spine and back pain. It shows ways how everyone of us can obtain a strong spine and how parents can teach their children to walk erect. Whoever suffers from back pain, will get advice and help, and can begin some self-education in preparation in case any important decision must be made about an operation.

Prof. Dr. Rudolf Bertagnoli

Our Spine—A Masterpiece of Nature

Back pain is very common. Almost everyone has experienced it. Back pain is experienced most frequently in the lower back (lumbar), the neck and shoulder areas. It can strike without warning or slowly creep upon you and then disappear with or without medical help or become a lifelong companion. The pain can be restricted to small area or radiate from a single point or it can be experienced in only certain positions or during certain movements. It can certainly rob you of your sleep.

Even if you have never had back pain, you can get it in the next instant.

Everyone knows, what pain is, and yet no one can exactly describe it. Pain is a totally personal experience, and there is no device, which can measure the intensity of it. Pain can be independent of a point of trauma and of the size of the source, and it can become perceived as stronger or weaker. Sensitivities to pain are different and distinct for each person and changes according to momentary conditions.

Pain can occur even without recognizable causation. It needs no injury or sickness or mental illness to appear.

Only in rare cases is pain feigned and it is difficult for even the physician it to recognize when it is feigned. Much more frequently pain is induced, either unconsciously or even consciously. Such pain is not imagined, but actually present. In these cases, pain has a motivation behind it; for example, the pain may evoke sympathy, get attention, get assurances, indulge in self-pity, or even be used as self punishment. Pain often has a real psychological subconscious component.

The vast majority of reported pain has functional or organic causes. Congenital or acquired misaligned posture, work-related stresses, physical overloading as well as a lack of use, degeneration of the joints, distinct weak musculature, inflammations, infections, accidents, the aging of the structures and nerve irritation are only a few examples of what frequently causes back pain.

Pain is always a warning signal that something is not as it should be. It warns of underlying changes or injurious habits. Today many pain patients seek medical aid. With back pain an orthopedic specialist is needed. They can prevent further damage and aggravation or at least curtail it and/or repair existing injuries . However, pain abatement and function restoration take precedence. Pain, depending on the type of problem, can be successfully treated with warmth, cold, baths, packing, massages, calisthenics, electrotherapy, and medicine. Only after these treatments should one consider surgical intervention.

Statistics from western countries show that the number of back cases have increased. Approximately 20 percent of the population suffer some sort of frequent back pain. Almost every second person reported back troubles during their life time, most frequently between the ages 30 and the 50. Women suffer more frequently than men. Surgical intervention increase with the age. These numbers only illustrate the frequency of the back pain however, every case is unique.

There are many possible causes why we have more pain sensitivity today than earlier generations:

• Earlier generations accepted injury and pain as a fact of life.
• There were no usable treatment measures, therefore we were unaware of the amount of back pain.
• The capacity to bear troubles, is less than earlier times. With more civilizing influences we may have become more sensitive or less tolerant to pain. Less physical work, central heating, warm water, movement deficiency, excess body weight have all been cited as examples of alienation from the natural life or life of earlier generations.
• Our expectations about our state of mind and quality of life have risen.
• Increased life expectancy brings about an array of considerable signs of wear and tear, always requiring a greater tolerance for pain.
• With the high cost of health insurance premiums companies and individuals expects first-class medical treatment as a return. Moreover, medical care has become of modern social politics.

Although pain can be unpredictable and different for everybody, the doctor can use this pain profile for diagnosis and treatment. Therefore as a patient, you should select a doctor you trust and takes the time for an extensive discussion of the treatment proposal. After this it is important that you both jointly agree on the measures to be implemented. Also, you should realize that the treatment may not immediately yield the hoped for success. Self treatment is not recommended, because it may lead to misinterpretation of your symptoms by the doctor. It would be very helpful to the doctor, if the patient gave him a completed pain list (see My Pain Check List) indicating the characteristics, frequency and duration of the pain.

People are the only creatures with an erect spine walking on two feet. Therefore the spine assumed entirely new tasks and this resulted in changes of its structure. The tail as a balancing appendage for climbing and jumping became obsolete and nearly disappeared. And to enable the upper extremities to grab, hold and make things, the spine changed again. As a result we have a younger back than other species.

I have had pain since _________ Weeks ___________ Months

Since then it has gotten __better ___ worse (Please X the appropriate blank)

My pain starts:

The pain is:

The pain feels: