The irony …we exercise to strengthen and tone and to avoid back
Injuries, and yet so many of our injuries are the result of exercise!
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(HealthNewsDigest.com) – The good news is that most exercise-related back injuries are innocuous and self-limiting. We think back and the instant memory replay reminds us that we omitted to warm up, that we rushed thru the exercise program or did more than we should have. We didn’t rest or we failed to hydrate adequately.
We end up sore and aching. For the majority of us, this is not a first
time experience and we know the treatment regimen by heart. We rest ,
ice the painful area of the back, and start a short course of
aspirin, acetaminophen, or ibuprofen and we are back in the gym
in no time.
The overwhelming majority of such back injuries are muscular in
origin. Commonly referred to as Ordinary Backache, it usually affects
healthy folks between the ages of 20-55 with pain confined to the
lumbosacral area, buttocks and thighs. The pain is usually mechanical
in nature, which means that it varies with position and physical
activity. The discomfort rarely lasts for more than four to six weeks and
usually less.
But what if the pain doesn’t go away. What if the pain worsens?
Ordinary Backache can be severe and limit the person’s ability to
function. The concern arises when the pain doesn’t significantly
improve during those first six weeks and the usual regimen doesn’t
seem to be working. I stress the word “concern” because even with
Ordinary Backache lasting longer than six weeks there is rarely a
cause for alarm. However, if the pain affects one’s ability to function
at home or at work the sensible thing to do is to discuss this with
your doctor who will probably suggest a “work up.” That is a series
of tests to exclude or “rule out” a more significant problem.
Most physicians will initiate the work up with three tests that will
rule out greater than 95% of possible underlying problems. The first
is routine x-rays of the spine. This old standard is still best to
discover a fractured bone, benign misalignment of the spine from the
trauma or a previously undiagnosed congenital abnormality made worse
by trauma.
The second test is usually a bone scan, which can detect more subtle
fractures, areas of arthritis that were disrupted and made painful by
a trauma. It can also detect traumatic alterations in the facet
joints.
We forget that the spine, like the knee, hip and shoulder, has joints
which can be disrupted by exercise. These painful situations are most
commonly the result of exercises that require us to torque or rotate
the spine. That is why it is important to tell your doctor the type
of exercise that caused the pain initially as it may be a clue to the
proper diagnosis and treatment.
Although some physicians will request a CT scan or MRI right away, I
usually wait till the other tests are done. Remembering that the CT
scan is superior for the visualization of bone and the MRI better for
the visualization of soft tissues, both are useful.
Having gone down this route, it is still unlikely that a specific
diagnosis as to the origin of the Ordinary Backache will be made. The
reason for this is that even our most sophisticated imaging techniques
can’t detect subtle traumatic and inflammatory changes in the muscle,
ligaments and tendons. Because we can’t effectively immobilize
these areas, the pain cycle may continue. That is why it is important
to diagnose and treat Ordinary Backache quickly and before the pain
continues and becomes chronic.
A final word of caution: be alert if, in addition to the back pain, you
develop leg pain, numbness, tingling, leg weakness, and decreased
ability to control your bowels or bladder. These are the warning signs
that indicate that the injury is more severe and demand immediate
medical attention and a proper medical workup!
Every year, my phone lines are busy with patients old and new who are
ailing with back pain. Most calls are from folks like you and me who
didn’t warm up, didn’t hydrate, didn’t rest between exercises or simply
did much too much that first week in the gym. The best advice I can give
is don’t make these mistakes. It took a while to get out of shape; it will take a
while to get back in shape.
If you develop Ordinary Backache have it diagnosed and treated quickly. If
the symptoms don’t respond or progress with increasing pain, leg
numbness, leg weakness or bowel or bladder dysfunction, seek
medical attention right away.
About the Author:
Jack Stern, M.D., Ph.D., is widely acclaimed as one of the world’s finest neurosurgeons and a leading authority in his field. A board certified neurological surgeon who is internationally recognized for his expertise in lower back pain, Dr. Stern is an acknowledged medical expert in the diagnosis and treatment of conditions and injuries to the spine.
He is a founding partner of Brain & Spine Surgeons of New York and co-founder of Spine Options, Westchester County’s first non-surgical back pain treatment facility. In 1984, Dr. Stern opened the United Hospital Center for holistic medicine, the first hospital-based integrative healing center in the United States.
With more than 30 years experience in treating the spine through both surgical and non-surgical approaches, Dr. Stern uses a multidisciplinary approach to diagnosing back ailments and, as a surgeon, favors minimally invasive procedures. His pioneering approach to the diagnosis of back pain continues to revolutionize treatment of this pervasive condition.
For more information, please visit www.safespinesurgery.com.
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