BACK ACHE- WHO THE CULPRIT IS….PSYCHOLOGICAL OR PHYSICAL STRESS ????????????

If you have lower back pain, you are not alone. About 80 percent of adults experience low back pain at some point in their lifetimes. It is the most common cause of job-related disability and a leading contributor to missed work days.
Four out of five adults will experience an episode of significant back pain sometime during their life. Not surprisingly, back pain is one of the problems most often seen by health care
providers. Fortunately, the majority of patients with back pain will successfully recover and
return to normal social and work activities within 2-4 months, often without treatment
This pain is a complex experience that includes both physical and psychological factors.
It is quite normal to have emotional reactions to acute back pain.
These reactions can include fear, anxiety and worry about what the pain means, how long it will last and how much it will interfere with activities of daily living.
Though it’s normal to avoid activity that causes pain, complete inactivity is ill-advised. Rather, it is important to take an active role in managing pain by participating in physician-guided activities. In order to minimize emotional distress, it is important to ask your health care provider questions about your back pain so you do not leave the office uncertain or anxious .
During the acute period, feelings of helplessness, stress and even anger towards your health care provider (for not relieving your pain) may occur. In order to help allay this distress, you need to be sure that your health care provider is attending to all of your important physical and psychological needs. Chronic pain can be associated with even greater psychological
distress.

Anxiety and stress can actually increase your pain and reduce your pain coping skills.
There is a dynamic relationship between state of mind like stress level and physical condition like pain.
The back pain is not attributed to mechanical and physical factors,but rather due to the patient’s feelings,personality and unconscious issues. Key emotions include unconscious anger and rage. This unconscious tension causes changes in the body’s nervous system. These changes include constriction in blood vessels and reduction of blood flow to the various soft tissues ,including muscles,tendon,ligaments and nerves in the back.
This causes a decrease in oxygen to the area as well as a build up of biochemical waste products in the muscles. In turn this result in muscles tension,spasm and back pain experienced by the patient.
The back pain is not attributed to mechanical and physical factors,but rather due to the patient’s feelings,personality and unconscious issues. Key emotions include unconscious anger and rage. This unconscious tension causes changes in the body’s nervous system. These changes include constriction in blood vessels and reduction of blood flow to the various soft tissues ,including muscles,tendon,ligaments and nerves in the back.
This causes a decrease in oxygen to the area as well as a build up of biochemical waste products in the muscles.

Risk factors for developing low back pain-
Age: The first attack of low back pain typically occurs between the ages of 30 and 50, and back pain becomes more common with advancing age.
Fitness level: Back pain is more common among people who are not physically fit. Weak back and abdominal muscles may not properly support the spine.
Pregnancy is commonly accompanied by low back pain, which results from pelvic changes and alterations in weight loading. Back symptoms almost always resolve postpartum.
Weight gain: Being overweight, obese, or quickly gaining significant amounts of weight can put stress on the back and lead to low back pain.
Occupational risk factors: Having a job that requires heavy lifting, pushing, or pulling, particularly when it involves twisting or vibrating the spine, can lead to injury and back pain.
An inactive job or a desk job may also lead to or contribute to pain, especially if you have poor posture or sit all day in a chair with inadequate back support.

Mental health factors: Pre-existing mental health issues such as anxiety and depression can influence how closely one focuses on their pain as well as their perception of its severity. Pain that becomes chronic also can contribute to the development of such psychological factors. Stress can affect the body in numerous ways, including causing muscle tension.
Management of pain and anxiety-Stress management, relaxation training, biofeedback,hypnosis and cognitive-behavioral therapy(a method to reduce feelings of doom and helplessness).There are also medications available to help with sleep problems, anxiety and depression. Such comprehensive pain management programs,when integrated with your medical care,have proven to be quite successful.

Conventionally treatments for low back pain
Hot or cold packs have never been proven to quickly resolve low back injury; however, they may help ease pain and reduce inflammation for people with acute, subacute, or chronic pain, allowing for greater mobility among some individuals.
Activity: Bed rest should be limited. Individuals should begin stretching exercises and resume normal daily activities as soon as possible, while avoiding movements that aggravate pain. Bed rest alone may make back pain worse and can lead to secondary complications such as depression, decreased muscle tone, and blood clots in the legs.
Strengthening exercises-beyond general daily activities, are not advised for acute low back pain, but may be an effective way to speed recovery from chronic or subacute low back pain. Maintaining and building muscle strength is particularly important for persons with skeletal irregularities.
Physical therapy/Physiotherapy programs to strengthen core muscle groups that support the low back, improve mobility and flexibility, and promote proper positioning and posture are often used in combinations with other interventions.
Traction involves the use of weights and pulleys to apply constant or intermittent force to gradually “pull” the skeletal structure into better alignment .
Biofeedback is often used in combination with other treatment methods, generally without side effects. Evidence is lacking that biofeedback provides a clear benefit for low back pain. The therapy involves the attachment of electrodes to the skin and the use of an electromyography machine that allows people to become aware of and self-regulate their breathing, muscle tension, heart rate, and skin temperature. People regulate their response to pain by using relaxation techniques.

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