Tuesday, April 6, 2010

Back Pain Guide

It is important to understand that back pain is a symptom of a medical condition, not a diagnosis itself. Medical problems that can cause back pain include the following:

Mechanical problems: A mechanical problem is due to the way your spine moves or the way you feel when you move your spine in certain ways. Perhaps the most common mechanical cause of back pain is a condition called intervertebral disc degeneration, which simply means that the discs located between the vertebrae of the spine are breaking down with age. As they deteriorate, they lose their cushioning ability. This problem can lead to pain if the back is stressed. Other mechanical causes of back pain include spasms, muscle tension, and ruptured discs, which are also called herniated discs.


Injuries: Spine injuries such as sprains and fractures can cause either short-lived or chronic back pain. Sprains are tears in the ligaments that support the spine, and they can occur from twisting or lifting improperly. Fractured vertebrae are often the result of osteoporosis, a condition that causes weak, porous bones. Less commonly, back pain may be caused by more severe injuries that result from accidents and falls.

Acquired conditions and diseases: Many medical problems can cause or contribute to back pain. They include scoliosis, which causes curvature of the spine and does not usually cause pain until mid-life; spondylolisthesis; various forms of arthritis, including osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis; and spinal stenosis, a narrowing of the spinal column that puts pressure on the spinal cord and nerves. While osteoporosis itself is not painful, it can lead to painful fractures of the vertebrae. Other causes of back pain include pregnancy; kidney stones or infections; endometriosis, which is the buildup of uterine tissue in places outside the uterus; and fibromyalgia, which causes fatigue and widespread muscle pain.

Infections and tumors: Although they are not common causes of back pain, infections can cause pain when they involve the vertebrae, a condition called osteomyelitis, or when they involve the discs that cushion the vertebrae, which is called discitis. Tumors, too, are relatively rare causes of back pain. Occasionally, tumors begin in the back, but more often they appear in the back as a result of cancer that has spread from elsewhere in the body.

Although the causes of back pain are usually physical, it is important to know that emotional stress can play a role in how severe pain is and how long it lasts. Stress can affect the body in many ways, including causing back muscles to become tense and painful.

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I like to imagine that I’m a kind, patient person. That I embody calm when confronted with prickly personalities. That their aggravations roll off me like water off a duck’s back. But this delusion is quickly dispelled every time I have a run-in with a difficult person. Take last week: My friend (let’s call her Liz) and I decided to meet at noon for lunch. She’s often late, so I took my time walking over to the cafĂ©. But mid-stroll, I became paranoid that Liz would be punctual for once, so I rushed to be there on the dot. She was nowhere to be seen. I breathed deeply, rationalizing that now I had some coveted alone time. That lasted all of four minutes. At 12:08, I called Liz on her cell, convinced I’d given her the wrong address. She never picked up. Ten minutes later, she showed up with a big smile and zero apology. “Oh, don’t be mad at me. You know I’m always late,” she said. “It’s just part of my personality. Besides, haven’t you enjoyed all the great people watching?" My reaction was less like a duck, more like a rabid dog. The worst part was that my emotional equilibrium had been knocked off-kilter. It took me a good 15 minutes to calm down enough to actually enjoy spending time with my friend. Trying personalities like Liz’s are everywhere — in your home (possibly sharing your bed), at the office, in your book club. They may even be complete strangers. What makes them difficult may be an undisputed character flaw — they’re sycophantic or self-centered or perpetually gloomy — or simply a quirk that rubs you the wrong way. But inevitably, a brush with them leaves you fuming or at least out of sorts. Instead of devising elaborate avoidance schemes or barbed comebacks, you can change your dynamic with these sanity stealers. Use the following strategies to end the emotional tug-of-war, once and for all. Turn the Spotlight on You “You must change how you react to people before you can change how you interact with them,” says Rick Kirschner, N.D., coauthor of Dealing with People You Can’t Stand. That requires some self-examination. People who irritate us usually have something to show us about ourselves. “Ask yourself: How is this person holding up the mirror to me?” suggests Sandra Crowe, author of Since Strangling Isn’t an Option. For example, being around my chronically late friend reminds me how quick-tempered and impatient I can be — not my favorite traits. Reminding myself of this may keep me from bouncing off the walls when I find myself waiting for her yet again.