WHAT IT IS
In general, instead of a backache, we should call it pain of the spine, which is a painful symptomatology affecting the backbone of our body and that, for different reasons, is affected by daily activities to such a point that it “signals” itself by causing pain.Therefore, let’s see the anatomic characteristics of the spine. The spine is a complex osteo-articular structure made by a series of “supporting” components that are the vertebrae, joined together by a set of ligaments and muscles and separated by the interposition of fibro-cartilaginous disks. The spine, which goes from the base of the neck to the gluteus, is divided into three fundamental parts: the cervical spine, the dorsal spine and the lumbar spine. It is an elastic structure that allows movement and bending. However, because of its elasticity, even an incorrect torsion can bring pain to the spine, muscles and ligaments that keep the vertebrae united.
In many cases, we could replace the word “backache” with “lumbago” and we could almost be sure of not being wrong. In fact, in most cases, the pain is in the lowest part of the back, the lumbar and lumbosacral spine. In these cases, pain is dull and not well-defined; it irradiates to the gluteus, to the back of the thighs and down to the calf and foot. It can be located on both sides or, more frequently, only on one side. The pain often starts subtly, with a sort of stiffening and a progressive difficulty in movement. In these cases, it is important to distinguish between acute phases, when the pain spontaneously disappears between the third and fourth week, sub-acute forms, which last less than 12 weeks, and chronic forms, which last more than 12 weeks and have frequent recurring episodes. Finally, there are backaches with a dramatic and sudden onset known as “back strain,” an acute lumbago or dorsalgia, depending on whether the pain is in the upper chest or on the first lumbar vertebrae.
There is only one cause for backache: lifestyle. The way in which we sleep, work whether seated or standing up, and perform those efforts that characterize our daily life all determine a load increase or decrease on the spine. In these cases, there can occur distortions or muscle strains that may cause backaches. Even the posture is a risk factor for backaches.
The diagnosis is mainly clinical and, only in a small percentage of cases, exams are necessary. After a careful check-up and a deep case history, if there are no other significant events, such as a recent trauma, important weight loss, neuritic sufferance due to an impairment of sensitivity and movement, or a tumor in one’s medical history, it is not necessary that the patient undergoes X-rays, CAT or magnetic resonance imaging. A careful case history will tell which excessive stresses or activities have determined the backache.
The therapy must be both symptomatic and causal. In the acute phase, it is necessary to eliminate pain to prevent the patient from being immobilized. In this phase, pain-killing drugs are better than anti-inflammatory ones. Avoid resting in bed for long periods of time and, after the acute phase, try to understand the causes of the backache and face them with other therapies. During this phase, acupuncture, manipulation, massages, osteopathy, ultrasounds are useful to prevent the pain from becoming chronic.
The best solution is to learn to respect our back through a correct lifestyle, alternating the positions, performing movements correctly and having an active life, and never forgetting to have half an hour of walking every day while wearing comfortable shoes. Use your back properly and find a good compromise between movement and posture. Then, as years pass by, thermal mud cycles and bath therapies can be useful, provided that they are taken in a suitable environment and for a minimum duration of 12 applications.