Back pain is very common and can be severe and debilitating either in acute episodes, or as chronic pain suffered over a long period of time that is both uncomfortable and fatiguing. Why does back pain occur There are many different reasons for back pain, and if prevention and treatment is to be most effective it is important to have a good understanding of the cause. The onset can often be traced to an accident or trauma, even one that occurred many years previously.

Accumulation of stresses in the body Back pain often does not arise immediately after an injury because the body is very good at adapting to injuries and accommodating strains and stresses. However, the disruption to spinal mechanics causes strain to build up over a period of time and symptoms begin, often insidiously. Episodes of pain may be triggered by events such as physical exertion, emotional stress or illness. Sometimes a minor strain may give more pain and take longer to heal than expected. This may be because the body has reached the limits of its ability to cope with the combined effects of past injuries, and any new demand is ʻthe final strawʼ. In treatment it is often necessary to release the retained stresses from past injuries and traumas in order to relieve the current back pain, and reduce the chances of it occurring.

Other symptoms Stresses within the body often cause problems in other areas as well as the back. Common associated symptoms are undue fatigue, mood swings or depression, disturbed sleep, headache, period problems, digestive problems, vulnerability to infections due to a depleted immune system. Many of these improve during a course of osteopathic treatment. Common types of trauma and injury

There are certain types of accidents that are common contributors to back pain, even if they did not cause pain at the time. The most common ones are described here, but it is by no means a comprehensive list.

Occupational Strain Habitual bad posture such as poor seating at computers can place strain on areas of the spine and lead to back pain. The seating position should be improved, as well as using osteopathic treatment to release ingrained spinal stresses.

Lifting Strains Lifting heavy or awkward weights including babies, children and shopping can cause back strain, especially if not done correctly. If the spine is already under stress from another cause, it may only take a small lifting strain to cause strain, usually occurring at the weakest point in the spine.

Car Accidents In any car accident, even at relatively low speed, the body is subjected to sudden deceleration forces and can be thrown around violently in many different directions. Osteopaths are often able to feel components of the directional stresses locked into the body tissues after a whiplash accident. The whole body is affected, not just the neck, and unless these strains are treated they are present for life. Common findings after whiplash accidents:- Neck: Overstrain of the neck muscles and ligaments. This often causes persistent neck pain and headaches, and may lead to arthritis. Low Back: The sacrum or the tail bone at the base of the spine often becomes wedged down into the pelvis, leaving it rigid and immobile. This is one of the most important effects to release in the treatment of any whiplash, because it can disturb the function of the whole spine. Rib cage: Twisting and compression through the rib cage from the seat belt restraint. Common problems in this area resulting from whiplash injuries are shoulder pain, indigestion, heartburn, gall bladder problems and chest complaints (pain or asthma).

Falls The spine is often jerked or twisted during falls, and parts can become quite impacted or compressed. Sit-down falls such as falling on ice or a slippery surface are particularly damaging because in addition to the direct impact on the base of the spine, the impact of the head onto the top of the spine causes strain at the top of the neck. Headaches and neck problems are very common after this type of injury.

Direct Injury Any direct injury, for example kicks or blows to the spine can create a local area of disruption of normal spinal mechanics. Problems may gradually develop over a period of time, even if the back seemed uninjured at the time. Blows to the Head Blows to the head can disrupt the normal minute movements of the bones of the skull, a situation that has far reaching effects on the whole of the rest of the body. Posture may be modified by blows to the head as the spine adapts to the injury, which can cause areas of strain.

Childbirth strains During childbirth the motherʼs pelvis can become distorted as the babyʼs head descends. In many cases the distortion corrects itself, but if severe it can remain for many years and disrupt spinal and pelvic mechanics. This can cause very diverse symptoms including backache, constipation, stress incontinence, headaches, disruption of periods when they start again, and even postnatal depression.

Dental Trauma Uneven bite, bridges, plates and extractions can all have far reaching effects on the body. (See Osteopathy and Dentistry)

Self Help for Back Sufferers Whilst every person is different, there are a few general rules to observe to help reduce or precent back pain. If in doubt consult your Osteopath. Lifting When lifting, stand straight in front of the object to be lifted and hold weights close to the body. Bend the knees and keep the back as straight as possible. Sitting Do not slouch in chairs with the lower back unsupported. Push your bottom well back into the seat of a chair and sit tall. Chairs with seats that tilt forwards keep the spine well balanced and strain free. Be sensible with physical exertion. If you are unfit then muscles fatigue easily and injury is more likely. Short bursts of heavy activity should be interspersed with more gentle tasks. If it hurts, stop! Pain is there for a reason. If you take heed of the early warning signs, it is often possible to prevent the situation getting worse. Painkillers mask the early warning signs, so take extra care if using them. Do whatever is most comfortable, now what is most convenient! Gentle exercise helps improve flexibility and muscle strength. Yoga and swimming are both beneficial. Try a small amount of activity the first time, and see what effects it has if any the next day. If all is well, a little more of the chosen exercise can be done next time. Seek osteopathic treatment if your back pain does not go away within a week or two. After an acute episode of back pain, check with your osteopath about when it is safe and advisable to resume exercise.

Osteopathic Treatment Osteopaths are skilled in assessing the mechanics of the whole body, in particular the spine. They use a variety of manipulative techniques, most extremely gentle, to restore a state of balance and ease to the movement and function of the spine. This both relieves pain and discomfort, and reduces wear and tear on the spine that leads to arthritis. When to consult an Osteopath Prevention is better than cure, and it is often easier for an osteopath to treat underlying stresses and strains when there is no current back pain. You do not have to have the pain on the day of the treatment. It is better to consult an Osteopath before back pain becomes severe. Most back pain is easier to treat in its early stages, and it is important to minimise structural damage or arthritis that can be caused by uneven load on weak areas of the spine.

Text taken from patient information produced by Elizabeth and Clive Hayden