Understanding and combatting your back pain

More than 3.5 million Canadians suffer from back pain. You're more likely to experience back pain if your posture is poor, you're overweight or the psychological stress in your life veers out of control.

The human back is made up of a column of intricately connected but separate bones, which are called vertebrae.

• A complicated lacing of ligaments, tendons and muscles holds the vertebrae together in a flexible chain, with disks between them acting as shock absorbers.
• The spinal cord tunnels through the vertebrae, and from the cord, a vast network of nerves emerge.
• It is subjected to pressure, twisting and bending. Back pain is the inevitable result — from ligaments that sprain, muscles that strain, disks that rupture, nerves that get pinched or joints that get irritated.
• Back pain is labelled "acute" if it’s intense and comes on suddenly.
• If the pain doesn't subside with standard treatments and lasts six months or more, it’s considered "chronic."
• Back pain can affect all aspects of your life, from how you move around your house to how well you do your job.
• Because of it, you may feel sleep-deprived, physically and emotionally off-balance, and even depressed.
• To make matters worse, even the best diagnostic test might not be able to pinpoint a cause.

For acute low back pain

• Alternate applications of cold pack and heat.
• Take over-the-counter pain medications, or prescription drugs if the pain is severe.
• Return to normal activities as rapidly as possible.

For chronic back pain

• Visit a doctor or chiropractor to assess the nature, degree and cause of the pain.
• Pursue daily stretching and strengthening exercises.
• Try medications, including acetaminophen, NSAIDs, antidepressants, antispasmodics and opioids.

Try alternating drugs:

• Since acetaminophen and NSAIDs work differently, you can safely combine the two for more complete pain coverage.
• A long-acting NSAID such as Naprosyn is a good choice to take along with the shorter-acting Tylenol.

Consider a back brace:

• If you have to stand or sit much of the time try a back brace.
• Properly fit and correctly worn, it can comfort and support you.
• Don't overdo it: a back brace limits normal movement, detracts from muscle conditioning and reinforces the notion that your back needs protection.

Deal with your anxiety:

• This can make back pain worse.
• Anti-anxiety drugs (benzodiazepines are the classic choice) can blunt the jitters, although becoming dependent on them (physically and psychologically) is a risk. SSRI antidepressants also lessen anxiety but aren't habit-forming.

Try the Alexander technique:

• Trainers of this mind-body re-education method use verbal instruction and gentle touch to teach proper alignment of the head, neck and spine.
• The goal is to replace bad postural habits with good ones.

Beware of "miracle cures:"

• There aren't any. Back pain is simply too varied and complex.
• On the list: spinal traction, permanent bipolar magnets and facet injections (steroids or anesthetics injected into connections between adjoining vertebrae).

• The North American Chronic Pain Association of Canada (1-866-470-PAIN or www.chronicpaincanada.com) offers links to support groups devoted to those living with chronic pain.
• The website of the Canadian Chiropractic Association (1-800-668-2076 or www.ccachiro.org) has tips to avoid back injury and strain, the latest research, links to provincial assocations and a custom search engine to help you find a licensed chiropractor in your area.
• To find a reputable acupuncture practitioner, contact the Acupuncture Foundation of Canada (416-792-3988 or www.afcinstitute.com), which has a list of certified Canadian acupuncture practitioners on its website.

Back pain is a brutal reality of many lives. Try these tips to help combat back pain, and be sure to talk to a doctor if these tips do not help.