In developed societies, back pain has acquired the characteristics of an epidemic and is considered one of the most relevant health problems. It affects more than 80% of the population at some point in their lives.
To better understand this concept, we must make appropriate distinctions, since this type of discomfort receives a different name depending on the part of the back where it is experienced. The terms are formed by joining the suffix -algia (meaning pain) to each of the vertebral regions. Thus, we have cervicalgia, when it affects the cervical area (neck); dorsalgia, if the dorsal region hurts; and low back pain, in the lower part.
It is common to find these words in a multitude of clinical reports, but they do not really correspond to a diagnosis: we are simply indicating that there is pain in a specific region.
When do you have to worry?
Although almost the entire population will experience back pain at some point in their lives, fortunately it is not serious in most cases. In a large percentage, it decreases a month after starting.
Physiotherapists and doctors use the expression “red flags” (translation from English red flags) for those signs and symptoms that could reveal a serious disease in the spine or another part of the body.
Some warning signs are experiencing sensory and muscular alterations (tingling in the limbs, loss of strength, urinary incontinence…), losing weight without justification, having suffered a blow, feeling pain in the thoracic region or having a fever.
For this reason, although back pain is usually benign, a health professional should be consulted whenever there are doubts. As long as there are no red flags, we must remain calm, because there are no signs of serious pathology.
Does the way you deal with it influence your evolution?
Psychosocial factors, called “yellow flags”, are essential for pain to last for a long time. That is, it becomes chronic.
Some examples of yellow flags are: adopting a negative attitude (we must keep in mind that a lot of pain is not synonymous with serious injury or disability); stop doing physical activities for fear of discomfort or that the problem will worsen (the so-called kinesiophobia); thinking that passive treatments are better than exercise; and also face social, family or financial problems.
If my back hurts, should I get an X-ray?
It is a decision that must be made by the doctor, because X-rays are not innocuous. After the age of 50 it is normal to suffer from degenerative processes in the spine or alterations in the intervertebral discs, but people without discomfort also suffer from it.
In the end, the diagnosis of these ailments through imaging tests contributes to over-medicalizing patients and increasing the number of sick days.
The International Association for the Study of Pain indicates that pain is non-specific (cannot be associated with a specific problem) in 85% of cases. For this reason, X-rays are often used when there are red flags.
What are the best exercises to combat it, according to science?
Considering all the options available, from zone-specific activities to full-body exercises, it’s hard to summarize without leaving out relevant information. The physiotherapist will prescribe it based on the needs and pathology of each patient.
In long-term low back pain, the international network of experts Cochrane Collaboration indicates that therapeutic exercise is more effective than other interventions or treatments, but no program demonstrates a clear advantage over others.
However, some recent publications do venture to propose Pilates and the Mckenzie method exercises (which focus on back extension movements) as notable for relieving low back pain.
Can I do sports after having suffered it?
A sedentary lifestyle, a great enemy of our health in general, favors back pain to lengthen and generate greater disability. Therefore, rest must be duly justified and limited to the minimum possible time.
We must choose the appropriate discipline and have the advice of an expert. This is the case of swimming, whose practice must be supervised if we opt for the butterfly style. In cycling we must adjust the position in the saddle to maintain a proper posture.
