Back pain is a discomfort most commonly located in the lumbar (lower) region of the spine and surrounding tissues. It is an extremely common ailment and is most often caused by injury or stress to a muscle, ligament, bone, or nerve. Low back pain can become chronic if the cause of the discomfort is not properly treated.
Question: What are common causes of back pain?
The most common causes of back pain are sudden tears or strains of the muscles, tendons, or ligaments of the back. The area of such tears is tender to the touch, and the pain is increased by moving about.
Pain also can be caused by chronic strain to the back caused by curvatures of the spine (lordosis, kyphosis, scoliosis), having one leg shorter than the other, bad posture, or repetitive lifting of heavy objects.
Question: What is a slipped disk?
A "slipped," or herniated, disk occurs when one of the intervertebral disks, which serve to separate the vertebrae and act to absorb the shock of motion, slips out of place. This displacement can compress a spinal nerve and place a strain on the surrounding ligaments. This can also result in sciatica, where pressure on the sciatic nerve causes pain down one or both of the legs.
Question: What other spinal disorders cause back pain?
Pain can result from osteoarthritis, where the roughened surface of the bone results in local irritation. In osteoporosis, the bones become brittle due to lack of calcium; vertebrae can, therefore, collapse, resulting in pain and possible nerve compression. In young and middle-aged people, a disorder that causes the vertebrae to fuse together (ankylosing spondylitis) produces pain and gradual stiffening of the spine. Also cancer can spread to a vertebra with resulting pain.
Chronic deformities of the spine (lordosis, kyphosis, scoliosis) can result in pain, as can a condition called spondylolisthesis, in which one or more vertebrae are not correctly formed. This can lead to partial dislocation of the spine.
Question: What nerve disorders cause back pain?
A tumor of the spine can cause back pain. But, more commonly, back pain of neurologic origin results from inflammation of a nerve.
Question: Apart from causes directly associated with the spine, what other disorders can result in backache?
A low ache in the back often occurs in women before the onset of menstruation or as part of a painful menstrual period (dysmenorrheal). Other gynecological disorders may also cause backache.
Pain from a kidney infection (such as pyelonephritis) often occurs in the lower or mid-back. A dull ache high in the back may be a symptom of a chest disorder.
Question: What is the treatment for back pain?
Painkilling drugs, such as acetaminophen or aspirin, can be taken to relieve pain due to a minor strain of a ligament or muscle. For more severe pains, a physician may prescribe a strong, anti-inflammatory and/or muscle relaxant drug.
Rest can be a very important aid in back pain treatment. The patient should rest in a position that will straighten out the lower back, such as on the back with the knees supported in a bent position by a pillow, or lying on the side with the head supported by a pillow. A firm mattress is essential.
Treatment by physical therapy may include exercise, massage, or local heat. The spine may be carefully stretched using traction; a patient is usually hospitalized for this treatment.
If back pain is severe, prolonged, or accompanied by serious symptoms, such as a fever or a weakness in a leg, it is important that a physician be consulted immediately.
Question: What everyday precautions can help relieve or prevent back pain?
Correct posture, a firm mattress, and strengthening of the muscles by means of careful exercise all can help to relieve some types of backache. Maintaining correct body weight (by dieting, if necessary) also helps to prevent backache. Being overweight puts extra strain on the spine. It is important to remember, when lifting objects, to bend at the knees and hips, rather than at the waist. This allows use of more powerful leg muscles and avoids strain on the back. Also, when carrying something in the arms, it should be held close to the body, rather than with outstretched arms.
Hospitalization - Admission Procedures
The procedures you follow on admission to a hospital vary from one hospital to another, but basically the process is the same in most institutions in the United States.
Care of the Dying - Role of Friends
The friend can show appreciation of the work being done by the family and offer to stay with the patient if the family needs a little time away from home.
Care of the Dying - Death of an Older Child or an Adolescent
From the age of three years onward, a child begins to understand the concept of death and dying. The dying child feels protective toward his or her parents. Although the child desperately needs to talk about what is going to happen, he or she may never get close to the subject. The child may attach himself or herself to a nurse or physician while still relying on the parents. By doing this, the child is sharing the emotional responsibility. The parents may find this difficult to accept, but must realize that someone else can perhaps give more help by listening dispassionately to the child's fears and anxieties.
