The Back Pain Blog

While the computer age has done wonders for our society in general, it certainly hasn’t done us back pain sufferers any favors. More and more of us are spending time in front of a pc, whether it be for work or just surfing the world wide web, in fact I’m not physic but I bet you are sitting in front of a computer screen right now . Seriously though, it can play absolute havoc with our back, neck and shoulders but if you can follow these tips I’m sure that your suffering will be limited. 

• An adjustable chair with good back support is a must. If your chair is lacking in back support a small pillow placed in the small of your back can help and if you already have a back complaint a kneeling chair may also be a good option as they transfer your bodies weight from your lower spine and hips to your legs. They can take a while to get used to though!
• Have your chair set a height that allows your feet to rest flat on the floor with your knees slightly higher or level with your hips. If you find the chair is to high use a platform to support your feet. Do Not tuck your feet under the chair!
• A chair that reclines slightly is also useful in moving your body’s weight on to the back rest rather than your spine taking all of the weight. Also keep the chair close to the desk to help maintain a more upright position.
• Keep your head up and avoid leaning forward. Place any typing material on an angle rather than flat on the desk where you have to continually lean forward to read them.
• Position the top of your screen just below eye level and close enough so that you don’t have to lean forward or move your head in any way to read it and have enough room in front and beside your keyboard to rest your hands and wrists. Your shoulders should be able to ‘hang’ loosely without any muscle tension.
• Above all, take frequent breaks away from your desk. The human body is not designed to sit idle in one place for any great length of time. Once muscle fatigue sets in it is almost impossible to maintain good posture. Even if you can manage two minutes every hour away from your desk, preferably walking rather than just standing you will feel a lot better for it.

I find it takes a lot of concentration to maintain good posture for any length of time when I’m working at my computer and quite often I resort to using an alarm clock to remind me that it is time to get up and go for a walk. All of the other tips mentioned do help to some degree but I find that there is no substitute for taking a break and stretching and walking around. I’d love to hear from you if you have any other tips for limiting your pain while sitting for long periods of time.

Take Care,

Craig

Source – Columbia University Press Release

Finding, in Animal Model, Offers Proof of Principle that Inhibiting Serotonin in the Gut Could Become a Novel Treatment for Tens of Millions of Osteoporosis Sufferers.

NEW YORK (February 7, 2010) – An investigational drug that inhibits serotonin synthesis in the gut, administered orally once daily, effectively cured osteoporosis in mice and rats reports an international team led by researchers from Columbia University Medical Center, in the Feb. 7 issue of Nature Medicine. Serotonin in the gut has been shown in recent research to stall bone formation. The finding could lead to new therapies that build new bone; most current drugs for osteoporosis can only prevent the breakdown of old bone.

Gerard Karsenty, M.D., Ph.D.

“New therapies that inhibit the production of serotonin in the gut have the potential to become a novel class of drugs to be added to the therapeutic arsenal against osteoporosis,” said Gerard Karsenty, M.D., Ph.D., chair of the Department of Genetics and Development at Columbia University College of Physicians and Surgeons, lead author of the paper. “With tens of millions of people worldwide affected by this devastating and debilitating bone loss, there is an urgent need for new treatments that not only stop bone loss, but also build new bone. Using these findings, we are working hard to develop this type of treatment for human patients.”

The Nature Medicine paper follows on a major discovery, also made by Dr. Gerard Karsenty’s group (published in the Nov. 26, 2008 issue of Cell), that serotonin released by the gut inhibits bone formation, and that regulating the production of serotonin within the gut affects the formation of bone. Prior to this discovery, serotonin was primarily known as a neurotransmitter acting in the brain. Yet, 95 percent of the body’s serotonin is found in the gut, where its major function is to inhibit bone formation (the remaining five percent is in the brain, where it regulates mood, among other critical functions). By turning off the intestine’s release of serotonin, the team was able, in this new study, to cure osteoporosis in mice that had undergone menopause.

Based on their findings reported in the Cell paper, Dr. Karsenty and his team postulated that an inhibitor of serotonin synthesis should be an effective treatment for osteoporosis. Shortly thereafter, they read about an investigational drug, known as LP533401, which is able to inhibit serotonin in the gut. “When we learned of this compound, we thought that it was important to test it as proof of principle that there could be novel ways to treat osteoporosis with therapies that can be taken orally and regulate the formation of serotonin,” said Dr. Karsenty.

Dr. Karsenty and his team developed a research protocol to test their theory, where they administered the compound orally, once daily, at a small dose, for up to six weeks to rodents experiencing post-menopausal osteoporosis. Results demonstrated that osteoporosis was prevented from developing, or when already present, could be fully cured. Of critical importance, levels of serotonin were normal in the brain, which indicated that the compound did not enter the general circulation and was unable to cross the blood-brain barrier, thereby avoiding many potential side effects.

Implications for the Treatment of Osteoporosis

Most osteoporosis drugs, including those currently under clinical investigation, do not generate new bone but rather, prevent the breakdown of old bone. Only one drug currently on the market can generate new bone – but it must be taken by injection once a day, and because it may increase the risk of bone cancer, at least in rats, its use is restricted for short-term use in women with severe osteoporosis.

“There is an urgent need to identify new, safe therapies that can increase bone formation on a long term basis and to such an extent that they compensate for the increase in bone resorption caused by menopause,” said Dr. Karsenty. “Furthermore, it is important to note that since this study was conducted in rodents, it will need further confirmation in human subjects.”

Osteoporosis: A Disease of Bone Mass Decline…

Osteoporosis is a growing public health concern, with the aging population and the incidence of post-menopausal osteoporosis on the rise. It is a disease of low bone mass, most often caused by an increase in bone resorption not compensated by a similar increase in bone formation.

Far from being inert, bone constantly undergoes renovation, with some cells responsible for removing old material and other cells responsible for creating new bone. In humans, after age 20, the balance between bone formation and breakdown tips toward breakdown, and bone mass starts to decline. In women, the rate of decline increases after menopause, when estrogen levels drop and cells that tear down old bone become overactive. Osteoporosis is a disease in which bones become fragile and porous, increasing the risk of breaks. It is diagnosed when bone mass drops below a certain level.

I don’t know about yourself but when I started suffering from back pain I thought it would be a simple case of going to my doctor and explaining what was going on and be handed a prescription and life would be good once again in a day or two.

Yeah right! Nearly five years later and countless hours spent reading and researching have led me to the conclusion that back pain is one of the most misunderstood and hard to treat conditions known to man (and woman of course!).

What frustrates me beyond comprehension is the minefield of information that you have to get through to try and get a reasonable understanding of what is going on with your body. Ask a dozen different doctors and you’re likely to get a dozen different answers, read a dozen books and they are all likely to spell out different reasons and treatment methods for your condition.

I’m probably only adding to the confusion by writing this article, but what I aim to do is to make a summary from all that I’ve read regarding each of the most common reasons for back pain. Now I must stress again that I am not a doctor, nor do I aspire to be one (although I wouldn’t mind the income!), I am just a chronic back pain sufferer looking for answers.

First off we will take a look at the most common reasons for back pain today and then follow up with the suggested treatments for each condition in future posts. I hope you find this article helpful, living in pain is not what life is all about surely!

Reason Number One – Muscle Strains and Ligament Sprains

Back muscle strains are said to be the cause of around 85% of back pain cases. What is interesting about this line of thought is that these strains and/or ligament sprains can be the cause of a great deal of referred pain and muscle imbalances that can affect the spine if not treated correctly and in a timely manner.

For example a muscle strain that is left untreated and the muscle still used in the daily routine can result in, among other things, a titled pelvis which can lead to a lot of lower back pain and in the worst case scenario, a herniated disk. What started out as a minor ‘niggle’ can lead to much worse things and according to a number of therapists, chiropractors and physiotherapists this is the most common cause of back pain in today’s society.

To quote a case from Steve Lockhart’s Bad Back Book, a thirteen year old girl here in Australia had a fall down some stairs when she was six years old and after being checked out by a doctor she was found to ‘only’ have muscle pain but no structural damage. Now at the age of thirteen she came to Steve for treatment of constant tiredness and muscle fatigue and it was found that her right leg was almost two inches shorted than her left leg and she had developed a scoliosis or curve in her spine. Steve believes that all of this was caused by tight muscles brought on by the fall and the seven years of growing that she did while this condition persisted. Interesting food for thought?

In my somewhat uneducated opinion this is where all of my problems started. As a motor mechanic it was almost considered to be normal to have a sore back after a day’s work and had I addressed this at the time instead of working for ten years like this I don’t think I would be facing the issues that I am now. What a dufus!

Reason Number Two – Herniated Disk or Bulging Disk

A herniated or bulging disk is the most common ’structural’ problem that causes back pain and the majority of back surgeries are carried out because of a herniated or bulging disk. The causes of this are thought to be either wear and tear over a period of time, a severe strain or a traumatic injury to the spine.

This condition is often accompanied by sciatic nerve pinching, rubbing or entrapment which results in sharp, shooting pain in the lower back, buttocks and legs otherwise known as Sciatica. This condition is caused by a bulging or herniated disk narrowing the hollow that the spinal cord passes through at the L4/L5 level. Irritation of the nerves occurs and if the outside or annulus of the disk has ruptured it is also possible for the fluid from inside the disk to irritate the nerves and cause discomfort.

Although in theory having surgery to correct a herniated or bulging disk seems to be the obvious choice, the success rate of these surgeries is reported to be around 75-85% and many therapists and doctors alike look at this kind of surgery as a last resort measure.

Once again many therapists see muscle imbalances as the root cause of a herniated or bulging disk. The thinking behind this is that through the muscle imbalances the disk is subjected to stresses and pressure that it wasn’t designed to handle. By successfully treating the imbalances the pressure can be relieved from the disk and it is given a chance to heal without the need for surgery.

Also related to the disk’s between the vertebrae is Discogenic Back Pain. This condition is thought to be responsible for quite a large number of back pain cases and is the result of damage to the intervertabral disk without actual herniation occurring. Diagnosis of this condition may require the use of a discogram.

Reason Number Three – Osteoarthritis 

Osteoarthritis is also related to the disk’s and vertebrae that make up the spine, only this is a degenerative condition that causes deterioration of the vertebrae and disks and often results in the body producing small bony growths on the vertebrae to compensate for this wear and tear. This condition can also affect the disks between the vertebrae  which reduces the cushioning effect of the disk and when combined with the bone spurs can lead to considerable back pain and stiffness.

The pain from Osteoarthritis can subside over time as the body adjusts to these new bone growths, however the stiffness of the back associated with this condition often continues because of reduced range of movement between the vertebrae. Because of the ‘wear and tear’ nature of Osteoarthritis it is not easily treated, however supplements such as Glucosamine, Chondroitin and Neurontin have been shown to help slow down the deterioration of cartilage, relieve joint pain and improve mobility.

Reason Number Four – Osteoporosis

This condition is mainly associated with age and it is the result of decreased levels of calcium in the bones resulting in a lower bone density and porous and brittle bones.

Carrying out daily tasks when you have Osteoporosis can bring on back pain by the fracturing of the front part of the weakened bones. Likewise a fall can have the same effect and these fractures are known as compression fractures.

Reason Number Five – Fibromyalgia

One of the most common and hard to treat conditions is Fibromyalgia. This condition is usually chronic and symptoms include fatigue and widespread pain in muscles, tendons and ligaments and increased pain in response to applied pressure. There are specific points on the body that are used to diagnose Fibromyalgia and tenderness or pain in at least eleven of these eighteen areas usually indicates the onset of Fibromyalgia.

The diagnosis and treatment of Fibromyalgia is still not a perfect science although there are a number of alternative treatments and medications that are reported to be helping people suffering from this condition.

Reason Number Six – Spinal Stenosis

Spinal Stenosis occurs when the disk or disk’s dry out and degenerates causing the hollow where the nerve exits from the spine to become narrow which places the nerve at a greater risk of being irritated. Aging is the main cause of Spinal Stenosis, however a herniated disk can also contribute to this condition, as can osteoporosis or a tumor.

Surgery can be an option although the success rate has been documented as quite low. Steroid epidural injections are often used to ease the pain of someone suffering from Spinal Stenosis and there is also a number of therapists that believe a combination of gentle exercise, a healthy diet and massage can be of use.

Reason Number Seven – Scoliosis and Scheuermann’s Disease

Scoliosis is the curvature of the spine resulting from stress in the surrounding muscles and nerves. This condition can be treated by a good massage therapist and by doing exercises that restore the strength to the failing muscles, although it can take some time and chronic aching pain is often endured until the condition is brought under control.

Scheuermann’s Disease is a hereditary disease that produces progressive rounding of the back and this condition can be treated in a similar way to Scoliosis.

Reason Number Eight – Spondylolysis

This condition comes about either from being born with or developing it through injury and it relates to defective vertebral arches. Thankfully this condition is present in only 3 to 7 percent of the population and it is usually the fifth lumbar vertebrae that is involved. This condition also creates the necessary conditions for one vertebrae to slip forward in relation to the one below it and once this has occurred the condition is then known as Spondylolisthesis.

Once again treatment by way of restoring and maintaining the strength of the back muscles can greatly impact on how much this condition affects daily life.

So there you have it, my quick run down on what the most common back pain conditions are, according to the research that I have done over the last few years. I hope that you have found this article useful and in the next few posts I will endeavour to write about the common ways that each of these conditions are treated.

While I do realise that every single person is different and their condition, symptoms and likely useful treatment methods are probably all different I feel that having all the common treatments listed in the one place will help to take the confusion out of selecting a likely treatment for your individual circumstances.

Like I said at the start the biggest problem I had was working out which treatment or method was worth trying, I certainly didn’t have the money to try them all and the research that I did just led to big time information overload! Hopefully we will go a long way to simplifying the process.

Take Care,

Craig