BACKACHEAND ITS CAUSES

Backache is a rather common condition and often seems to be the only disturbing symptom in people otherwise in reasonably good health. It is a common symptom of many diseases, as well. By the term backache usually is meant a lumber pain, beginning in the region of the first lumber vertebra and extending downward along the “small of the back”. The pain may be in the center of the back, along the spine, or on either one or both sides of the spine; and it may affect any region of the back.

There are a great many causes of backache, but the largest number result from strain, fatigue and lack of balance. Strain may result from unnatural posture while sitting, standing and walking, or trom a one-sided occupation. Those who carry weight on one side, such as postmen, or children with their school books usually over one shoulder, may have considerable backache--and may develop definite spinal curvature. Other causes of strain are a poor muscular balance or abnormal abdominal conditions, such as enlarged or prolapsed organs, obesity, etc. Fatigue often results from a constant attitude in such occupations as require stooping, bending or lifting heavy objects. In many cases abnormal muscular balance results from fallen or broken arches of the feet or from the use of poorly fitting shoes. In these cases the pain usually extends upwards from the lower extremities to the back. High heels are very prolific causes of backache. The natural foot is constructed to walk best in a horizontal position, with the heel no higher than the sole of the foot. The muscles are designed to support the body best in this position. When heels of two or more inches in height are worn it is necessary for the muscles of the back to be unnaturally tensed in order to support the trunk in the erect position; also the pelvic bones must tip in an unnatural position, placing stress upon certain muscles and ligaments, and pains or aches will result in some degree. Backache sometimes becomes so constant or frequent that a patient, with unstable nervous system or neurotic in natural will develop a condition of the mind that allows mental concentration on the back with the resultant pain, in the back continuing, although it may originate from some other source. Such a spine is know as “hysterical spine.” Treatment in such cases must be general and directed toward relieving and curing the neurotic tendencies, and the nervous system must be restored to normal balance. However, local treatments will be of value and should include heat by a means, massage, vibration, probably specific spine manipulation etc. A more or less similar condition results from physical shock without a definite injury to the spine or with a slight injury that should be quickly corrected. The backache lingers and the patient becomes neurotic. This condition is called “ rail-road spine”. It requires the same type of treatment, as does the hysterical spine. Backaches not infrequently result from nerve inflammation or neuritis either of a simple type or as a part of a multiple neuritis resulting from alcoholism, lead-poisoning or diabetes. The alcohol or lead must be removed from the system and the diabetes must be properly treated to correct these backaches. There are many backaches resulting from a focus of infection elsewhere. Such infections may be acute or chronic tonsillitis, apical (tooth-root) abscesses, gonorrhea, pneumonia or influenza. The last two are acute conditions and the pain usually is in the early stages. In these disorders there usually are other symptoms pointing to the causative condition. The backache will subside when the infection disappears by proper treatment. It may be necessary to resort to a rigid course of diet, baths, manipulations, water treatments and so on. Infected tooth abscesses must receive the proper dental attention; the backache may or may not need special treatment, but usually this will be necessary also. Other infections causing backache are tuberculosis and typhoid fever. A deformity frequently results in the case of tuberculosis. This condition requires quiet, rest on a fairly rigid bed and a nourishing diet of natural foods, avoidance of constipation, proper care of the skin by sun, air, friction, and cool sponge baths, plenty of fresh air and sleep. Typhoid fever may produce a rigid tender spine with considerable aching. This usually disappears upon the clearing up of the typhoid fever, but local back treatment may help it to disappear more quickly. Many backaches are due to relaxation of the joints of the lower spine and hipbones or to a natural rigidity of the ligaments in these regions. There may be a genuine arthritic development in these joints, due to rheumatic or other infections. Long illness and surgical operations requiring prolonged lying in bed may cause relaxation of the joints of the lower spine and hips. Sleeping on a bed with very relaxed springs, on which one assumes such a posture as in a hammock, may produce similar conditions. Using harder bedsprings, taking cool baths and exercises will clear up many of these cases. Strapping may be necessary for a time when the relaxation is extreme. Specific manipulative treatments, osteopathy especially, will be very beneficial in most of these cases. Backaches often result from prosthetic disease in men and from diseases and displacements peculiar to women. The ache in these cases is in the lumbar or sacral region or between the shoulders or in all of these regions. These conditions must be overcome by appropriate treatment to reduce inflammations, congestions, enlargements or malpositions, as the case may be. Sudden twists and turns may result in backache, especially when the muscles and ligaments supporting the backbone are abnormally relaxed. Hot and cold applications, hot and cold sitz-baths, more or less rest for a time, and sometimes strapping, will take care of these cases. Kidney disease, pendulous abdomen, and prolepses of the stomach or other abdominal organs frequently result in backache. Special treatment for the causative condition will be necessary. Diet will prove very important, as well as proper posture, and any other general measures seemingly indicated, together with considerable local treatment. Kidney disorders may require a very strict dietetic and general treatment (see Kidney Disease). Constipation is a very frequent cause of backache, and this form readily responds to treatment that will correct the constipation. Included in this treatment should be proper diet and exercise, but local treatment to the back may be given to hasten the cure of the constipation as well as to overcome the backache. Other causes of backache are spinal curvature, often-mild degrees of curvature that are not suspected; hysteria and neurasthenia: ulcer of the stomach, liver congestion, gall-stones, hemorrhoids, cystitis or inflation of the bladder, and lumbago. All of these will require direct and specific treatment for the underlying cause. From the above it will be seen that the causes of backache are many and common and, while local measures will be of value in all case, the underlying condition should be discovered if possible, and this condition should receive proper treatment. Lumbago often is a term applied to fit any type of ache or pain occurring in the lumbar region. True lumbago is not a particularly common condition. It is a severe paroxysmal form of muscular rheumatism involving the muscles of the loins and their tendon attachments. With this condition one may be unable to twist or turn the back or to rise to an erect position after stooping. Even the jar of walking or riding in a motorcar may cause pain. In the treatment of this condition hot-water applications and especially the hot sitz-bath followed by proper applied by an electric pad in order to maintain uniform heat for a considerable length of time. Hot-water bottles may be used satisfactorily in many cases. Usually there should be a proper eliminative diet. Constipation should be corrected; and as a rule manipulation and vibratory treatment should be applied, beginning very gently and increasing with successive treatments as the pain subsides.