Back Pain

A few years ago, back pain was called (perhaps a little dramatically), 'the disease of the century'. Actually, it is not strictly speaking a disease, but a symptom - a precise diagnosis is needed, for the pain has many causes. It is very often due to poor functioning of the spinal column and of the muscles and/or ligaments that support it. Back pain is extremely common, accounting for almost as many visits to the doctor as ear, nose, and throat problems. Men whose backs are strained by their work, or by the long journey needed to get to work (driving ++). tend to complain of lumbar (or lower back) pain. Women, on the other hand, are more prone to pain in the cervical (neck) and dorsal (upper back) areas. Factors such as an uncomfortable sitting position at work, housework, and stress (++) can trigger or aggravate this pain.

Problems with rheumatic ailments cause millions of people per year to see their doctor, with pain as their only symptom in common. Back pain can generally be divided into the following categories:

-lumbago, accounting for two thirds of the cases
- sciatica, in 20 per cent of the cases
- cervical pain, in 20 per cent
- dorsal pain, in 10 per cent

Preventive measures

These are of vital importance and can be divided into five groups:

• Movement
  - You should try to spare your back whenever possible, always seeking out a comfortable position for it
  - Avoid any movement that causes pain, and treat pain signals as a warning
  - Be wary of leaning forward, the familiar 'touch your toes' position from gym lessons, as it opens up the spaces between the vertebrae and may cause the disc to come into contact with the annulus fibrosus
  - Be careful with twisting movements, for example, when you turn round to pick up a file or answer the telephone
  - Be careful when stretching up to reach something, such as when putting a book back on a high shelf
  - Crouch down on your knees when reaching down to the floor, and take the weight on your hands when you get up again, ungraceful though it might look. Strengthen and maintain the muscles of the abdominal wall; when you use your abdominal muscles, you reduce the pressure exerted on the discs by one-third
• Choice of exercise: any form of exercise is more or less injurious to the back, but be especially careful about weightlifting, judo, and tennis. Swimming, on the other hand, is highly recommended
• Equipment: you should avoid long walks or sports activities when you do not have suitable shoes, and wear warm clothing if it is cold
• Mattress and furniture: these should 'firm', neither too soft nor too hard
• Dietary measures your diet should be ,alanced and varied, and should include sufficient portions of magnesium and calcium Keep your weight under control, as excess weight only increases the strain on the back

Three principles derived from the sport of weightlifting should always be used when lifting heavy objects: (1) keep as close to the load as possible; (2) keep your back straight; (3) lock the muscles of the back when making the lift.

Manipulation of the spine

This is at the heart of many treatments, whether they are called osteopathy, chiropractic, or occasionally vertebrotherapy. Osteopathy and chiropractic are both very popular in Britain and the US.
Osteopathy is possibly better known, but chiropractic often seems more attractive because it is perceived as more gentle. Both are generally pleasant experiences and practically risk-free, contrary to what might be said or imagined

Treatment Schedule: three sessions one week apart should be quite sufficient in most cases.

All these manipulation methods require both 'brains' and 'brawn': a competent practitioner, the right diagnosis, complete technical mastery, and trained hands.

Acupuncture

This is one of acupuncture's most appropriate applications, and it should be systematically suggested for back pain.

Treatment Schedule: it can be used for acute episodes at a relatively intensive rate of one session every two or three days, reducing the frequency once improvement has begun.

Mesotherapy

This therapy can be used alone or in combination with others. The micro­injections of diluted treatments directly into the affected area act relatively quickly in having an effect on spasms and muscle pains.

Treatment Schedule: two sessions several days apart should be enough in most cases.

Acupuncture and/or mesotherapy are an excellent alternative when the patient's condition rules out manipulation of the spine, whether temporarily or permanently.

Pool exercise

This mild form of exercise can be recommended to patients of all ages, because, as Archimedes demonstrated, water supports and relieves the burden on the back, while still allowing it to exercise full mobility. As well as health spas, more and more fitness centres are also offering this type of therapy.

Homeopathy

Bryonia

- Four 5c tablets, to be sucked slowly, four times a day between meals

Bryonia alba

- Vegetable origin the fresh root of white bryony
-The homeopathic remedy for pain made worse by the slightest movement -Two specific indications: the pain eases when pressure is applied or when the patient lies on the painful side

• You can also try Bryaconeel@ (Heel), containing Bryonia D4, Aconitum D4 and Phosphorus D5:
  -Available in packs of 50 and 250 tablets
  -In general one tablet to be dissolved under the tongue three times daily. In acute disorders, initially one tablet every 15 minutes

Or you can take Rheuma-Heel@ (Heel), containing Bryonia D4, Rhus toxicodendron D6, Arnica D4...
-Available in packs containing 50 and 250 tablets
-One tablet to be dissolved under the tongue three times daily

Herbal remedies

Devil's claw and white willow

These two plants can be prepared and packaged by your herbalist, either individually or combined in a mother tincture powdered in capsules, or as dried extracts.

Sample Prescription: obtain a 30ml bottle of mother tincture of white willow (known as the 'aspirin plant'), and take 30 drops in a little water twice a day. You can also massage your back with a devil's claw gel made up by your herbalist.

Devil's claw (harpagophytum)

This creeping perennial from southwest Africa has long been used by the 'witch doctors' of Namibia to relieve rheumatic pain. It comes by the name 'devil's claw' because its fruits catch the hooves of unwary antelope.

White willow

This plant has been used empirically since antiquity to treat rheumatic pain and fever. Its effectiveness comes from its high salicylic acid content - this is the main ingredient of aspirin, first synthesized from the plant in the 19th century.

• You could also try 'Bioforce' Oevil's Claw in tincture form:
  - Available in drop bottles of 50ml
  - Take 15 drops in a little water, three times daily before meals
• Alternatively you could take ARENCAP@ (Thorne), which includes extracts of devil's claw, turmeric and Boswellia as well as glucosamine sulphate and MSM:
  - Available in containers of 240 capsules
  - Take four capsules twice daily.

Oligotherapy

Magnesium is highly recommended for its muscle-relaxing properties.

This trace element usually comes from the diet, which should be varied and of high quality. In cases of deficiency, which often occurs with magnesium, it can be given as a medicinal supplement.

• Magnesium treatment: this is available in various brands and formats, such as Organic Minerals (Colloidals) which contains 70+ trace minerals:

- Available in 946ml bottles
- Take 1-3 caps just before breakfast and/or evening meal
- Children 1 teaspoon daily for each 20lbs of body weight

Or Maximol (Ionized colloidals):

- Available in 500ml bottles
- Take 1/2 capful once or twice daily on an empty stomach

• In the case of serious muscle spasm, you could try a higher dose magnesium supplement, such as Magasorb@ (Lamberts) containing 150mg of magnesium (as citrate):
  - Available in containers of 60 and 180 tablets
  - One to three tablets daily.