Rheumatism: The Back- Lower Part |
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Aches in the lower part of the back have been the subject of thousands of books and articles.
Your backbones is a column of bones (vertebrae) like a pile of draughtsmen only bigger, 24 in all. Each attached to the next round the edges by a tough ring of fiber (the annulus). This ring encloses softer material (the nucleus), which separates the bones and prevents them sinking on to one another under your weight. The tough ring and the soft stuff together form what is known as an intervertebral disc, or just disc for short. This pattern, something tough round something soft, is the one used in the balls used in many sports: in goof it is rubber round something that looks like paint; in squash it is rubber round air; in tennis it is rubber and fabric round air. In the spine it allows a little movement but prevents damage to the spinal cord which lies down the back of it and carries the nerves connecting the brain with the rest of the body.
Sometimes the fibers of the annulus tear and allow the soft center to ooze out and press on the spinal cord or the nerves joined to it; this sends messages about pain to the brain. It is not really accurate to say that the disc slips: if it did slip it would have to be detached from the bone above it or below it, and the bone would then be free to move and squash the spinal cord, which would disastrous. 'Slipped disc', however, remains a useful term and is certainly easier to say than 'prolapsed intervertebral disc' or 'prolapsed of the nucleus pulposus'.
Another thing that is blamed by some people for causing backache is the sacro-iliac joint. There are two such joints, joining the spine to the two halves of the pelvis; they are normally almost immobile but may sometimes become loose and painful, especially in the later stages of pregnancy.
Despite all this theory the treatment of backache caused by rheumatism runs along the same lines as that of neck-ache. If the pain comes on suddenly manipulation may help: if it comes on gradually or repeatedly manipulation is unlikely to help. Whatever the cause, strict rest, by which it means bed rest 23 hours a day, will quickly right a severe backache. All backaches are helped by the usual combination of warmth (hot water bottle), massage and pain relieving drugs: it is a good idea to take the drugs at night, even if the pain is wearing off, so that the sleeplessness does not add to your discomfort.
When the pain is wearing off special exercises may help. You should take professional advice before starting exercises.
If the pain will not go completely or keeps on and on coming back you may have to consider wearing a surgical corset. This is a way of preventing the back from bending so far that the muscles work at an awkward handle or so far that a slipped disc can slip again. A corset is, however, open to the the same objection as arch supports that it may, by taking the strain off the muscles, allow them to become weak and incapable of doing their job. Footwear and posture may also deserve attention.
Backache caused by rheumatism is a condition that occurs in spells of days or weeks at a time and then goes away. You have to learn the best balance between rest and exercise which makes your recovery most speedy. If the backache continues unrelenting for week after week then it is probably not caused by rheumatism. |
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