Back pain is painful, common problem

Physical therapists at The Orthopedic Specialty Hospital see a variety of back strains and sprains and pre- and post-surgical patients with back ailments.

They see folks who've hurt themselves in auto accidents or who have athletic injuries or who shoveled too much snow or who twisted the wrong way.

They've treated patients complaining of back pain who are as young as 15 and others as old as 90. It's a painful and common problem with a broad reach.

Back pain is the topic of Saturday's Deseret Morning News/Intermountain Healthcare Hotline. From 10 a.m. to noon, TOSH physical therapists Aaron Swalberg and Barry Olsen, who both work extensively with the spine, will take phoned-in questions. All calls are confidential.

Attitude is important, says Olsen. "People need to think more positively than negatively if they hurt themselves. It's a myth that back pain means something really bad, that there's terrible spinal damage."

One of the big questions is when pain indicates you should seek medical help.

Olsen and Swalberg say difficulty urinating or controlling either the bowel or bladder indicates the need to see a doctor immediately. And there are certain associated problems that should never be ignored, including fever, chills, weight loss, enlarged lymph nodes and pain that's constant or so intense it wakes you up at night. Those can indicate other problems that can cause back pain, occasionally even cancer or something wrong with internal organs, among other things.

At the clinic, the physical therapists check patients as well for neurological signs and for abnormal reflexes, for difficulty with balance or coordination.

Decisions on how to treat back pain often depend on when someone seeks help, says Swalberg, who has a master's in physical therapy and orthopedic certification. "With certain types of back pain, the success rate is very high with manipulation or mobilization if we see someone in the first 16-19 days of onset."

For suspected strains and sprains, try ice on the spot, take over-the-counter anti-inflammatory medications, move around but don't overdo it and give it a little time, they say. Acute problems that result from a trauma such as a car crash or fall should be evaluated quickly.

The first reaction when people hurt their backs is to do nothing. Literally. "Bed rest used to be the standard treatment protocol. Then we found those who were not compliant with that type of treatment were doing better," Swalberg said.

People who moved around improved because movement and flexibility are essential to the back. The joints and disks in the spine only get nutrition through movement. And muscles need it, too.

With minor strains and sore muscles, ice is the first thing, along with simple over-the-counter anti-inflammatory medications such as acetaminophen or ibuprofen.

Back pain is less common in adolescents, although between one-fourth and one-third will experience some back pain by age 15. It goes up significantly for those 20-50 years old, then decreases again with age.

Tomorrow: Treatment and preventing recurrences

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E-mail: lois@desnews.com