FEATURE Musculoskeletal
Back Pain
Back pain is a prevalent condition, to the point that exact and accurate statistics are not easily available. In 2001 it was estimated that 2.5 million people had back pain on any one day of the year. [1]
pain. The UK government has recently released a document outlining back pain and its effect on work related illness. This more recent study suggests that there has been a slight decline in the prevalence of back pain amongst working people however the numbers are still high. The report states that back pain continues to be a major ill health concern for the UK and the European Union in general. [2]
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With this in mind, and thinking of Community Pharmacy within Northern Ireland, having a full understanding of musculoskeletal disorders which affect the back are an important aspect of a community Pharmacists skills. Patients regularly present with lower and upper back pain and so it is important that evidenced based medicinal advice can be disseminated to patients, so that an
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his figure although now somewhat dated, indicates the scale of people affected by back
appropriate treatment or rehabilitation schedule to be implemented.
So what is back pain? Back pain is a problem that will be all-too familiar to some that can range from a constant ache to a sharp pain that can leave you entirely incapacitated. Back pain can come as a result of an accident, a fall, or lifting a heavy or cumbersome object – it can also develop slowly over a series of months or years as the result of age related changes to the spine. Regardless of how back pain occurs, patients will know when they have it.
Although anyone can have back pain, a number of factors can significantly increase a person risk of developing symptoms. Back pain becomes more common with age, with many people experiencing their first attack of back pain typically between the ages of 30 and 40 years.
Back pain is more common in patient who are not physically active, as relatively weaker back and abdominal muscles may not properly support the spine. Similarly, people who exercise excessively after periods of inactivity are more likely to injure muscles, compared to those people who regularly make moderate exercise a daily habit.
Healthcare professionals are urged to recommend to patients that they carry out regular and appropriate exercise – which will be determined by the person’s age, weight, and current health status. Diet can inadvertently have a negative impact on a person’s risk, as poor diet consisting of high calories and fat are often associated with an inactive lifestyle and as such, being overweight and inactive can put unnecessary stress on the spine column and back muscles.
Other factors include ethnicity, family history, presence of co-morbidities such as osteo- and rheumatoid arthritis, and occupational risk factors such as pulling/pushing or lifting heavy objects as part of your day-to- day routine.
For Community Pharmacists, it is important to note that back pain is a symptom of a medical condition, and not a diagnosis in itself. Medical conditions that cause back pain include:
• Mechanical problems – This broad category describes problems with how a person’s spine moves, or the feeling a person gets when they move their spine in a specific way. One of the most common mechanical causes of back pain is a condition called invertebral disk degeneration – the cushioning disks located between the vertebrae of the spine break down >
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