Lutful Aziz, FCPS, PHD, Consultant "analgesia", Pain
Causes Back Pain?
The back is a complex mechanical device, and one of the single most
studied areas of the body. However, a great deal of the time, a clear
cause to back pain is never found. Basically, anything that puts pressure
on your back muscles or nerves can cause pain. Any illness or damage
to your spine also can cause pain. The cause of most acute back pain
is unknown, but probably is due to minor strains, sprains and overuse.
Emotional stress may add to the pain, especially since it slows the
rate of recovery. Other possible causes of back pain are ruptured discs,
spinal stenosis, osteoarthritis, ankylosing spondylitis, injury, osteoporosis,
rheumatoid arthritis, fibromyalgia, pagets disease, cancers, and referred
pain form other locations. This by no means is a complete list.
causes acute low back pain?
There are many reasons for acute back pain, from muscles pulls, strains,
a disk problem in your spine, pinched nerves, arthritis or depression.
Acute low back symptoms can then be classified into one of three working
1. Potentially serious spinal condition-tumor, infection or spinal fracture,
or a major neurologic compromise, such as cauda equina syndrome
2. Sciatica-back-related lower limb symptoms suggesting lumbosacral
nerve root compromise.
3. Nonspecific back symptoms-occurring primarily in the back that do
not suggest nerve root compromise or a serious underlying condition.
Due to the back's complexity, even with modern technology, doctors aren't
always able to arrive at a simple diagnosis.
common is low back pain?
Low back problems affect virtually everyone at some time. Surveys indicate
a yearly prevalence of symptoms in 50 percent of working-age adults;
15 to 20 percent of these persons seek medical care. Low back problems
rank high among the reasons for physician office visits and are costly
in terms of medical treatment, lost productivity and other factors such
as diminished ability to perform or enjoy usual activities. In fact,
for persons under age 45, low back problems are the most common cause
of disability. Acute low back problems are defined as activity intolerance
due to lower back or back-related leg symptoms of less than three months'
can I prevent low back pain?
General physical fitness is the best way to prevent low back pain. However,
if you have had a problem with your back in the past, you are more likely
to have problems in the future. It is important to learn to lift heavy
objects by bending your knees instead of bending over to lift the object.
You should also try to avoid repeated heavy lifting, and working with
vibratory objects suck as impact wrenches, avoid sitting on the floor,
use high commodes in toilet etc.
should I call my doctor?
In most cases, low back pain goes away within a few days. You should
call your primary doctor if:
Your back pain continues for longer than a month.
Your back pain starts after you are over 60 years old or before age
Your pain is worse when you lie down.
Your pain causes weakness in your leg or numbness in your genital area.
You have difficulty with your bowels or bladder.
You have a fever at the same time as the pain.
You have a history of cancer.
You have had progressive weight loss.
Your back pain is caused by a serious injury, such as falling off a
Your pain prevents you from walking.
Your pain or symptoms are getting worse.
should I have an x-ray, CT scan or MRI?
These examinations are usually not necessary when you first develop
pain. Because in most people acute back pain will go away on its own,
most physicians will not order radiological studies unless the pain
persists. However, even with tests, it can be difficult to pinpoint
the exact reason for the pain.
can my family doctor do for my low back pain?
Your family doctor will first do a careful physical examination. If
your doctor does not find a serious problem causing your low back pain,
he or she may tell you to rest for a few days, do certain exercises
and take medication for pain. Your doctor may also refer you to a pain
clinician who knows about treating back problems. Sometimes specialized
injections are helpful for easing back pain. Injections are usually
used only for severe back pain or for back pain that continues for a
is my chance of recovery?
About 90 percent of patients with acute low back problems spontaneously
recover tolerance to activity within one month.
can I do for my low back pain?
If you develop low back pain, the first thing to do is to avoid any
heavy lifting or bending. Bed rest is usually not necessary, although
your doctor may recommend resting for a day or two. Your doctor can
give you information about exercises you can do at home to strengthen
I need surgery?
Very few people with low back pain ever need surgery. However, if you
have a severely damaged disk with weakness in your leg or numbness in
your groin, you are more likely to need surgery. Your primary doctor
will refer you for surgical opinion to help you decide if surgery is
right for you.
is Chronic Back Pain?
Chronic back problems are generally defined as back-related activity
limitations of greater than three months duration.
Dr. Nighat Ara, Psychiatrist
The last issue of LS was really interesting. I would really like to
know some thing about fear from your expert Nighat Ara. After the grenade
incident I am always scared when I am out. Even a tyre puncture scares
me. I am always tensed, which is effecting my perforamace in the prefessional
life. I would like to know what is fear and why is this happeing to
me? Thank you.
Fear is a primary
emotion that can be perceived as a mild sense of uneasiness (e.g. facing
an interview) to an extreme sense of terror (e.g: bomb blast in a peaceful
rally). Fear is a negative emotion and can be potentially harmful to
both the body and the mind. It decreases the sense of well being and
seriously interferes with the performance and productivity of a person
(when we are afraid, our rational thinking is impaired and we can do
silly things). In fear, a particular pattern of physiological response
takes place as a result of Autonomic nervous system (ANS) arousal and
release of stress hormone "adrenaline". The ANS arousal is
responsible for butterfly sensation in stomach, racing heart, cold clammy
extremities etc. The abundance of adrenaline in our system leads to
"fight or flight response" to the source of threat (some people
flee and others turn around to fight back). This hormone is also responsible
for wear and tear of the body. Our ancestors had to use it quite often
for their survival. It however seems that we are back to that stage
of human civilisation and need to guard our safety and security above
all. Any emotion has three main components in it- A physical component
(the internal body state that accompanies the emotion. e.g. pounding
heart), cognitive component ( how you interpret the situation will determine
the response. Response to a loud noise if interpreted as tire burst
will definitely differ from that interpreted as bomb blast) and a behavioural
component (facial expression, body posture, tone of voice like screaming
etc.). An environment that persistently triggers the ANS and causes
release of stress hormone is quite damaging to health and may lead to
many psychosomatic illnesses. In this present political and social situation
of the country, albeit we all understand the impact of fear on our health
and quality of life. Never the less, the impact will be automatically
multiplied several times if you have to "fight or flight"
against/from unidentified source of threat.
be a mum or a friend
be a friend or to go all parenty and stern-that is the dilemma most
parents face all through their lives. Usually, people fluctuate between
being too nice and over friendly, and being a stern disciplinarian and
a voice of no reason. The answer always lies in being a combination
of gentle and firm. Being a best friend and a parent means listening,
communicating, sharing information, trusting and being supportive. It
also means being authoritative when necessary and teaching children
about values. Now you decide whether you want to be a strict mum or
a friendly mum.
A DIFFERENT SKY
the world of offerings
The other day
while I was having a moment of pure slackery I decided to indulge
myself with some good "deals" over the internet through
free classified list serves. These sites play quite a huge role in
our semi-American, no-time-to-waste-but-enough-time-to-surf lives
than you can imagine. Like many I usually find these sites extremely
useful and often quite entertaining. They allow people to connect
in a one to one basis. From selling or giving away your broken car
to pencil sharpener, finding pets to boyfriends and one-night-stands
to ink cartridges. You name it, they have it all.
From the moment
my cursor steps into the crowded screen full of options, I find myself
clicking away, often without an agenda just to suffice my shopaholic
tendencies, and sometimes just to pry into other peoples' lives, and
I strongly believe I am not alone in this, I trust many working men
and women in America spends a few minutes of their mid-week mid-day
doing the same. Reading through descriptions of 8'x12' rooms or a
perfect lesbian match, whatever it might be, it's eye opening, representing
the true face, the true needs, the desires and true supplies and demands
of the metro-culture in America.
I remember when
I first bumped into such sites, I was almost startled, different boxes
with different titles, Jobs (both need and want sections), Partners
(women seeking men, men seeking women, men seeking men, women seeking
women, strictly platonic, missed connection and Miscellaneous romance),
For Rent, For Sale, Forums (from Haiku to Self-employment), Gigs,
Services, Community and personals, it's all there, neatly compartmentalized
and advertised, humans to machines to pure rhythmic words.
The best thing
about these sites is the fact that they unlike most media based mediums
still consume the power to amaze you. In a world where we are constantly
running out of amusements, few strange words written by strangers
are often precious. Especially when it's found in an unexpected place,
provoking unanticipated thoughts, ideas and questions.
For example, just
the other day while I browsed through the advertised apartments for
rent section I came upon this particular posting, it went:
26 year old single male looking for full time live in female slave
to share 2 bed room apartment in DC. Your rent will depend on which
tasks you're willing to perform, how often, and how well you do them.
I do not yet have an apartment, so part of your duties will be helping
me find a place in Georgetown, Dupont, Foggy Bottom, or possibly Rosslyn.
Even better if you already have a place. Please be N/S, D&D free,
and under 30. Inexperienced OK. Contact me to tell me what you're
As you assumed this particular one definitely was a shocker. First
I was thinking the audacity of this individual to ask for someone
to be his female slave, but that's not really an issue here I guess,
everyone is free to express their opinions and search for what they
fancy. In a bizarre way it was kind of reassuring to see this kind
of ignorant needs do exist in America, we are constantly blaming our
Bangladeshi men for their sexist, chauvinist comments, actions and
thought patterns, but some fellow Americans share similar or worse
ideas. I guess the difference would be the man who advertised is valuing
willingness and freedom of choice, as in the person who would reply
would knowingly agree to be his female slave, and he has every right
therefore to advertise what he did…
I did ponder if a female who is under 30 and drama and disease free
replied back to him. As they say anything is possible in America,
the land where your dreams (no matter how twisted) can come true.
My intention was
not to highlight this particular posting by the female slave-sleeker
in this column, but I am afraid I have already done so. My real objective
was to show the liberty, freedom and convenience these kinds of sites
offer. I would say this is a great way to peak into the lives of the
Americans, but that would not be fair. Although this sites represent
a large population, it does not represent all who are out there; plus
the list serve lingo is often confusing if one is not use to the cyber-metro-culture
of America, so even though I am very tempted to list a few good list
serves from the web for you I am going to resist myself.
So for now you
will just have to be happy with my biased highlights and observations.
But seriously, in this selfish world when everything seems out of
context, these postings are often the only true connection, between
me, you and the world of offerings, a place to call home to a home
to call space.