By Judith DeLany, LMT, Massage Today
Back pain is one of the most frequent complaints by massage therapists and their clients. In fact, 15 percent to 20 percent of Americans report back pain yearly, and 80 percent will suffer from at least one episode of back pain during their lifetime.2
A number of risk factors have been determined, including smoking, being overweight and poor physical fitness.Common causes of back pain include spasm, tension, disc degeneration, scoliosis, spondylosis, spondylolisthesis, arthritis, spinal stenosis, pregnancy, kidney stones, infections, endometriosis, fibromyalgia, tumors, stress and trauma.3
Back pain divides into simple backache, nerve-root pain and serious pathology. Although it is easy to blame work as the culprit, pain originating from the latter two may stem from sinister causes, including visceral disease. Beware of the following red flags, as they might indicate advancing pathologies. Further investigation is needed if the sufferer:
- is under 50 years of age and the back pain has failed to improve.
- has a previous history of cancer, tuberculosis, rheumatological or other systemic diseases, use of steroid medication, drug abuse or is HIV-positive.
- is patently unwell or reports unexplained weight loss.
- also reports thoracic or chest pain.
- presents with widespread neurological symptoms.
- had a road traffic accident or other severe trauma.
- reports constant or progressively severe pain apparently unrelated to mechanical influences (no relief from bed rest).
Simple backache, on the other hand, often emerges from a compounding of minor predisposing myofascial factors, such as tight muscles, trigger points and muscle weakness. After considering the muscles that lie in the region of the low back, investigation moves to the anterior and lateral abdominal muscles, muscles of the lower extremity that attach to the pelvis, habits of use, posture and gait. Tucked away deep to the erector spinae and the multifidus often is overlooked as potentially a substantial source of lumbar dysfunction.
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