By Penelope A. Domogo, MD
During labor, when the baby takes long in coming out, one traditional remedy is for the husband to carry the pregnant wife like holding a baby to poo. This position makes it easier for the mother to “pas-en” (Igorot) or “eddek” (Ilocano) or “push” (English). (Nothing beats local terms.) Anyway, I had difficulty delivering my first child and my husband wanted to carry me like that but could not as he had a back problem. Nasiket sia. He told me then that this was due to running to catch a train carrying 2 very heavy maleta (his and his friend’s). That was my first time to hear the term “nasiket”.
Nowadays, I hear it often said, and it’s usually by men. This usually comes out when we ask a favor from the men to carry something we, girls, can’t carry. I am sure these men are not telling a lie just to escape the task.
Back pain can mean pain anywhere along the spine from the neck down to the buttocks but the most commonly affected area is the lower back and so this issue, we will discuss low back pain. Low back pain is also known as “lumbago”, perhaps because the pain is in the lumbar area of the spine. You see, the spine is divided starting from the top into cervical, thoracic, lumbar and sacral areas. The lumbar area or the lower back which includes the “siket” supports much of the weight of the body so it is understandable why it is the most commonly affected.
Let us dissect the structures of the spine that could be possible sources of the pain. These are a complex, interconnected network of spinal muscles, nerves, blood vessels. tendons, discs and bones. Our spine is similar with that of other mammals. So next time you eat chicken or bulalo, dissect the spine and note how interconnected the nerves are with the bones, discs and tendons and blood vessels and muscles. You will note that nerves come out in between the “dulig” ( vertebrae).
The lower back includes the five vertebrae named L1, L2, L3, L4 & L5. Try to feel them in your back. In between these vertebrae are round rubbery pads called intervertebral discs that cushion the bones so that they won’t scrape each other as the body moves. Remember that these vertebrae or dulig are bones. Think of bulalo and alas-as. These discs also maintain the space in between the bones. These spaces are very important as these are where nerves emanating from the spinal cord pass through. If this space is obliterated, then the nerves will be squeezed and that would be very painful. Nerves are our sensors and are very sensitive so that even just a light touch is felt, right? What more if it is pinched? Eowww.
There are more structures in this little area. Tough ligaments hold one “dulig” to the next to keep them in place. So that we can move our back, tendons anchor muscles to the spinal column. An irritation or a problem with any of these structures can cause low back pain.
Most cases of low back pain are a mechanical problem- caused by the general degeneration of the spine occurring in the joints, discs and bones. Examples are sprains and strains that cause acute (meaning sudden) back pain. Sprains are caused by overstretching or tearing ligaments and strains are tears in tendon or muscle. Both occur from twisting or lifting something improperly, lifting something too heavy or overstretching. Such movements may also cause spasms in the back muscles. These could be very painful but are not serious.
Other mechanical problems are disc degeneration, slipped disc and sciatica. Sciatica is a compression of the sciatic nerve which causes pain, numbness and tingling from the back that travels down one leg.
Usually, back pain is not serious but it could cause extreme discomfort. The feeling of pain varies per individual. One can tolerate pain better that others, depending on a lot of factors like psychological, emotional and financial factors. It is a common observation, though, that happy people can tolerate pain better than whiners and staying positive can help you recover faster.
This general degeneration of the spine is, like hypertension, a recent phenomenon. In the 1980s, I have seen Bontoc men run home with a “gimata” full of palay and it was no problem. Again, it is the modern diet which is weakening our bodies. The modern diet which is rich in sugar including white rice makes the blood acidic thus the body leeches calcium from the bones to buffer this acidity. When calcium is leeched from the bones, you get osteoporosis or brittle bones.
Aside from a poor diet, what are the other risk factors for developing low back pain?
Lack of physical activity. Back pain is more common among people who are not physically fit. Weak back and abdominal muscles may not properly support the spine. An inactive job or desk job may also lead to or contribute to back pain, especially if you have poor posture or sit all day with inadequate back support. Many hours of sitting will shorten muscles which, in turn, will strain the spine.
People who are inactive the whole week and exercise a lot during weekend are more likely to suffer painful back injuries than people who have moderate physical activity daily.
Weight gain – being overweight or just gaining a lot of weight can stress your back.
Occupational risk factors. Jobs that require heavy lifting, pushing or pulling especially when it involves twisting or vibrating the spine, can lead to injury and back pain.
Athletes, be careful, because any weight-bearing sport or exercise that involves running, jumping or rapid dynamic movements produces tension on the lower back. When these activities are repeated over time without properly stretching and releasing these tight muscles, overuse injuries may occur.
Mental factors like anxiety and depression.
Smoking
What to do? Remove the risks mentioned above. Some wise person said that to be able to this, “you will need will power and determination, two things severely lacking in most people.” With God’s help, we can. We can say “NO” to bad food and say “YES” to daily exercise.**
