Chronic Lower Back Pain in Adults - Essay Example

?Incurrence of chronic diseases has been found to be increasing these days. These diseases affect the patient at different levels by interfering withvarious aspects of patient’s life and well being. One major disease among these is Chronic Low Back pain. This medical condition is defined as Chronic back pain is sometimes defined as “back pain that lasts for longer than 7-12 weeks. Others define it as pain that lasts beyond the expected period of healing, and acknowledge that chronic pain may not have well-defined underlying pathological causes. Others classify frequently recurring back pain as chronic pain since it intermittently affects an individual over a long period (Andrerson ,1999, p.583)”. There are several factors which are associated with chronic lower back pain. The biological, environmental, social and cultural factors which are associated with this medical condition have been well understood and researched upon. An understanding on the factors that are associated with chronic lower back pain is very important to have a sustainable approach towards the management of the medical situation. It must be understood here that the complex interconnections of these factors results in patient specific diagnosis. To manage these medical scenarios, a patient specific approach would be needed. Thus, it is important to have thorough understanding over the factors which are associated with low back pain. The objective of this essay is to analyze the psychological, environmental and social factors which are associated with chronic low back pain. Psychological factors It has been confirmed by several researchers that psychological factors play a major role in the sustenance of chronic lower back pain. Along with this, there are psychological factors which are associated with the development of pain as well. Depression is a psychological state which has been proved to have direct connection with chronic back pain (Maloney & McIntosh, 2001). Patients of stress and anxiety develop back pain in case of lack of effective coping skills. There are evidences which prove that these states of mind directly lead to back pain. More importantly, patients who have already developed chronic back pain and have psychological issues will have problems in managing and adapting to the pain. Adapting to the changing situations created by the pain and adapting to the pain itself is very important in the management of chronic back pain. Thus, psychological factors will acutely increase the pain (Maloney & McIntosh, 2001).It is an interconnected process which promotes mutually. In other words, psychological disorders cause pain and pain causes psychological disorders. Crombez, Vlaeyen, Heuts & Lysens (1999) have confirmed that the pain related fear causes more disability than the actual pain in the case of chronic back pain. When the patient gets chronic low back pain, it affects the life style of the patient. The movement and quality of life will be largely affected. The peripheral effect of the medical condition is that it not only affects the patients, but also the quality of life of the relatives of the patients. Leeuw , Goossens , Linton , Crombez, Boersma & Vlaeyen (2007) have opined that patients with chronic pain will tend to avoid activities which they perceive as causative of further pain and injury. This state of inactivity will result in the reduced or non-use of the injured parts of the body. This further reduces the physical level activity of the individual (Verbunt , Seelen , Vlaeyen, van de Heijden, Heuts, Pons & Knottnerus, 2003). In the case of chronic low back pain, this will further contribute to the pain experience. However, there are studies which have contradicted this observation. Verbunt, Westerterp, van der Heijden, Seelen, Vlaeyen and Knottnerus (2001) have observed that there was there was no difference in the energy expenditure of patients of chronic low back pain in comparison with control population. Hasenbring , Hallner and Klasen (2001) have opined that the inactivity due to the perceived pain of the patient can lead to further disability and pain. Environmental factors The living environment of an individual largely affects the chances for developing chronic low back ache. These factors include the natural built up, natural and the human induced impacts. Back pain is largely evolving as life style disease. The processes involved in the daily routines including long hours of sitting in a wrong posture can lead to the development of back pain. Other occupational processes like lifting and carrying weight without appropriate support, extensive travelling without rest all can cause chronic low back ache. It has been observed that both over activity and under activity contributes to disabilities ultimately developing or aggravating the pain (Vlaeyen & Linton, 2001). The physical makeup of the body is also an important factor which can be largely influential in both development and management of chronic back ache. The weight and makeup of the body have been found to be connected with the incurrence of back pain. Researchers have concluded that obesity and overweight increases the chances of chronic low back pain. Shiri, Solovieva, Husgafvel-Pursiainen, Taimela, Liisa, Huupponen, Viikari, Raitakari and Viikari-Juntura (2009) undertook a meta analysis of the connection between body weight and chronic low back pain. The study reviewed literature available on the research subject to conclude a statistically significant connection between overweight, obesity and low back pain. The physical built up of an individual is a key factor which determines the individual’s probability of developing back pain. For patients of chronic back pain, physiotherapy exercises to develop and nurture the muscles and tissues which support the spine is recommended. This is because strong built up in terms of these muscles and tissues will give extra support to the spine protecting it from physical strains. It has been reported that 70% of all the cases of chronic low back pain is related to strained myofascial system (CHP, 2011). The myofascial system includes the ligaments, tendons and muscles which supports the spine and binds it together (CHP, 2011). Thus, strengthening these muscles would automatically strengthen spine support and averts risks of back pain development. The height of the individual also has been found as a determinant of chronic low back pain risk. People with heights not optimal for the spine to support have high chances of developing back pain. Human induced pressure on the spine can also lead to injury and physical conditions of the spine, leading to back pain. Damages to vertebral bodies, vertebral discs, cartilage, and the myofascial will cause back pain. Physical conditions like muscle strain, osteoarthritis, spinal stenosis, discogenic disc disease, Spodylolisthensis and vertebral fracture are examples of physical conditions which are induced by human activities (CHP, 2011). These activities may include accidents, wearing out the parts of the spine by over exertion etc. Social Factors Low back pain has been identified as a major public health problem in terms of is implication on the larger society and the large percentage of its incurrence. Breivik, Collett, Ventafridda, Cohen and Gallacher (2006) have classified chronic back pain as a health issue with high level of societal burden. This medical condition is referred to as the largest cause for disabilities among young adults (Walker, Muller & Grant, 2004). It has been estimated that chronic low back pain affects every adult at varied intensities and at various stages (Walker, et al, 2004). In terms of the gender distribution of backache, several studies have confirmed both male and female having the same probabilities of developing backache. In the context of Australia, low back pain is a very common problem amongst its adult population. In a random sample study conducted amongst 3000 Australians from all across the country, it was concluded that all of them had chronic low back pain. Interestingly, out of this random sample, 10 % had developed significant disability because of low back pain. This suggests the high intensity of chronic low back pain in Australia (Walker, et al, 2004). Conclusion Considering the social, psychological and environmental factors which are associated with chronic low back pain, the management of the medical condition has to be given due attention. As the medical problem has social implications including the societal burden that it causes, public educational programs on the management of chronic low back pain must be carried out extensively. Due to the increasing incurrence of the medical condition in Australia, and also globally, these campaigns deserve serious attention. The changes in the activity level and exertion patterns of the patients cause serious consequences on the society and on the recovery of the patient. Rehabilitation programs focusing on the normalization of patient’s activity pattern have been designed by researchers (van Tulder, 2006; Abenhain et al, 2006). Patients along with the common public will have to be educated on the scope of these rehabilitation programs. Treatment approaches and management strategies must be holistic, dealing with the social, psychological and environmental factors associated with chronic low back pain. References Abenhaim, L., Rossignol, M., Valat, J.P. et al (2000). The role of activity in the therapeutic management of back pain. Report of the International Paris Task Forceon Back Pain. Spine ; 25(suppl): 1S–33S. Andersson. G. B (1999). Epidemiological features of chronic low-back pain. Lancet. 14; 354(9178):581-5. Breivik, H., Collett, B., Ventafridda, V., Cohen, R. & Gallacher, D. (2006). Survey of chronic pain in Europe: prevalence, impact on daily life, and treatment. European Journal of Pain; 10: 287–333. CHP (2011). Low Back pain: causes. Continuum Health Partners, Inc. Retrieved from http://www.healingchronicpain.org/content/backpain/causes.asp Crombez, G., Vlaeyen, J. W., Heuts, P.H. & Lysens, R. 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Walker, B.F., Muller, R. & Grant, W.D. (2004). Low back pain in Australian adults: prevalence and associated disability. Journal Manipulative Physiological therapeutics, 27(4):238-44. Read More