Back pain, What is it?

back pain1

Edited by Hans de Wit – StretchingSA – Centurion

Back pain, What Is It?

Back pain can be a symptom of many different illnesses and conditions. The main cause of the pain can be a problem with the back itself or it can be a problem in another part of the body. In many cases, doctors can’t find a cause for the pain. When a cause is found, common explanations include:

  • Stress or injury involving the back muscles, including back sprain or strain; chronic overload of back muscles caused by obesity; and short term overload of back muscles caused by any unusual stress, such as lifting or pregnancy
  • Disease or injury involving the back bones (vertebrae), including fracture from an accident or as a result of the bone-thinning disease osteoporosis
  • Disease or injury involving the spinal nerves, including nerve injury caused by a protruding disk (a fibrous cushion between vertebrae) or spinal senosis (a narrowing of the spinal canal)


  • Degenerative arthritis, a “wear and tear” process that may be related to age, injury and genetic predisposition.
  • Kidney stones or a kidney infection (pyelonephritis)
  • Rarer causes include:
  • Inflammatory arthritis, including ankylosing spondylitis and related conditions
  • A spinal tumor or a cancer that has spread (metastasized) to the spine from elsewhere in the body
  • Infection, which may be in the disk space, bone (osteomyelitis), abdomen, pelvis or bloodstreamBack pain varies widely. Some symptoms may suggest that the back pain has a more serious cause. These include fever, recent trauma, weight loss, a history of cancer and neurological symptoms, such as numbness, weakness or incontinence (involuntary control of urine flow). Back pain is usually accompanied by other symptoms that may help point to its cause. For example:

back bulging

  • Symptoms
  • Back sprain or strain – Back pain typically begins on the day after heavy exertion. Muscles in the back, buttocks and thighs are often sore and stiff. The back may have areas that are sore when touched or pressed.
  • Fibromyalgia – In addition to back pain, there are usually other areas of pain and stiffness in the trunk, neck, shoulders, knees and elbows. Pain may be either a general soreness or a gnawing ache, and stiffness is often worst in the morning. People usually complain of feeling abnormally tired, especially of waking up tired, and they have specific areas that are painful to touch, called tender points.
  • Degenerative arthritis of the spine – Together with back pain, there is stiffness and trouble bending over, which usually develops over many years.
  • Inflammatory arthritis, including ankylosing spondylitis and related conditions – In these disorders, there is pain in the lower back, together with morning stiffness in the back, hips or both. There also can be pain and stiffness in the neck or chest or an extremely tired feeling. Other features may include psoriasis, eye pain and redness, or diarrhea, depending on the specific disorder causing back pain. This group of diseases is a relatively rare cause of back pain.
  • Osteoporosis – This common condition is characterized by thinned, weakened bones that fracture easily. It is most common in postmenopausal women. When vertebrae become compressed because of fracture, posture may become stooped over or hunched along with back pain. Osteoporosis is not painful unless a bone fractures.
  • Cancer in the spinal bones or nearby structures – Back pain is consistent and may become worse when you are lying down. Numbness, weakness or tingling of the legs that continues to get worse. If cancer spreads to spinal nerves that control the bladder and bowel, there may be bowel or bladder incontinence (loss of control).
  • Protruding disk – People with significant disk disease sometimes have severe pain in the lower back. If a disk compresses a nerve, the pain may spread down one leg. The pain gets worse during bending or twisting.
  • Spinal stenosis – Pain, numbness and weakness affect the back and legs. Symptoms get worse when you are standing or walking, but are relieved by sitting or leaning forward.
  • Pyelonephritis – People with a kidney infection typically develop sudden, intense pain just beneath the ribs in the back that may travel around the side toward the lower abdomen or sometimes down to the groin. There also can be a high fever, shaking chills and nausea and vomiting. The urine may be cloudy, tinged with blood or unusually strong or foul-smelling. There may be additional bladder related symptoms, such as the need to urinate more often than normal or pain or discomfort during urination. Your doctor will ask about your symptoms and your medical history. He or she will examine your back muscles and spine and will move you certain ways to check for pain, muscle tenderness or weakness, stiffness, numbness or abnormal reflexes. For example, if you have a disk problem, you may have pain in your lower back when the doctor raises your straightened leg.
  • Your symptoms and the physical examination may give your doctor enough information to diagnose the problem. However, with back pain, your doctor may only be able to tell you that the problem is not serious. If your doctor determines that your back pain is caused by muscle strain, obesity, pregnancy or another cause that is not urgent, you may not need any additional tests. However, if he or she suspects a more serious problem involving your vertebrae or spinal nerves, especially if your back pain has lasted longer than 12 weeks, you may need one or more of the following tests:
  • Diagnosis
  • X-rays of your back
  • Blood test
  • Urine tests
  • Spinal magnetic resonance imaging (MRI)
  • Computed tomography (CT) scan
  • Nerve conduction studies and electromyography to determine whether nerves, muscles or both may be injured
  • Bone scan, especially if you have a previous history of cancer Expected DurationWomen who have back pain caused by the added weight of pregnancy almost always will get better after delivery. People who are obese may need to lose weight before back pain eases.People with more serious forms of back pain caused by problems with the vertebrae or spinal nerves may have more persistent back pain that lasts for months and may last for years. You can help prevent some forms of back pain by strengthening your back with exercises and by avoiding activities that lead to back injury. Measures that may help prevent back pain include:
  • Prevention
  • People with back pain caused by pyelonephritis often begin to feel better within days after they start taking antibiotics, although they usually need to continue taking antibiotics for up to two weeks.
  • How long back pain lasts depends on its cause. For example, if your pain is caused by strain from overexertion, symptoms usually subside over days or weeks and you may be able to return gradually to your normal activities. However, you should avoid heavy lifting, prolonged sitting or sudden bending or twisting until your back gets better.
  •  Maintaining good posture.
  • Sleeping on your side or on your back with a pillow under your knees if you can.
  • Exercising regularly, but stretch before and after.
  • Practicing abdominal crunches to strengthen abdominal muscles, which support your lower back. Also, walk or swim regularly to strengthen your lower back.
  • Always lifting objects from a squatting position, using your hips and your legs to do the heavy work. Avoid lifting, twisting and bending at the same time.
  • Avoiding sitting or standing for extended periods of time.
  • Wearing soft soled shoes with heels that are less than 1 and one-half inches high. Treatment
  • Most episodes of back pain are not serious and may be treated with:
  • To help prevent osteoporosis, make sure you get enough calcium and vitamin D daily to meet the dietary requirements for your age group. Follow a routine program of weight-bearing exercise. Avoid smoking and limit the amount of alcohol you drink. If you are a woman who has entered menopause, speak with your doctor about testing for osteoporosis and medications that can help to prevent or reverse it.
  • Limited bed rest (no more than two days)
  • Physical therapy
  • Acetaminophen (Tylenol and others) for pain or oral anti-inflammatory drugs, such as aspirin, ibuprofen (Advil, Motrin and others) or naproxen (Aleve, Naprosyn), for pain and inflammation
  • Muscle relaxants or prescription pain relievers, if necessary, for a short period
  • Hot or cold compresses If you are recovering from back pain, your doctor may ask you to call or return to his or her office for a follow-up visit in about two weeks to confirm that your symptoms are gone and that you can safely resume all of your normal activities.When to Call a Professional
  • Contact your doctor if:
  • If your back pain is related to more serious disorders of the vertebrae or spinal nerves or if it hasn’t improved over a few weeks, you may be referred to a specialist, such as a pain specialist, an orthopedic surgeon (a doctor who specializes in diseases of the bones), a neurologist (a doctor who specializes in diseases of the nerves and brain) or a rheumatologist (an arthritis specialist).
  • People with back pain are encouraged to return to their normal activities gradually, and to temporarily avoid heavy lifting, prolonged sitting, or sudden bending or twisting.
  • Severe back pain makes it impossible for you to do your normal daily activities.
  • Your back pain follows significant trauma.
  • Mild back pain gets worse after a few days or persists more than a week or two.
  • Back pain is accompanied by weight loss, fever, chills or urinary symptoms.
  • You develop sudden weakness, numbness or tingling in a leg.
  • You develop numbness in the groin or rectum or difficulty controlling bladder or bowel function.
  • You have had cancer previously and you develop persistent back pain. More than 90% of people with back pain get better after conservative treatment. Only 5% of people with back pain will have symptoms for more than 12 weeks and for most of these people, the cause is not serious.

The incredible human heart!

Heart factsby Ryno van den Berg – StretchingSA – Pretoria East

Heart Fact 1: The incredible human heart The human heart beats 100 000 times a day.  It pumps enough blood  in a person’s lifetime to fill 3 supertankers.  The coronary arteries are the “fuel lines to the engine” and need to remain open for your heart to keep pumping. When one or more of the major vessels is obstructed for some reason, blood cannot get to the region of the heart muscle downstream of the blockage leading to a heart attack. Heart Fact 2: There is a 1 in 3 chance that your first heart attack will also be your LAST.    35% of all acute heart attacks are FATAL. Half of these deaths are SUDDEN and will occur within 1 hour after onset of chest pains. But contrary to popular belief, you will not have warning signs weeks before a heart attack occurs. 70% of heart attacks have NO Warning Symptoms. Heart Fact 3: Heart disease kills people 45-65 yrs old. It is the major cause (40%) of premature death in middle-aged men, which is most tragic because of the many unfulfilled obligations and responsibilities resulting from premature death.

Heart Fact 4: Heart disease actually kills two times more women than all cancers combined. Breast cancer is not the No 1 killer of middle aged women. More women die of heart disease than breast cancer and all the other cancers combined.  60% of women think that breast cancer is the greatest threat to their health but only 4% die from it. Heart Fact 5: Coronary artery disease is due to atherosclerosis, or hardening of the arteries, which is a slow progressive build-up of cholesterol plaque in the arteries of the heart. Most patients find out that they have heart disease when it is quite advanced. This is due to lack of understanding about how heart disease develops. Heart Fact 6: Most “classic” warning signals of a heart attack: – Uncomfortable pressure, fullness, squeezing or pain in the centre of the chest that lasts more than a few minutes, or goes away and comes back. – Pain that spreads to the shoulders, neck or arms. – Chest discomfort with light-headedness, fainting, sweating, nausea or shortness of breath.
Less common warning signs of heart attack: – Atypical chest pain, stomach or abdominal pain. – Nausea or dizziness (without chest pain). – Shortness of breath and difficulty breathing (without chest pain). – Unexplained anxiety, weakness or fatigue. – Palpitations, cold sweat or paleness.
Not all these signs occur in every attack. Sometimes they go away and return. If some occur, get help fast. IF YOU NOTICE ONE OR MORE OF THESE SIGNS IN ANOTHER PERSON, DON’T WAIT. CALL YOUR EMERGENCY MEDICAL SERVICES SO THE PERSON CAN GET TO A HOSPITAL RIGHT AWAY!
How do I know if a heart attack has occurred? A physician who studies the results of several tests should be able to make the actual diagnosis of a heart attack. The doctor will: – Review the patient’s complete medical history. – Give a physical examination. – Use an electrocardiogram (E.K.G.) to discover any abnormalities caused by damage to the   heart.


What’s the fuss all about?

By: Hans de Wit – stretch therapist , Founder of StretchingSA

Hans-de-Wit.jpgStretch therapy is a one of a kind technique used by stretch therapists over the past decade that had astonishing results with patients suffering from chronic pain, musculoskeletal ailments, sports related injuries as well as joint and bone structural issues.

It is sometimes hard to believe why nobody else has been doing this for all these years since there are existing modalities in South Africa governed by a national council that has the credo to enhance, optimize and utilize healing and health in a nondiscriminatory way for all to benefit. Unfortunately this had not been the case, and as with so many other industries, we had a huge growth in the alternative health sector in the past 20 years. In fact stretch therapy has grown with it and with international recognition leading the way, South Africa will soon be unable to deny it.

Stretching therapy comprises a very hands on, manual and labour intensive approach to healing. There are no fancy machines, no little green and red lights on a huge panel, no magic ointments, no wonder diet, no complicated exercise machines and no anaesthetics!

If you would like to come and see us to get your problems fixed, you’ll have to be someone that is dedicated and committed to getting better. It takes time to open up fibers in your body that had been stuck there for 80% of your life. Frequently old injuries from decades ago, are covered by layer upon layer of connective tissues, muscular fibers, and fascia. To get to the points that are irritating your body, those layers need to be ‘peeled’ of via gentle, highly isolated, and very controlled movements. No wonder nobody had the know-how of doing it. Instead pharmaceutical industries spend billions in the development of chemicals that will ease the pain, dull the pain receptors, drain the oedema (swelling) and make the problems magically disappear… for a day.

We are here to help you, our therapists are highly trained in the secrets of stretch therapy, and are very committed to your cause. Don’t delay, sent this article to a loved one, family member or friend that you know are having pain. This might just change their lives for good. Stop the contraindications of the hands full of pills they have to swallow every day, stop the sleepless nights from pain and suffering and give them a chance to be human again; living life, enjoying what they love most and regaining control of their minds that once where clouded with worries and stress.


A study on when surgery will or won’t be needed for medial knee problems

June 2015 – Volume 23 – Issue 2 – p e15–e22
A Review of Surgical and Nonsurgical Outcomes of Medial Knee Injuries
Smyth, Mark P. MD*; Koh, Jason L. MD†

Medial-sided knee injuries can result in pain, instability, and loss of function. Many clinical studies have been written on the treatment of medial-sided knee injuries; however, the vast majority are isolated case series of surgical or nonoperative treatment regimens, and only a few randomized prospective clinical trials can be found in the literature that compare different treatment modalities. Comparison of these treatments is challenging due to the variety of medial-sided structures that can be involved, the multiple different approaches to treatment, and the variability of how objective and subjective clinical outcomes are reported. In this paper we report on the injuries by extent and type of anatomic structures damaged including partial medial-sided injuries, completed isolated medial-sided knee injuries, and combined injuries. In general, most authors concur that isolated partial or complete medial collateral ligament (MCL) injuries can be treated nonoperatively with a brace and early motion with good clinical outcomes. Prospective, randomized trials support nonoperative treatment of the MCL in combined anterior cruciate ligament-MCL injuries. Knee dislocations and posterior medial corner injuries appear to have better results with surgical management including reconstruction. Multiple reconstructive techniques have been described for chronic injuries but it is difficult to compare their results.