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TRAUMA.TXT
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1992-12-04
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TRAUMA
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In a previous chapter we touched briefly on two primary causes
of back pain: chronic trauma and sudden trauma.
Let's dwell for a moment on sudden trauma. Some injuries to the
back may not result in an immediate fracture to the bony
vertebrae but instead result in tearing of the muscles and
ligaments or perhaps a rupture of an intervertebral disc. Sudden
twisting, inappropriate lifting or a Saturday game of backyard
football could be the culprits in these varying scenarios.
Sudden pain is the usual result.
The painful spasm of a muscle is one of the results of this sort
of sudden trauma. In simplest terms, spasm is the sudden, rigid
involuntary contraction of a muscle. The cause is usually a
sudden trauma although it can also result from prolonged or
chronic trauma as well, such as poor posture. These strained and
"knotted" muscles hurt and seem to refuse any attempt at
relaxation. In retrospect this "rigid reaction" to trauma may
have been an evolutionary attempt by the body to "splint" or
bind the injured area in a rigid manner to prevent further
damage. However, if the spasm remains for too long it can
produce more severe pain than the original injury and sometimes
additional injury.
Curiously, it is the weak muscle, lacking in tone or the over-
tense, constricted muscle that can cause the most pain when
sudden trauma occurs. A flexible, supple back is usually capable
of withstanding sudden trauma. After surgery, bed rest and
recovery from the traumatic episode sometimes involves
strengthening and flexibility exercises which are usually
prescribed by most physicians and orthopedic surgeons.
Sometimes a physician will administer other treatments in an
attempt to relieve pain resulting from sudden back trauma.
Injections of Novocaine or Xylocaine anesthetics are possible.
Cortisone injections have also been used with modest success in
the past. Usually these injections are made directly into the
muscle which is affected by spasm. The idea is to relax the
muscle, discontinue the state of spasm and relieve the pain.
These injections are not held to be completely effective by all
clinicians. There is some disagreement in the medical community
on the topic of muscle injections to relieve pain and promote
healing in cases of back trauma.
The use of hot or cold in the treatment of sudden trauma to the
back is also an area of medical disagreement. One school of
thought suggests that cold should be applied for the first 24
hours following injury to minimize swelling. After this mild
heat should be used to increase blood flow to aid in in healing
and reduce swelling. However deep tissue injuries in the case of
sudden back trauma may have small amounts of bleeding or
swelling in very deep layers of tissue which neither cold nor
heat will reach, so the benefits are not completely resolved
among all members of the medical community. If the pain is close
to the skin, ice packs may deaden surface nerves and provide
some relief from pain but little actual accelerated healing. The
application of mild heat treatments to stiff or inactive muscles
prior to exercise or physical rehabilitation is, however,
usually a reasonable suggestion.
Chronic trauma is the other category to be considered. Chronic
means recurring injury or damage. Many sources have been
identified as possible origins of chronic back trauma such as
poor posture, disease, a gradually aging disc or even a bad
mattress and sleeping position. Chronic trauma can also affect
an area of the back which has previously suffered a sudden
injury.
Back braces and supports are sometimes prescribed in cases of
chronic trauma. In certain injuries, a brace is an absolute
necessity for proper healing or at least a return to normal
function. However the continuous use of a back brace for
treatment of chronic back pain is usually an unwise course - a
bit like wearing a cast for a broken arm long after the arm is
healed. In fact prolonged wearing of a back brace can allow
further deterioration of weak back muscles which benefit from
use, exercise and a full range of motion. Braces are more
properly used to immobilize portions of the back following
surgery or severe fractures.
A better course of action in the case of chronic back pain, is
sensible muscular conditioning and specialized exercises
performed EXACTLY as recommended by a physician. Amazingly, even
ruptured discs and deteriorating vertebrae are less painful when
a proper regimen of physical reconditioning is attempted under
the supervision of a physician and exercise therapist. Once an
exercise plan has begun, it can usually be continued at home and
at work with occasional monitoring by the physician.
This tutorial is merely a starting point! For further
information on back care and back pain, be sure to register this
software ($25.00) which brings by prompt postal delivery a
printed, illustrated guide to back pain written by a physician
plus two software disks. From the main menu select "Print
Registration Form." Or from the DOS prompt type the command
ORDER. Mail to Seattle Scientific Photography (Dept. BRN), PO
Box 1506, Mercer Island, WA 98040. If you cannot print the order
form, send $25.00 to the above address and a short letter
requesting these materials. End of chapter.