Back pain is a common reason for absence from work and for seeking medical treatment. It can be uncomfortable and debilitating. It can result from injury, activity and some medical conditions. Back pain can affect people of any age, for different reasons. As people get older, the chance of developing lower back pain increases, due […]
A person with untreated attention deficit hyperactivity disorder (ADHD) has difficulty maintaining attention, managing energy levels, and controlling impulses. In the United States, around 8.4% of children and 2.5% of adults have ADHD. In some children, ADHD characteristics begin as early as 3 years of age. Ways of treating ADHD include medication, behavioral management techniques, […]
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Back pain is a common reason for absence from work and for seeking medical treatment. It can be uncomfortable and debilitating. It can result from injury, activity and some medical conditions. Back pain can affect people of any age, for different reasons. As people get older, the chance of developing lower back pain increases, due […]
A person with untreated attention deficit hyperactivity disorder (ADHD) has difficulty maintaining attention, managing energy levels, and controlling impulses. In the United States, around 8.4% of children and 2.5% of adults have ADHD. In some children, ADHD characteristics begin as early as 3 years of age. Ways of treating ADHD include medication, behavioral management techniques, […]
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Back pain is a common reason for absence from work and for seeking medical treatment. It can be uncomfortable and debilitating.
It can result from injury, activity and some medical conditions. Back pain can affect people of any age, for different reasons. As people get older, the chance of developing
lower back pain increases, due to factors such as previous occupation and degenerative disk disease.
Lower back pain may be linked to the bony lumbar spine, discs between the vertebrae, ligaments around the spine and discs, spinal cord and nerves, lower back muscles, abdominal and pelvic internal organs, and the skin around the lumbar area.
Pain in the upper back may be due to disorders of the aorta, tumors in the chest, and spine inflammation.
Causes
Problems with the spine such as osteoporosis can lead to back pain.
The human back is composed of a complex structure of muscles, ligaments, tendons, disks, and bones, which work together to support the body and enable us to move around.
The segments of the spine are cushioned with cartilage-like pads called disks.
Problems with any of these components can lead to back pain. In some cases of back pain, its cause remains unclear.
Damage can result from strain, medical conditions, and poor posture, among others.
Strain
Back pain commonly stems from strain, tension, or injury. Frequent causes of back pain are:
strained muscles or ligaments
a muscle spasm
muscle tension
damaged disks
injuries, fractures, or falls
Activities that can lead to strains or spasms include:
lifting something improperly
lifting something that is too heavy
making an abrupt and awkward movement
Structural problems
A number of structural problems may also result in back pain.
Ruptured disks: Each vertebra in the spine is cushioned by disks. If the disk ruptures there will be more pressure on a nerve, resulting in back pain.
Bulging disks: In much the same way as ruptured disks, a bulging disk can result in more pressure on a nerve.
Sciatica: A sharp and shooting pain travels through the buttock and down the back of the leg, caused by a bulging or herniated disk pressing on a nerve.
Arthritis: Osteoarthritis can cause problems with the joints in the hips, lower back, and other places. In some cases, the space around the spinal cord narrows. This is known as spinal stenosis.
Abnormal curvature of the spine: If the spine curves in an unusual way, back pain can result. An example is scoliosis, in which the spine curves to the side.
Osteoporosis: Bones, including the vertebrae of the spine, become brittle and porous, making compression fractures more likely.
Kidney problems: Kidney stones or kidney infection can cause back pain.
Movement and posture
Adopting a very hunched sitting position when using computers can result in increased back and shoulder problems over time.
Back pain can also result from some everyday activities or poor posture.
Examples include:
twisting
coughing or sneezing
muscle tension
over-stretching
bending awkwardly or for long periods
pushing, pulling, lifting, or carrying something
standing or sitting for long periods
straining the neck forward, such as when driving or using a computer
long driving sessions without a break, even when not hunched
sleeping on a mattress that does not support the body and keep the spine straight
Other causes
Some medical conditions can lead to back pain.
Cauda equina syndrome: The cauda equine is a bundle of spinal nerve roots that arise from the lower end of the spinal cord. Symptoms include a dull pain in the lower back and upper buttocks, as well as numbness in the buttocks, genitalia, and thighs. There are sometimes bowel and bladder function disturbances.
Cancer of the spine: A tumor on the spine may press against a nerve, resulting in back pain.
Infection of the spine: A fever and a tender, warm area on the back could be due to an infection of the spine.
Other infections: Pelvic inflammatory disease, bladder, or kidney infections may also lead to back pain.
Sleep disorders: Individuals with sleep disorders are more likely to experience back pain, compared with others.
Shingles: An infection that can affect the nerves may lead to back pain. This depends on which nerves are affected.
Risk factors
The following factors are linked to a higher risk of developing low back pain:
occupational activities
pregnancy
a sedentary lifestyle
poor physical fitness
older age
obesity and excess weight
smoking
strenuous physical exercise or work, especially if done incorrectly
genetic factors
medical conditions, such as arthritis and cancer
Lower back pain also tends to be more common in women than in men, possibly due to hormonal factors. Stress, anxiety, and mood disorders have also been linked to back pain.
Symptoms
The main symptom of back pain is an ache or pain anywhere in the back, and sometimes all the way down to the buttocks and legs.
Some back issues can cause pain in other parts of the body, depending on the nerves affected.
The pain often goes away without treatment, but if it occurs with any of the following people should see their doctor:
weight loss
fever
inflammation or swelling on the back
persistent back pain, where lying down or resting does not help
pain down the legs
pain that reaches below the knees
a recent injury, blow or trauma to the back
urinary incontinence
difficulty urinating
fecal incontinence, or loss of control over bowel movements
numbness around the genitals
numbness around the anus
numbness around the buttocks
When to see a doctor
You should seek medical help if you experience any numbness or tingling, or if you have back pain:
that does not improve with rest
after an injury or fall
with numbness in the legs
with weakness
with fever
with unexplained weight loss
Diagnosis
A doctor will usually be able to diagnose back pain after asking about symptoms and carrying out a physical examination.
An imaging scan and other tests may be required if:
back pain appears to result from an injury
there may be underlying cause that needs treatment
the pain persists over a long period
An X-ray, MRI, or CT scan can give information about the state of the soft tissues in the back.
X-rays can show the alignment of the bones and detect signs of arthritis or broken bones, but they may not reveal damage in the muscles, spinal cord, nerves, or disks.
MRI or CT scans can reveal herniated disks or problems with tissue, tendons, nerves, ligaments, blood vessels, muscles, and bones.
Bone scans can detect bone tumors or compression fractures caused by osteoporosis. A radioactive substance or tracer is injected into a vein. The tracer collects in the bones and helps the doctor detect bone problems with the aid of a special camera.
Electromyography or EMG measures the electrical impulses produced by nerves in response to muscles. This can confirm nerve compression, which may occur with a herniated disk or spinal stenosis.
The doctor may also order a blood test if infection is suspected.
Other types of diagnosis
A chiropractor will diagnose through touch, or palpation, and a visual examination. Chiropractic is known as a direct approach, with a strong focus on adjusting the spinal joints. A chiropractor may also want to see the results of imaging scans and any blood and urine tests.
An osteopath also diagnoses through palpation and visual inspection. Osteopathy involves slow and rhythmic stretching, known as mobilization, pressure or indirect techniques, and manipulation of joints and muscles.
A physical therapist focuses on diagnosing problems in the joints and soft tissues of the body.
Chronic or acute pain?
Back pain is categorized into two types:
Acute pain starts suddenly and lasts for up to 6 weeks.
Chronic or long-term pain develops over a longer period, lasts for over 3 months, and causes ongoing problems.
If a person has both occasional bouts of more intense pain and fairly continuous mild back pain, it can be hard for a doctor to determine whether they have acute or chronic back pain.
A person with untreated attention deficit hyperactivity disorder (ADHD) has difficulty maintaining attention, managing energy levels, and controlling impulses.
In the United States, around 8.4% of children and 2.5% of adults have ADHD. In some children, ADHD characteristics begin as early as 3 years of age.
Ways of treating ADHD include medication, behavioral management techniques, and other practical strategies.
Below, we explore what ADHD is, how it affects a person, and which treatments can help.
What is ADHD?
People with ADHD have difficulty focusing on tasks and controlling their attention, which can make completing a project, for example, challenging. ADHD can limit a person’s ability to study or work, and it can lead to stress, anxiety, and depression.
Some people with ADHD also find it hard to sit still. They may be quick to act on impulse and become easily distracted.
While children of any age can experience distraction and impulsiveness, these traits are more noticeable in those with ADHD.
Features
ADHD may develop in one of three ways. A doctor may find that the disorder has:
a predominantly hyperactive and impulsive presentation
a predominantly inattentive presentation
a combined presentation
People with ADHD experience hyperactivity, impulsivity, and inattention in varying degrees.
Inattention
Below are some behaviors related to inattention that a person might notice in someone with ADHD:
daydreaming
becoming distracted and having difficulty focusing on tasks
making “careless” mistakes
appearing to not listen while others are talking
having difficulty with time management and organization
frequently losing everyday items
avoiding tasks that need prolonged focus and thought
having difficulty following instructions
Hyperactivity and impulsivity
Some or all of the following may be apparent in someone with ADHD:
seeming constantly “on-the-go” and unable to sit still
running or climbing at inappropriate times
having difficulty taking turns in conversations and activities
fidgeting or tapping the hands or feet
talking and making noises excessively
taking unnecessary risks
In adults
Adults and children tend to experience the same symptoms of ADHD, and these can create difficulties in relationships and at work.
The effects of these features vary widely from person to person, and a person may find that their experience of ADHD changes over time.
Not everyone with ADHD is noisy and disruptive. A child may be quiet in class, for example, while facing severe challenges that they do not express.
In females
Females with ADHD may be more likely to have difficulty paying attention, while males may be more likely to experience hyperactivity and impulsivity.
This may be one reason why more males than females receive diagnoses of ADHD. Hyperactivity can be easier to spot than inattention.
Diagnosis
Most children with ADHD receive a diagnosis while they are in elementary school, but some may not do so until adolescence or adulthood.
No single test can identify ADHD, and the symptoms can overlap with those of other conditions. This can make it difficult to diagnose.
A doctor will conduct examinations to rule out other potential causes, such as hearing or vision problems.
Other conditions that can lead to similar behaviors include:
trouble hearing or seeing
anxiety
depression
learning disabilities
sleep disorders
A doctor will often ask questions to learn more about the person’s behavioral patterns. They may speak with the individual, members of their family, and any other caregivers, such as teachers.
Many children experience hyperactivity and inattention. For a diagnosis of ADHD, the symptoms must meet specific criteria, including having a significant impact on daily life and schoolwork.
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