Q I'm an avid runner, and I've recently been having a back pain that doesn't seem to go away. I've tried to rest, stretch and warm up more and even changed my running shoes, but it's still there. How do I know if this is a serious problem? Should I stop running and seek medical attention?
A It is not uncommon for runners to get back pain. Most patients who seek consultation suffer back pain that is typically muscular in origin. Only about 10 to 20 per cent of patients require surgical intervention.
The important questions to answer are: How to reduce the incidence of back pain, and when to know it is serious.
As we age, our soft tissues lose their natural elasticity. Muscles lose their tone, and we become more prone to injury as our soft tissues would tear more easily with the loss of elasticity.
Hence, it is very important to warm up properly before a run. In our busy daily schedules, we usually set aside a fixed amount of time for our "workouts" and this often does not include the warm- up and cool-down routines.
In the long run, however, this is detrimental to our body, as our soft tissues and muscles become tighter without proper warming up, stretching and cool down. Hence, we end up being more prone to injury, especially if our physical activities require explosive bursts of muscular strength.
Another way to reduce injuries to the spine when running is to note the style of running.
It is not advisable to land with the heel striking the ground first, as it is jarring and transfers more kinetic energy upwards to the spine. This energy is known to dehydrate the discs with time, as fluid is forced out of the discs with each impact.
Cross training is another way to keep fit while reducing "burnout". For instance, substitute running with cycling, swimming or workouts on elliptical machines.
Finally, an important but often neglected part of fitness is core strength.
Training our core gives us a good dynamic support to our spine, allowing it to have better shock absorption, better reaction to the biomechanics of running, and also to reduce the wear-and- tear of the static structural support - our discs, joints and bones in our spine.
How can we tell if the back pain is serious and requires medical attention? Generally, a muscular pain may be sharp initially, but reduces after a few days with rest, medications like anti-inflammatories or physiotherapy.
If your pain remains for more than a two weeks, it usually indicates a structural problem. Other red flags include pain that gets worse when coughing, sneezing or going to the toilet. Any associated incontinence is a serious matter. The pain should not shoot down the legs, and should be better at rest or when sleeping. It should also not be associated with any fever, sweating at night or unexplained weight loss.
It is wise to seek proper medical advice before the pain gets any worse. Nevertheless, we should continue exercising but in a safe manner.
Dr Chua Soo Yong
Orthopaedic surgeon at Mount Elizabeth Hospital
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