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People who deal with backaches have one message in common: Get it diagnosed, then decide whether to live with it or have it treated.

Doctors stress diagnosis because more than 80 percent of Americans will suffer from back pain at some point in their lives, and too many of them wait too long or never seek relief, even though relief may be available.

Backache is among the top five reasons for visits to the doctor, along with colds, flu, hypertension, infections and regular checkups, says Dr. Michael Cannon, associate professor of family practice at St. Louis University Medical School.

For chiropractors, it's the No. 1 reason, says Dr. Ralph Barrale, dean of postgraduate studies at Logan College of Chiropractic.

Both say back pain is often taken lightly because it seems so common. But it's important to know the source of the pain, they say, because it can run from sore muscles to organ failure.

The pain is an equal-opportunity nuisance. You can get it if you're young, old, male, female and in any ethnic group. Even young adults and children can get back pain, for reasons ranging from playing too hard to obesity to congenital abnormalities.

Here's some general information on back pain:

Q: Who can get back pain?

A: More than 80 percent of people report back pain; physicians and chiropractors believe those who don't report pain just live with it.

Q: What's the cause?

A: Back pain can come from any combination of these factors:

Work that requires lifting and twisting.

Work that requires sitting for long periods without stretching.

Inactivity and obesity, which often go hand in hand. Even athletic people can be inactive at work, sitting hours at a time in terrible positions. Couple that with obesity and the back is in trouble.

Q: Why the back?

A: The spine is a weight-bearing part of the body, built with shock-absorbing discs and a shock-absorbing design -- the S shape. Chiropractors say pain can come from muscles trying to pull the spine back into its proper shape after it gets out of alignment.

Ann Hayes, associate professor of physical therapy with St. Louis University, said that over the years, the discs get old and harden, then break, rupture, expand and put pressure on nerves in the spinal column.

The pain also can stem from cracked vertebrae and other degenerative problems that could come from lack of calcium or years of misuse. In addition, muscles can get injured or overstressed.

Chiropractor Barrale said the knot in a muscle, or a muscle spasm, is the body's way of locking a muscle in place so it and the joint can't be used while the system heals.

Sometimes the pain comes from more serious causes: infections of organs, organ failure or cancer near or in the back. That's why physicians want a diagnosis.

Q: What's the treatment?

A: It ranges from advice on exercise and lifestyle to ice and heat, spinal manipulation by a chiropractor, exercises by a physical therapist, over-the-counter painkillers, prescription painkillers and shots. The extreme remedy, surgery, is for incapacitating pain.

Q: What can you do to prevent back pain?

A: Back pain can be delayed, but people who pay the most attention to their posture, exercise and weight still can have recurring back pain.

Avoiding the pain

The National Institute of Neurological Disorders and Stroke suggests:

* Stretch before you exercise or do other strenuous physical activity.

* Don't slouch when you stand or sit.

* Make sure work spaces are suitable for you and don't require straining to use them.

* Sit in a chair with good lower-back support and proper position and height for your work. A pillow or rolled-up towel placed behind the small of your back can provide support. If you sit for a long period of time, rest your feet on a low stool or a stack of books.

* Switch sitting positions often and periodically walk around the office or gently stretch muscles to relieve tension.

* Wear comfortable, low-heeled shoes.

* Sleep on your side to reduce any curve in your spine. Always sleep on a firm surface.

* Don't try to lift objects too heavy for you.

* Keep your weight down.

* Eat a diet sufficient in calcium, phosphorus and vitamin D to help promote new bone growth.

* Don't smoke. Smoking reduces blood flow to the lower spine and causes the spinal discs to degenerate.

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