By Dr.Manvir Bhatia & Ananya
Our backbone is a very important part of our body. It maintains our posture. The vertebrate is made up of 24 bones sitting one on top of the other with discs in between each of them except the tail bones. These bones are supported by muscles and ligaments. The spinal cord connects the base of the skull to the rest of the body. The spinal cord passes through the vertebrae. It acts as a protective structure for the spinal cord. There are facet joints placed on either side of the spine.
Back Pain is a very common ailment. About 8 out of 10 people suffer from back pain at some point in their life due to various reasons such as any form of strenuous work, getting back to an old sport, or some underlying health condition such as arthritis or spondylitis.
Types of back pain :
Acute – It develops suddenly and lasts for less than six weeks.
Subacute – It lasts for around three to four months.
Chronic – It develops over a period of time and lasts for more than three months limiting our normal lifestyle.
Causes of back pain :
Muscle strain and ligament sprain are very common causes of acute back pain. Excessive strain, weight lifting, unsupervised training, etc can cause a strain on the muscles and ligaments resulting in back pain.
Strenuous work or exercise:
Being fit and exercising regularly strengthens our spinal and stomach muscles. Strenuous exercise or work e.g. lifting heavy objects suddenly, after a prolonged period of inactive lifestyle affects the back causing severe pain.
These include ruptured or bulging discs present between each vertebra. Sciatica is a result of a bulged or herniated disc that causes pain to shoot and travel through the buttocks and downwards from the back of the leg. Arthritis, abnormal curvature of the spine(e.g.scoliosis), osteoporosis and kidney problems are also responsible for back pain.
This is an inflammatory condition in which the joints of the spine swell up. This causes excessive pain, especially during the morning. There is stiffness which improves with movement.
As we age, the bones and discs of the back become very weak. Hence, the incidence of back pain is very common after the age of 45.
Medical ailments such as cancer of the spine, Cauda Equina Syndrome, fibromyalgia, infections, sleep disorders, etc. are common causes that can cause or exacerbate back pain.
Diagnosis of back pain:
The consultation of a doctor becomes extremely important in managing back pain. Depending upon his examination, a tentative cause is identified and investigations suggested accordingly, such as diagnostic tests, which will help in reaching the root cause of the pain. A few of them have been listed below:
X-ray: It gives a clear idea of the alignment of bones, broken bones, and arthritis.
MRI or CT scans: The generated images reveal herniated discs, and problems with bones, muscles, tissues, etc.
Blood tests : This helps in detecting underlying deficiencies, and infections that might be the cause of the back pain.
Bone scan: This is used very rarely, but identifies the tumors or bone compressions caused due to osteoporosis.
Nerve tests: measure the electrical impulses produced by the nerve cells and the response of the muscles. It can confirm nerve compression in case of herniated discs and spinal stenosis (narrowing of the spinal cord).
Treatment of back pain :
Medication – Pain killers are used. Non-steroidal anti-inflammatory drugs such as ibuprofen and narcotics such as codeine, hydrocodone, etc. are prescribed for a short period of time.
If these medications do not work, cortisone, an anti-inflammatory drug is injected into the epidural space. This provides relief by reducing the inflammation around the nerve endings.
Exercise – There are exercises that need to be under the guidance of trained professionals. Making a chart of exercises that may be relevant to a particular body type and the underlying problems in presence of a trained instructor is very effective.
Manual therapy – It includes treatments where the trained therapist uses hands to massage and apply pressure to muscles, bones, and joints present along the spine. It is known to work wonders if supplemented with exercise.
Nerve treatment – Needles are inserted into the nerves connected to the affected nerves. Radio waves are sent through the needles to these nerves. This heat prevents them from sending pain signals. A local anesthetic is used to numb the back before performing the procedure. The associated risk of bleeding, bruising, and accidental nerve damage should be discussed with the Surgeon beforehand.
Transcutaneous electrical nerve stimulation (TENS) – This is popular among patients with chronic back pain. A machine provides electrical signals to the body through electrodes placed on the skin. It is non-invasive and cost-effective. The body releases endorphins that reduce pain signaling.
Spinal fusion surgery – This is recommended only if our bones are significantly damaged. It fuses two vertebrates to strengthen the bones. It stops the damaged vertebrates from squeezing the nerves thereby reducing the pain.
Self-management of back pain:
It was earlier believed that rest tends to relieve back pain. Now individual suffering from back pain should remain active in performing their regular activities and also find time to exercise regularly. Stretching and back exercises are of great help.
Hot and cold packs:
Heat works well to relieve back pain for some people. Therefore, placing a hot water bottle on the affected area is very helpful. Cold packs are also effective for the short term. Alternating between hot and cold packs works very well.
Relaxing and staying positive:
It is important that one stays positive irrespective of their condition. Believing that proper treatment and care shall be helpful. Relaxing helps relieve pain and muscle tension.
Hence, we conclude that our back being such an important part of the body deserves our utmost care. We should exercise regularly to keep our backbone strong and in good condition. Eating good food, getting a good night’s sleep, etc. are measures that we need to inculcate in our life. Also, one should not avoid consulting a doctor for too long in case of back pain. Getting diagnosed and treated appropriately at the right time can work wonders in improving our condition.