Doctor! I have a Back Pain

This is one of the commonest things we hear in our Chamber, So are you alone?

No, The occurrence of low back pain in India is quite alarming with nearly 60% of the people in India have suffered from low back pain at some time during their lifespan. 

And in worldwide data, it's 50% to 84%.

Why am I having this Pain?

Any pain is a Signal given by the Body to the Brain that something Somewhere is Wrong.                                                                                            Take action. 

Similarly, back pain is a signal of something wrong in the back and it may be as simple as just a Sprain which will heal on its own too as dangerous as Cancer!

What are the Bad Back Pains that I should worry about most?

1. Any Pain that Increases at Night and disturbs your sleep.
2. Pain that Increases in the morning and Lasts Longer than 30 mins.
3. Low Back Pain with gradually increasing weakness in either of the Limbs
4. Low Back Pain after any serious trauma or accident
5. There is a shooting pain in both or a single Leg.
6. Back Pain with Pain in many other joints with or without swelling.
7. Back pain with fever or weight loss or with chronic cough.
8. Any pain that lasts more than a month should be Investigated.

So if any of these matches, please consult a doctor as soon as possible.

What is the commonest cause of Back Pain?

Commonly it occurs due to sprain. Where due to improper posture or sudden movement the muscles or ligaments around your back tightens and get stiff to protect your spinal cord.

It generally heals on its own within a week.

So What are the Other Causes of Back Pain?

1. Arthritis. (Spondylitis)
2. Degenerative Conditions related to age. (Spondylosis)
3. Disc Related Problems. ( Disc Prolapse)
4. Facet Joint arthritis.
5. Kidney Stones too present as Back Pain.
6. Osteoporosis. ( Minerals decreased in your vertebra )
7. Cancer or Metastasis (rare, but a possibility)

And, are Spondylosis and Spondylitis Different things?

Yes, Not every  Pain is Spondylosis/Spondylitis.

There are four terms, used by Doctors:

1. Spondylosis: It is generally seen in patients above 45years. It means your bones are degenerating and it's quite normal with age. 
2.  Spondylitis: This is something more serious. Caused due to various Inflammatory conditions like arthritis. 
3. Spondylolysis: This is fracture of a bone that connects two Vertebrae (your back bones)
4. Spondylolisthesis: Here one of your vertebrae has slipped forward or backward with respect to your other vertebra. 

Studies suggest almost 80% of People aged 45 and above have degenerative changes (spondylosis) but only 30% of them have Back Pain!! ( More common in Women).

Hence! Your Back Pain may not be caused just because of spondylosis !! Get it Investigated.

Can bad posture cause Back Pain?

Yes, and this is growing at a very alarming rate! Long-standing bad posture like working in front of computer Screens, or driving for a Long duration may result in stress to a side of the back resulting in back pain.

This is quite simple to treat and never occurs if we maintain the correct posture.

Why do I feel Numbness or Tingling sensation in one of my legs along with Back Pain?

Your Back has some important structures as follows:

1. Vertebra or the backbones: They mainly take the load off your back and protect the most important structure called the Spinal cord.
2. Disc: These are soft structures between the Vertebra that acts as a Cushion.

Now from the spinal cord, some nerves go down through a gap in Vertebra to your legs (It's just like mega electric wiring with the Main control center at the Brain).

Sometimes this Disc due to various causes bulges out and gives pressure on your Nerve causing the tingling sensation or  Numbness. (Check out the video)

So, Doctor what are the treatments?

To treat 1st, you need to know the exact cause of your pain. ( The Pain Generator)

That's why, your doctor will keep you asking questions regarding the origin of pain, duration of pain, the radiation of pain (like, any Loin to Groin pain may mean a Kidney stone), and various other questions to pinpoint the diagnosis.

Sometimes certain blood tests, as well as X-rays, may be suggested to verify the diagnosis.

MRI is" generally" not needed, except if the diagnosis was not possible with Simple X-ray or your Doctor has planned some interventions.

 ( Never forget to bring any old X-rays, blood tests, or prescriptions you have).

1. Medicines: 

• Pain killers with Muscle relaxants are the 1st line of Drugs that you may be prescribed. (Note: Pain killers if taken as advised don't cause kidney problems :))                      
• Some Nerve Medicines ( like Gabapentin) to relax the sensitized nerve which is caused by pressure due to your disc.
• Sometimes Calcium tablets are also given to improve bone strength.

     2. Exercise: 

     Believe it or not, this is the best and one of the most effective ways to cure your back pain                 permanently.

      But Exercises should only be performed after a proper diagnosis regarding the cause of the              pain.

     3. Modalities:

 Yes, Electric Modalities like TENS and UST are effective but dangerous too if not given by            properly trained Physiotherapists!!

     4. Interventional Pain Management: 

     One of the latest methods to relieve your pain. Here under C-Arm or Ultrasonography Machine         Doctor identifies the exact place of Pain and Injects medicine in that area to block the Pain               Generator. 

    After block for 4-5 hours you may feel numbness over one of your legs. (Its quite Normal)

5. Surgery: The last solution to any Problem!! ( Look out for a separate blog Soon).

Please leave out Comments if you have any doubts or Suggestions.