BENGALURU: Lower back pain is common and confusing because it varies with person to person. The occurence too is unpredictable – it may be sudden or see a slow onset. It may be intermittent or constant.
Each episode can be extremely painful and can cause significant disruption in the patient’s life, to the extent that they may not be able to go to work for a few days.
Many patients with lower back pain fear surgery and this brings them to an orthopedic surgeon or a spine surgeon. Lower back pain can be acute or chronic.
It is important for patients to understand the underlying cause. The pain sometimes occurs after a sudden movement such as lifting or bending.
Old age is another factor when there are degenerative changes in the spine or if there is loss of bone density in older women. Correct diagnosis can only be done by a doctor.
Overly strenuous physical activity can cause muscle soreness which in turn causes back pain. Muscles and ligament fibers can be overstretched or injured. At the same time, sitting for prolonged period of time at work can also be an equally important reason for lower back pain.
A survey has reported that half of those with sitting jobs suffer lower back pain. This is quite prevalent in the IT industry.
Smoking has shown to be one of the causes for lower back pain. In a recent study from Feinberg School of Medicine, researchers have discovered a surprising connection between smoking and back pain. More and more studies indicate that smokers tend to suffer from back pain more frequently compared to non-smokers.
A British study looked into lifestyles of around 15,000 people including their smoking habits, jobs, activity levels and history of pain. It concluded that smoking alone increases one’s chances of developing a sore back by 30 per cent. Another metanalysis in Spine Journal revealed that there is consistent relationship between smoking and back pain. Smoking not only increases the risk of back pain but also increases the chances of developing chronic musculoskeletal pain.
When lower back pain persists for a week or two, there can be a possibility of disc injury or herniation. In old age, small tears in the outer part of the disc causes prolonged pain. When the jelly-like centre pushes against the outer ring, herniation can occur. Herniation bulges out toward the spinal canal, putting pressure on the sensitive spinal nerves, therefore causing pain.
When the pressure is put on the nerve root leading to the leg and foot, pain occurs in the buttock and down the legs. When the inter-vertebral discs begin to wear away and shrink due to old age, they may collapse completely and cause joints in the vertebrate to rub against one another triggering pain and stiffness.
Usually, treatment for lower back pain falls into one of three categories: medications, nerve blocks, physiotherapy and surgery.
Acute or chronic it is advised to show it to the doctor as they try to restore normalcy and prevent chances of disability.
Surgical treatment is only required in degenerative cases and only after the failure of conservative therapy.
While one cannot avoid the normal wear and tear on the spine that goes along with aging, there are things one can do to lessen the impact of low back problems.
Maintain a healthy weight. Being overweight puts added stress on your lower back.
Combine exercise like walking or swimming along with specific exercises to keep the muscles in your back and abdomen strong.
Do not bend over to pick something up. Keep your back straight and bend at your knees.
■ Correct posture is important. A physiotherapist can teach you how to stand, sit, and avoid LBP.
■ Do not panic.
■ Do not overtake pain killers as they cause side effects.
■ Consult a doctor for correct medication and treatment.
The author is from Manipal Hospital, MBBS,HOD
Department of Interventional Pain Medicine
Honorary Secretary (British Pain Society - PDC)