A 13-year-old school student, Rishab (name changed), had to seek immediate treatment when one day he suddenly developed lower back pain accompanied by shooting pain in both his lower limbs. He even found it difficult to walk. The Delhi student, who was brilliant in his studies and rarely missed school, had to halt his studies.
After a detailed evaluation, he was diagnosed with a genetic condition that leads to narrowing of the canal of the spinal cord. With the help of intraoperative CT and neuromonitoring, surgery was carried out at the Indian Spinal Injuries Centre, Vasant Kunj, Delhi, which helped him walk again.
Today, the boy is recovering and, hopefully, will soon pick up where he left off.
Similarly, 40-year-old Anil Kumar (name changed), who was a carpenter in Bengaluru, suddenly suffered from severe pain in the back and left leg. He had mistakenly lifted a weighty object without taking proper precautions.
The MRI showed a large extruded disc which had come out of its usual place and was severely compressing the left-sided nerve root. As he was scared of surgery, his friends and family took him for multiple alternative treatments. But there was no relief.
Finally, when he could not take the severe unbearable pain, and was unable to sit for more than five minutes and suffered from weakness in his legs, he underwent a minimally invasive microdiscectomy - a minimally invasive spinal surgery removes part of a herniated disc in the lower back. The pain subsided immediately, and he was able to walk comfortably.
Both the Delhi schoolboy and the 40-year-old man suffered from spine-related problems, which, according to experts, are becoming very common in India.
Highlighting the notable increase in spine-related problems among the Indian population, Dr Deepak Joshi, director, Sports Injury Centre, Vardhman Mahavir Medical College (VMMC), and Safdarjung Hospital, Delhi, said approximately 60% of Indians may experience significant spine-related issues at some point in their lives.
“Studies indicate that lower back pain (LBP) has a prevalence rate of 48%,” he said.
According to the World Health Organisation, in 2020, lower back pain affected 619 million people globally, and it is estimated that the number of cases will increase to 843 million by 2050, mainly driven by population expansion and ageing.
LBP is the single leading cause of disability worldwide and the condition for which the most significant number of people may benefit from rehabilitation. It can be experienced at any age, and most people experience LBP at least once.
According to Dr Vikas Tandon, director and chief of Spine Services at the Indian Spinal Injuries Centre, Vasant Kunj, who treated the Delhi schoolboy, spine health is often overlooked in India.
“We often hear about the importance of physical health, but one of the most overlooked areas is spine health. Your spine plays a crucial role in your overall well-being, supporting your head, allowing movement, and protecting the delicate spinal cord that sends signals to the rest of your body.”
“Your spine is much more than just a structure that holds you upright - it’s the foundation of your mobility and overall function,” he stressed.
Why is spine health important?
Dr Aashish Chaudhry, director and head, Department of Orthopaedics and Joint Replacement, Aakash Healthcare, Dwarka, Delhi, said spine health becomes extremely important because it is a central axis of the human body, which, at the same time, is responsible for providing stability in the standing or bending or a sitting position and at the same time give enough flexibility to carry out all the regular physical activities and even the sporting and the aggressive physical activities. “All are possible because of the spine’s health,” he said.
The main reasons for the rise in spine-related problems in the Indian population, according to Dr Joshi, are a sedentary lifestyle, poor posture, obesity, and ageing, and is seen more in women, rural population and labour-intensive workers.
Dr Anup Khatri, senior consultant in Orthopedics at Gleneagles Hospital, Parel, Mumbai, added long working hours and excessive screen use could also contribute to spine-related problems.
“Spine problems can be seen more among office workers, IT professionals, older adults, and manual labourers. These people often sit in front of their digital screen for hours, lift weights, and rarely get time to stay mobile. This can negatively increase their risk of spine problems.”
Dr Dhruv Chaturvedi, associate director of Neurosurgery at PSRI Hospital, Delhi, said another category of people experiencing increasing spinal problems is young adults, especially those who go to the gym and do deadlifts and weighted squats and may develop lumbar spine problems.
Agreeing that spine-related problems have gone up in the country, Dr Raghuram G, additional director of Meurosurgery, Fortis Hospital Bannerghatta Road, Bengaluru, said one reason could be the bad quality of roads and the increasing number of people doing desk jobs and having poor posture.
It could also be because more and more Indians are becoming diabetic and obese, which indirectly affects the spine health, Dr Chaudhry said, adding he is seeing many children in the age group of 15-17 years suffering from spine-related problems because they spend more time on screen than outdoors.
“Most Indians are leading a sedentary lifestyle. The physical activities of most people, even children, are less. All these factors are significantly leading to an increase in spine-related issues in the Indian population.”
Spine-related problems Low back pain, slipped discs, spondylitis, sciatica, osteoporosis, and spinal stenosis are the most common spinal problems being reported in the country. Spinal cord injuries and degenerative spine diseases are the other commonly reported spine problems.
Road traffic accidents and sporting activities also lead to many spinal fractures, which are acute conditions and can cause permanent or temporary paralysis of the lower limb or the upper limbs.
The treatment options range from non-surgical management in the form of anti-inflammatory drugs, physiotherapy, core or back muscle strengthening exercises, and epidural steroid injections to surgical management, said Dr Tandon.
According to Dr Biji Bahuleyan, senior neurosurgeon and spine surgeon at Welcare Hospital, Kochi, excluding patients with spine infections and malignancies, a significant number of patients with spine degenerative diseases improve with conservative treatment measures like lifestyle modification, medications, and physiotherapy.
“Hence, this should be tried first in all patients for at least 6-8 weeks before considering them for surgery. An MRI of the spine with or without a CT scan is important in all patients who do not improve with the above mode of treatment. If patients do not improve with these measures’ surgery should be considered based on what is seen on the MRI.”
He said the surgery to be offered depends on the cause of the patient’s symptoms. “For example, patients with disc prolapse are candidates for discectomy (removal of the prolapsed disc). For spondylolysis, spondylolisthesis or scoliosis, decompression of the spinal cord and roots with fusion of the vertebrae with the aid of titanium screws and rods is recommended.”
Dr Raghuram G, who treated the Bengaluru-based carpenter, said spinal surgeries are usually considered safe and successful.
“Spine surgeries in India boast high success rates, typically 80% to 95%, depending on the procedure and patient health. However, the outcome of the surgery mostly depends on the patient’s condition and physical well-being. Advanced surgical techniques like robotic surgery have improved recovery rates with minimal incisions.”
But not all spine problems need surgeries. Dr Joshi says surgeries are typically performed to address degenerative conditions, injuries, deformities, and spine tumours.
Mantra for a healthy spine
The best approach is to ensure proper posture, mobility, and flexibility, which will lead to pain-free living.
“For a healthy spine, you have to exercise regularly (especially your core and back muscles), maintain good posture, lift properly (always bend your knees, not your back, when lifting heavy objects), maintain a healthy weight, and avoid smoking,” added Dr Tandon.
Dr Khatri also suggested that people should avoid lifting heavy weights without proper technique or support.
“Individuals are advised to use ergonomic chairs, take frequent small breaks from sitting and sleep on firm mattresses to protect their spine.”
For those on desk jobs, Dr Raghuram G stressed they should take regular breaks to stretch and move around, maintain a healthy weight, and exercise regularly. At the end of the day, spine health matters as it provides structural support for one to stand, sit and move with ease.