Posted by: wockhardthospitals | July 7, 2009

Understand Back Pain

Back Pain
By Dr. K N Krishna, Consultant Neuro Surgeon, Wockhardt Hospitals

Most people suffer from back pain at one time or the other during their lifetime. Back pain ranges form mild pain in the back to sharp and sometimes chronic pain that can severely affect a person’s mobility. Most back pain is generally the result of trauma to the back caused by stress or strain at Back painhome or at work or the result of diseases and disorders such as disc prolapse, spondylolisthesis (slipping of vertebral bones) etc.

Causes:
Back pain is only a symptom that suggests an injury or disease of the spine and surrounding soft tissues like muscles, ligaments etc. but not a disease by itself. Some of the common medical conditions that cause back pain are:

Trauma to the back: Injury caused to the back while lifting weights, sports injuries, Lumbar strain, improper posture, repetitive stress injuries, sprains, strains, fractures etc…Here predominantly the soft tissues like the muscles and ligaments are involved and it contributes to the bulk of the Back aches

Vertebral and disc related conditions: Conditions such as the disc related problems like herniation or prolapse, or degeneration of disc due to reccurent trauma, ageing,; spondylolisthesis( slipping of vertebrae), and ankylosing spondylitis; spinal stenosis (a narrowing of the spinal column that puts pressure on the spinal cord and nerves), etc…

Osteoporosis with or without the fractures specially in the elderly and post menopausal women.

Infections of the vertebrae, like spinal TB, and other bacterial infections especially in diabetics, immuno compromised patients, debilitated patients with some other focus of infection in the body.

Tumours of the spine can cause acute back pain however it is extremely rare.

Prevention:
Maintaining physical fitness by following an exercise routine strengthens the back muscles and makes it less prone to injury, maintaining a health diet and keeping ones weight under control puts less strain on the back, diets that include calcium and vitamin D help strengthen the back and protect it from fractures.

Calcium is found in abundance in milk and dairy products and even in green leafy vegetables. Vitamin D is manufactured by the skin when exposed to the sun.

Treatment:
The treatment for back pain is centered on the cause of pain the patient is experiencing. During the treatment it is important to remember that back pain is a symptom of a medical condition and merely treating the pain will not cure the condition. It is important to accurately diagnose and treat the causes of back pain for a lasting solution.

Pain killers, anti inflammatory drugs, exercise, stretching, aerobics, hot and cold compression are some of the popular forms of treatment prescribed to reduce back pain.

In the most serious cases, when the condition does not respond to other therapies, surgery may relieve pain caused by back problems or serious musculoskeletal injuries.

When should one see a doctor?
In most cases back pain usually goes away with a little rest; however it is important to see a doctor if the pain is extremely acute or if the pain persists over a period of time. If back pain is accompanied with other symptoms such as fever, numbness and tingling in the extremities, lack of mobility, weight loss etc it is advisable to immediately consult a doctor

What does the doctor say?
Back pain is one of the most common pains for which one seeks medical attention. Over 80% of back pains are due to the musculo ligamental minor injuries during daily activity and majority of them are self resolving or require minimal rest and pain medication. Hence all forms of therapy relive pain. However remaining back aches which either may be very severe or associated with leg pain or tingling sensation spreading to legs, or those persisting even after good rest and those present even during rest require further medical evaluation to rule out the underlying serious vertebral/ disc disease. Once again after the diagnosis treatment option may be even surgery. Today minimal access microsurgery on the spine assures safety and promises speedy functional recovery. For instance even patients undergoing spinal fixation for fractures or spondylolisthesis are ambulated within 24 to 48 hrs after surgery which is a boon to these unfortunate patients. Modern anaesthesia and minimal invasive techniques have made surgery safe even for elderly and those suffering from other medical problems like diabetes, heart diseases etc.

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