Reviewed By Dr Hasan Feroz, MD,
Back pain is a very common disease faced by most people nowadays. Most people experience back pain several times in their lifetime. Some back pain is very problematic while some back pains are mild and resolved with maintaining proper posture and lifestyle.
The reasons for back pain are numerous for e.g. some are due to bad habits and lifestyle while some are due to injury, infection or nerve compression. The treatment of back pain depends on the causes of the underlying disease.
Symptoms of Back Pain
The symptoms of back pain are many. let understand the anatomy of your spine. Your spine is made of typical structure that contains muscles, vertebrae, discs, ligaments, nerves. The spine contains several nerves coming from your brain to your legs. it communicates signals to and from the body to brain.
Persistent pain in any of the areas from your neck to lower spine.
Sharp pain while prolonged sitting specially in your lower spine (Lumber Spine)
Pain radiated from lower spine to legs via buttocks
Unable to walk
Loss of bladder and bowel control (in extreme condition)
Causes of Back Pain
Back pain may develop with or without cause. Some patient may face severe back pain suddenly while some develops gradually. The main causes of back pain are discussed below:
Bad Posture or Poor lifestyle- Bad posture while sitting plays a major role in developing back pain. People whose work is on a computer or their work requires continuous sitting face back pain. In about 80 percent of people faces back pain due to this condition.
Muscle or ligament strain- When a person lifts heavy weight or a weight lifter may face the problem of back pain due to muscle strain. When we lift the heavy weight our muscles get a lot of pressure on it and causes pain. The ligaments around the spine also tend to strain due to heavy weight lifting.
Bulging or ruptured disks- When we lift the heavy weight the disk between the vertebrae pressed with vertebrae and can bulge causing the nerve press. The disk is a soft material stuff act as a cushion in between the two vertebrae.
Arthritis- When people ages their bones getting weak and causes degeneration. When osteoarthritis occurs, the degeneration process starts resulting in narrowing the nerve roots causes severe back ache.
Infections- It is common nowadays to develop infections in the bones of the spine. In the spine generally, tuberculosis infection is common. Tuberculosis affects the disc, vertebrae and ligamentum flavum. This condition is called Pott’s Spine where your spine is infected with mycobacterium tuberculosis bacteria causes severe pain, illness, fever and in some cases claudication and loss of bladder bowel control.
Diagnosis of Back Pain
Diagnosis is made based on the location where the pain is and the type of the pain. If the pain is acute and sharp, there is some inflammation and changes in the spine while pain is chronic and is having for a long time, it means that you have some chronic disease of the spine like nerve compression, degenerative changes and maybe infection. He can also check your sensory and motor functions to determine the cause of the pain.
Based on the types of pain and location of pain your doctor will be able to examine you to identify the real cause of the problem. Your doctor may also prescribe you an MRI, X-Ray or CT-Scan of your spine to detect the problem.
Treatment of back Pain
There are various treatments available to relieve back pain. You may take hot and cold patches to relieve the back pain. If the pain is consistent you may take paracetamol or ibuprofen for pain relief. You may take any analgesics to relieve pain symptoms at home.
Doing proper exercises may also reduce the back pain but it should be under the physiotherapists advise. you may also get relief from back ache if you take proper bed rest with flat mattress. Avoid the bed or couch which makes your spine curve always use flat bed and mattress.
Steroids- Your doctor may prescribe you steroids to relive pain and stiffness of back. Steroids is a good good anti-inflammatory drugs which relives your inflammation and stiffness causing pain and stiffness. if your pain is not reliving your spine surgeon may use cortisone steroid injections in epidural space of the spine which relieves pain immediately.
Anti-depressants- Use of anti-depression medicines like tricyclic like nortriptyline, amitriptyline may also works on nerve pain and disc bulge. it reduces the nerve pain which causes back pain and stiffness.
Muscle Relaxant Ointments- You may also use the muscle relaxant available OTC medication. It relaxes muscle spasm and stiffness. it contains diclofenac sodium, linseed oil, methyl salicylate and menthol which is helpful in pain relief.
Nerve Stimulants- Most physiotherapists use nerve stimulants that trigger compressed nerves like IFT, Tense, SVD (Short wave Dithermi).
Surgery- If the patient is not reliving the pain with the above-mentioned methods the final option is to opt for the surgery. Surgery requires in only 5-10 percent of patients. Surgery is needed in patients who have been suffering from chronic nerve compression, spinal stenosis, degenerative disease causing thecal sac compression and whose bowel and bladder with sensory and motor affected.
In accidental cases, if the injury is in the spine and affected your bladder and bowel, your doctor will have to opt for the option of surgery to remove the compression from the nerves which affect the bowel and bladder.
When Back Pain is Serious
In some cases, back pain worsening day by day and causes severe pain. In some patients, pain goes to such a level that the patient is not able to do their daily activity. You have to be cautious if your patient is facing these issues-
Numbness in feet
Unable to walk/stand
Unable to control lower part of the bodt
Unable to feel urine urge
Urine Incontinence or urine retention
Loss of bowel control
Pain radiating to legs/sciatica
Loss of weight/appetite