By Dr Vinod
There are very few people who have not experienced back pain or its related complications at least once in their life. Factors such as age, gender, and occupation play a minimal role in its occurrence. Despite its prevalence, many individuals tend to overlook it, assuming it will resolve on its own. At the same time, according to the World Health Organization, women between the ages of 30 and 55 are more likely to experience these physical problems. In 90% of cases, non-specific back pain emerges as the predominant symptom.
What is lower back pain?
Pain or Discomfort occurring between the rib cage and the thigh bone is commonly identified as low back pain.
The functional components of the spine comprise of two vertebrae, the disc situated between them, and the connected ligaments. Movement and disorders affecting the midsection have an impact on these functional units.
Structure of the Spine
Vertebrae, discs adjacent ligaments, joints and muscles surrounding the vertebrae are important constituents of vertebral column. The vertebral column protect the spinal cord and nerves to the limbs, help the body stand upright, and help the body movements.
Recognizing Symptoms of Spinal Diseases
Pain in and around the lower back, pain radiating from the lower back to the legs, and pain confined to the legs can all be symptoms of an unhealthy spine.
Symptoms such as a burning sensation, paraesthesia , leg weakness, difficulty standing or walking for extended periods due to numbness and tingling, constipation, and urinary obstruction all indicate issues arising from nerve or spinal cord compression.
Common Triggers for Low Back Ache and Features
1. Non-specific back pain-without major pathological causes.
Back pain can be caused by a muscle strain, ligament strain that affects the lower back (spinal strain), after doing tasks that you don’t normally do, or due to trivial injury.
A day or two of rest will relieve this difficulty. Physicians may recommend medications and physiotherapy to facilitate recovery. The key lies in abstaining from the specific activity that triggered the back pain to prevent a recurrence of the same .
2. Disc related disorders
Conditions such as disc herniation (bulging disc), spondylosis (spinal wear and tear), muscle spasms, sprains, listhesis (spinal displacement), and stenosis (narrowing of the spinal cord) are all linked to an unhealthy spinal disc.
Mild back pain typically responds well to rest, physical therapy, muscle relaxant medications, and cold & warmth, constituting approximately 90% of cases. Meanwhile, for those with severe pain, a selective nerve root block injection into the spine can also help. Symptoms usually resolves within four to six weeks. Five to 10 percent of people with disc disease with severe pain or Neurological symptoms may need keyhole surgery depending up on severity of disease.
3. Spinal cord compression/ Lumbar canal stenosis-
Difficulties due to narrowing of the spinal cord are usually seen in the elderly. Such conditions are called lumbar canal stenosis.
When standing and walking for a long time, there is dull aching pain , burning, tingling and weakness in the legs. Get relief while sitting and lying down. For milder issues, medication and exercise can effectively manage the difficulties. However, in cases of more pronounced symptoms, surgical intervention may be necessary to remove compression of the affected segments of the spinal cord.
4. Persistent / Chronic back pain.
Obesity, smoking, sedentary work, poor posture, poor physical health, wear and tear of the spine, weak bones, atrophy of the muscles that strengthen the lower back, and recurrent or chronic disc-related disorders can all contribute to persistent back pain. If symptoms persist for more than six weeks, testing is necessary. Treatment should be done by observing the various symptoms of back pain and finding the exact cause.
5. Metabolic bone problems
Deficiency of vitamin D3, abnormalities of calcium, and phosphorus metabolism, thyroid disease, certain tumors and functional abnormalities of kidney and liver, can all affect the metabolic process of the vertebrae and cause back pain. Appropriate treatment should be administered based on the specific underlying condition.
6. Inflammatory back pain
Inflammatory back pain affecting the spine can be alleviated if detected early with medications and back care. In such people, the pain is worse during rest and early in the morning.
7. Quada equina syndrome-
It results from the intense compression of the spinal cord, typically due to massive disc herniation, tumors, fractures, or blood clots. Individuals may experience physical challenges, such as hindrance in bowel movements, urinary symptoms, saddle Anaesthesia and Para thesis and weakness in the legs. As it signifies nerve dysfunction, prompt surgical intervention, ideally within 48 hours, is crucial to restore the impaired nerve function. Beyond this timeframe, the damage to nerve function becomes irreversible.
8. Spondylolisthesis
This is back pain caused by misalignment of the vertebrae in the spine. Symptoms include back pain, leg cramps, weakness, leg paraesthesia, lumbar canal stenosis symptoms and cauda equina syndrome in severe cases.
Doctors often advise patients to wear a brace and follow back care . If it is affecting ADL with exercise, weight reduction and back care, etc., surgically displaced bones may need to be reattached with screws along with decompression of the nerves.
9. Curves of the spine/kyphosis or scoliosis.
Curves in the spine can also cause back pain. Bends can occur due to birth defects, growth abnormalities, trauma, problems affecting the nerves, lack of muscle strength or osteoporosis. Treatment is decided based on age, severity of the curve, pain, and disability.
10. Pain spreading from the organs near the spine
Diseases affecting organs near the spine such as the kidneys, pancreas, aorta, prostate, uterus, and peritoneum are often experienced as back pain. Such people often experience symptoms of the respective organ along with back pain. Herpes zoster, a disease that affects the nerves, is also seen with very severe back pain or leg pain. Blisters will appear on the skin within a few days of onset of pain along the nerve territory.
Low Back Ache with RED FLAGS/ Serious Causes Which Needs Urgent Treatment
Along with pain, various symptoms may indicate underlying issues, including nocturnal pain, fever, appetite loss, weight loss, back pain associated with bowel obstruction urinary symptoms, leg weakness, and those patients on long-term use of steroids or immunosuppressants (e.g., in cancer treatment). These symptoms may indicate severe causes like vertebral fracture infections, or tumors, necessitating prompt medical attention and emergency treatments.
Due to diseases affecting the spine, the patient may suffer lot of difficulties and disabilities. With regular exercise, weight reduction, proper back care and expert medical advice can reduce the disabilities. In minority of cases patients may need advanced spine surgeries which are safe and that can lead a normal life. So low back should not be ignored, get an expert opinion to find out the cause, treat early, follow proper advises and it can be completely cured.
