That nagging pain: Here’s how you can manage and reduce back pain

By Ankur Biplav

A new Lancet report says back pain will affect 800 million people by 2050 globally. In India, too, back pain is a common health issue experienced by many people, says Dr Yash Gulati, senior consultant, orthopaedics, joint replacement and spine, Indraprastha Apollo Hospitals, New Delhi. He says it can affect individuals of all ages and is caused by various factors, including poor posture, sedentary lifestyles, lack of physical activity, obesity, muscle strain and underlying medical conditions.

The prevalence of back pain in India is significant, with studies suggesting that around 20% to 30% of the population experiences some form of back pain. It is one of the leading causes of disability and work absenteeism in the country.

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What are the major reasons for chronic back pain?

Poor posture: Maintaining incorrect posture while sitting, standing or lifting heavy objects can strain the muscles, ligaments and discs in the back.

Muscle or ligament strain: Overuse, improper lifting techniques or sudden movements can cause strains in the muscles or ligaments supporting the spine.

Herniated disc: When the soft cushion-like discs between the vertebrae in the spine rupture or bulge, they can press against nearby nerves, causing back pain.

Degenerative disc disease: With age, the discs in the spine can degenerate and lose their ability to provide proper cushioning. This can lead to chronic pain, stiffness and reduced flexibility in the back.

Spinal stenosis: This condition involves the narrowing of the spinal canal, which can put pressure on the spinal cord and nerves, causing chronic pain.

Arthritis: Osteoarthritis and other forms of arthritis can affect the spine, leading to back pain.

Skeletal irregularities: Some individuals may have structural abnormalities in their spine, such as scoliosis (sideways curvature) or kyphosis (excessive forward curvature), which can cause chronic pain.

Injuries: Traumatic injuries, such as fractures, sprains or strains, can damage the structures of the back and result in chronic pain.

Medical conditions: Certain underlying medical conditions such as fibromyalgia, spinal tumours or infections can cause chronic back pain as a symptom.

When should one visit a doctor and are there any alarming signs to look out for?

Severe or worsening pain: If your back pain is severe, progressively worsening or does not improve with rest and self-care measures, it is important to seek help.

Pain radiating down the leg: Back pain accompanied by pain, numbness, tingling or weakness that radiates down one or both legs may indicate a nerve-related issue.

Bowel or bladder dysfunction: Difficulty or loss of control in urination or bowel movements or numbness in the groin area can be signs of a serious condition.

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Traumatic injury: If your back pain is a result of a recent injury such as a fall, car accident or sports-related incident, it is essential to seek medical attention.

Fever or infection: Back pain accompanied by fever, chills or signs of infection such as redness, warmth, or swelling around the spine should be evaluated.

Unexplained weight loss: If you are experiencing unexplained weight loss along with back pain, it may be indicative of an underlying medical condition.

History of cancer: Individuals with a history of cancer and new-onset back pain should consult a doctor.

Night pain: Back pain that consistently worsens at night or disrupts sleep should be evaluated by a healthcare professional.

When is surgical intervention needed?

Structural issues: If the back pain is caused by structural abnormalities such as herniated discs, spinal stenosis (narrowing of the spinal canal), spinal deformities (e.g., scoliosis) or spinal fractures, surgery may be necessary.

Nerve compression: When a nerve in the spine is compressed, causing severe pain, weakness, numbness, or loss of function, surgery may be performed.

Failed conservative treatments: If non-surgical treatments such as medications, physical therapy and injections have been tried without significant improvement, surgery might be considered.

Progressive neurological deficits: If the back pain is accompanied by progressive neurological symptoms, such as worsening muscle weakness, loss of bowel or bladder control or difficulty walking, surgical intervention may be necessary.

Traumatic injuries: In cases of severe trauma or injury to the spine, surgery may be required to stabilise the spine, realign fractured bones or repair damaged tissues.

Surgical intervention is typically considered as a last resort when conservative treatments have been exhausted, and the decision to proceed with surgery should be made in consultation with a qualified healthcare professional or spine specialist.