Back Pain: Causes And Treatment

About 60% of Indians experience pain in their lower back at some point in their lives. Most back pain is not critical, which implies it lasts between a few days to a few weeks and then is back to normal. But about 20% of people hit by acute low back pain develop persistent low back pain, suggesting their pain lasts 12 weeks or longer.

What Causes Back Pain?
Back pain can be triggered by an accident, heavy lifting, other vigorous activity, age-related alterations to the spine or some therapeutic conditions. These are some of the more common causes of back pain:
• Sprains and strains: Sprains are caused by overstretching or tearing ligaments, and strains are tears in tendons or tissues.
• Intervertebral disk degeneration: The whole process of ageing causes the normally rubbery disks to lose their spring ability.
• Herniated or ruptured discs: Intervertebral discs become compressed. A herniation is when this squeezing causes the discs to protrude outward.
• Radiculopathy, including sciatica: A spinal nerve route is compressed, inflamed or damaged. Force on the nerve root ends in pain, numbness or a tingling feeling that radiates to other areas of the body that are served by that nerve.
• Spondylosis: Normal wear and tear in the joints, discs and bones cause general degeneration of the spine.
• Spondylolisthesis: A vertebra of the lower spine slips out of place, pinching the nerves exiting the spinal column.
• Spinal stenosis: Narrowing of the spinal column puts tension on the spinal cord and nerves.
• Skeletal irregularities: Scoliosis, a curve of the spine, does not usually generate pain until middle age. Lordosis is an abnormally stressed arch in the lower back.
• Arthritis: This includes osteoarthritis, rheumatoid arthritis and spondylitis, swelling of the vertebrae.

What Treatments Can Provide Pain Relief?
It is most helpful to consider and use treatments for back pain, including hopeful new methods such as high-frequency spinal cord stimulation and dorsal root ganglion stimulation. Some summon treatment measures include:
• Physical Therapy: Exercises and stretches can strengthen core muscle groups that help the lower back, improve movement and flexibility and support proper posture.
• Behaviour modification: Discovering how to move your body properly during daily actions particularly those including heavy lifting, pushing or pulling can help relieve and prevent back pain. Adopting healthy habits, such as exercise, relaxation, regular sleep and proper diet, can also benefit.
• Complementary approaches: Yoga, acupuncture and massage are amongst the strategies that have shown some benefit.
• Spinal manipulation and mobilization: Chiropractors administer these techniques, which have been shown to provide small to moderate short-term benefits.
• Epidural spinal injections: A steroidal anti-inflammatory drug is injected into a spinal region called the epidural space.
• Nerve block injections: An anaesthetic and a steroid are injected into a specific nerve root of the spine.
• Radiofrequency ablation: A pain medicine specialist inserts a needle into the nerve responsible for the pain and zaps it using an electric current created by radio waves. This short-circuits the pain signals.
• Transcutaneous electrical nerve stimulation: These treatments send low-voltage electric signals from a small device to the painful area through pads attached to your skin.
• Intrathecal pumps: This implanted pump lets you push a button to deliver local anaesthetics, narcotics and other pain medications to your spinal cord.
• Low-frequency spinal cord stimulation: A small pacemaker-like device is inserted under the skin to deliver electric pulses to the spinal cord.
• High-frequency spinal cord stimulation: Early data are promising on the effectiveness of higher-frequency beats to give pain relief without the tingling or buzzing feeling felt with low-frequency stimulation.
• Dorsal root ganglion stimulation: This option to spinal cord stimulation interrupts pain signals by precisely targeting the nervures responsible for the pain.
• Medications: Muscle relaxants, analgesics and nonsteroidal anti-inflammatory medications can help.
• Surgery: Surgery is normally considered a last resort after more traditional approaches have failed. But the earlier or immediate cause of surgery is warranted for some conditions.

Dr Ashwin Kumar Reddy
Consultant – Orthopedics Sugeron