Dr. Neeraj R. Bijlani

Consultant Orthopaedic Surgeon Trauma,  Spine & Joint Replacement Specialist.

Spine Treatments

According to the Mayo Clinic, USA, approximately 80% of all Americans will certainly suffer from low back pain at least once in their life. Looking at this data, we can clearly see that back pain is one of a very common problems that ails people. Such is the effect of this ailment that it is considered as one of the common reasons for absence from work or visiting the doctor. 

As per the records of the NHS (National Health Service), UK; backache is the primary cause of work-related absence in the United Kingdom. Although back pain may be painful and may cause some discomfort, it is usually not serious. Back pain ails every individual belonging to any age-group, however, it significantly affects those falling in the age bracket of 35 years onwards. 
Pain in the upper back is caused due to disorders of the aorta, tumours in the chest and inflammation of the spine. 
Back pain, on the other hand, is associated with the combined working of our bones, muscles and ligaments. Pain in the lower back may be linked to numerous reasons. These may include the discs between the vertebrae, lower back muscles, ligaments around the spine and discs, bony lumbar spine, spinal cord and nerves, abdomen & pelvic internal organs and the skin around the lumbar area.

What are the factors causing back pain?
Listed below are the factors that may act as a catalyst in causing back pain:

  • A mentally stressful job
  • Pregnancy
  • A sedentary lifestyle
  • Age
  • Anxiety
  • Depression
  • Gender - back pain is more prevalent among females as compared to males
  • Obesity/overweight
  • Smoking
  • Strenuous physical exercise (especially if not done properly)
  • Laborious physical work

What are the main signs and symptoms of back pain?

The primary symptom of back ache is pain anywhere on the back and sometimes it goes down uptil buttocks as well as legs. If any of the following signs or symptoms accompanies a back pain, it is time to consult a doctor:
  • Weight loss
  • Elevated body temperature (fever)
  • Inflammation (swelling) on the back
  • Persistent back pain - lying down or resting does not help
  • Pain down the legs
  • Pain reaches below the knees
  • A recent injury, blow or trauma to the back
  • Urinary incontinence - You urinate unintentionally (even small amounts)
  • Difficulty urinating - Passing urine is hard
  • Faecal incontinence- You lose your bowel control (you pop unintentionally)
  • Numbness around the genitals
  • Numbness around the anus
  • Numbness around the buttocks
According to a study conducted by the National Health Service (NHS), UK, people falling the listed below categories should seek medical advice if they experience any kind of back pain:
  • Individuals aged less than 20 years or more than 55 years
  • Patients who have been taking steroids since the past few months
  • Drug abusers
  • Patients suffering from cancer
  • Patients who have suffered from cancer in the past
  • Patients with low immune system

What are the causes of back pain?

The human back is made of a structure of muscles, tendons, ligaments, disks and bones, all of which are cushioned with cartilage-like pads. Problem with any of these components may lead to back pain.
    Strain :
  • Strained muscles
  • Strained ligaments
  • Lifting something improperly
  • Lifting something that is too heavy
  • The resultant effect of an abrupt and awkward movement
  • A muscle spasm
  • Structural Problems
  • Ruptured disks
  • Bulging disks
  • Sciatica
  • Arthritis
  • Abnormal curvature of the spine
  • Osteoporosis
    Structural Problems :
  • Cauda equina syndrome
  • Cancer of the spine
  • Infection of the spine
  • Other infections
  • Pelvic inflammatory disease in (females)
  • Bladder or kidney infections
  • Sleep disorders
  • Shingles
  • Bad mattress
  • Everyday Activities or Poor Posture
  • Bending awkwardly
  • Pushing something
  • Pulling an object
  • Carrying an item
  • Lifting something
  • Standing for a long period
  • Bending down for a long duration
  • Twisting
  • Coughing
  • Sneezing

Diagnosing back pain
A back-pain is easily diagnosed by a doctor, after consulting the patient and carrying out a physical examination, which may or may not include imaging scans. In case the pain persists for too long, further tests may be recommended. Following are the tests used to determine the cause of back pain:

  • X-Rays
  • MRI or CT Scan
  • Bone Scan
  • Electromyography or EMG
What are the treatment options for back pain?

In majority of cases the pain subsides by itself by observing simple precautions and taking care of oneself, hence, no medical help is required. Resting proves effective in minimizing back pain.
Usually back pain is segmented into two categories:
1. Acute back pain
2. Chronic back pain
If home treatments do not prove effective in reducing backache, the doctor may recommend the following:

MedicationNSAID (non-steroidal anti-inflammatory drug) including Codeine, hydrocodone or narcotics
PhysiotherapyIncludes steps like
  • Application of heat or ice
  • Ultrasound
  • Electrical stimulation,
  • Some muscle-release techniques to the back muscles and soft tissues
Cortisone InjectionsIn case the aforementioned therapies do not prove effective enough or if the pain reaches down to the patient's legs, cortisone may be injected into the epidural space. Cortisone is an anti-inflammatory drug that helps minimise inflammation around the nerve roots.
SurgeriesIn case of persistent pain and nerve compression, surgery is recommended. Examples of surgical procedures includes:
  • Fusion
  • Artificial disk
  • Discectomy (partially removing a disk)
  • Partially removing a vertebra

Prevention of back pain

It is very important to prevent back pain so as to lead a normal and healthy life. Following are some steps that should be taken to prevent backaches:

  • Regular exercise
  •   Core-strengthening exercises
  •   Flexibility
  • Reduce or quit smoking
  • Maintain a balanced body weight
  • Observe correct posture when standing and sitting
  • Use expert's recommended posture while lifting things
  • Do not lift and twist at the same time
  • Move things by pushing and not lifting
  • Wear comfortable flat shoes
  • Ensure comfort while driving
  • Use a mattress that keeps you spine straight


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