Causes And Treatment Of Lower Back Pain
It is estimated that the chance of developing lower back pain in human beings is as high as 80 percent as per the studies of experts in the field. It is perhaps the price that we have to pay for our erect posture, in activities that place extreme loads on the lower back and ambulation using two legs only (back pain is unknown in quadrupeds).
It has also been estimated that sitting without back support or forward bending. create loads in excess of 10 to 15 times the body weight on the lower back, but walking and standing are more ‘back-friendly. ‘ This implies that the lower back gets rest only if one lies down. whereas Sitting to watch television, working at the laptop or mobile for long durations harm your back.
Modern day work demands. a sedentary lifestyle, unhealthy diet, poor posture, lack of exercise and improper rest increases the problem The worryingly high incidence of IOW back pain, nowadays, especially concerning those involved in desk bbs and even among children, are attributable to all these factors.
The lower back comprises the lumbar vertebrae With its joints. ligaments and muscles. intervertebral discs and nerves. all of which can contribute to pain. The onset of low back pain is usually between 20 to 40 years and increases With age And depending upon the duration, it can be acute. subacute or chronic.
Acute pain is usually mechanical in origin, presents dramatically and may be accompanied by sciatica. accompanied by back stiffness due to muscle spasms, aggravated by movement, sneezing or coughing and relieved by rest.
Chronic pain is generally dull ache and may be accompanied by sciatica. aggravated by certain types of activities only, incompletely relieved by rest. usually disturbs sleep and is subject to behavior modification.
It has been estimated that sitting without back support or forward bending create loads in excess of 10 to 15 times the bodyweight on the lower back
Inflammatory type of pains are aggravated by rest and accompanied by early morning back stiffness which gradually improves as tie day progresses. Aggravation of pain at night IS usually a hallmark of and tumors.
Causes For Lower Back Pain
This contributes to approximately 90 per cent of low back pain of Which more than 75 per cent are due to sprains and strains, other causes being degenerative lesions like disc prolapse, spondy10SIS, lumbar canal stenosis. vertebral fractures etc.
Ankylosing spondylitis and other arthritic conditions
This involves bone cancer
Infections Of Lumbar Vertebrae / Disc
Infections like tuberculosis. bacterial infections or of surrounding structures like kidney, gut, uterus, etc.
It can be from abdominal (gall bladder. pancreas. kidney) or pelvic structures (uterus, ovary)
This condition and even other psychological causes can also cause lower back pain
Congenital Or Developmental Conditions
It can be conditions like (sideways bending of sp.ne), spondylolisthesis (forward of one vertebra over the other)
Nevertheless, the silver lining is that majority of the pains can be relieved in six weeks and are caused by mechanical factors.
Non operative treatments include rest, intake of pain killers, muscle relaxants, drugs for neurogenic pain, antidepressants, physical modalities like traction, heat, transcutaneous nerve stimulation, acupuncture, chiropractic manipulation, various braces, and spinal supports. Once the is relieved. back and posture exercises are initiated.
Surgeries For Lower Back Pain
There are three main types of surgeries for low back pain:
- Minimally invasive surgeries
- Surgeries aided by endoscopy or an operating microscope
- Open surgeries
Here are some indications for the surgery:
- Intervertebral disc prolapse with neurological deficit or recurrent episodes of severe incapacitating pain requiring hospitalisation or absence from work
- Lumbar canal stenosis which is generally addressed by open surgeries like Iamnectomy and discectomy or decompression and s spinal fusion
- Vertebral fractures in young adults due to high velocity injuries may require open surgery for spinal stabilisation using metallic implants, in older population with weakened bones (osteoporosis) may benefit from minimally invasive surgeries like vertebroplasty or kyphoplasty
- Ankylosing spondylitis and other arthritis may require open surgeries like decompression or spinal osteotomy
- Surgeries for cancers include minimally invasive surgery for biopsy, open surgeries like decompression spinal fusion or stabilisation
- Infections. perhaps the most frequently indicated ones such as drainage of or dead tissues or decompression and spinal fusion With or Without aid of metallic implants, which may be addressed by minimally invasive. endoscopy aided or open surgeries.
- Spondylolisthesis and scoliosis, where spinal fusion is done with or without decompression
Surgeries for low back pain should be done only after careful consideration – the exact cause Of pain, failure of other treatments adequately given, presence of ‘red flag indications’, and after psychologic assessment (especially for chronic pain).