As a clinician, the most common anomaly for which people approach me is back trouble. WHO also identifies low back pain amongst the top 10 causes accounting for the highest number of Disability Adjusted Life Years (days with compromised quality of life)? What congregated my attention even more is the shift of this patient group from elderly to all ages in the recent present. Low backache is more common with increasing age substantially due to the progressive degeneration of the intervertebral discs. Moreover, the causes of backache are such that once incident, backache tends to recur. Recently low Back Pain has evolved as the most common Work-Related Musculoskeletal Disorder among the IT Professionals.
The adjacent figure showing the prevalence of all musculoskeletal problems amongst IT Professionals is an eye-opener.
In various sections we have covered diverse aspects of low back pain, today we will focus more on how to get rid of backache.
Before I start to read the praises about exercise management, it is important to know a little about types of backache.
Type of backache
- Acute- Recently incident due to a cause
- Chronic- Keeps troubling occasionally once incident
What causes low back pain?
Our lower back has the vertebra at which maximum movement occurs making it extremely exposed. The causes of low back pain are
- Slip Disc
- Chronic degenerative conditions
- Lumbar Spondylosis- Arthritis of the spine
- Spinal stenosis-shrinking of spinal space due to disc degeneration
- Muscular strain while Pulling, lifting, or twisting
- Prolonged sitting
- Awkward posture
- Spinal tumor or infection
- Autoimmune disorders like Ankylosing spondylitis
- Kidney or Bladder conditions
- Abnormal curvature of the spine
- Radiating into the buttocks, leg or foot
- Unable to walk far without developing leg pain
- Bending forward
- Leaning back
- Initiating the movement
- Completing the movement
How to get rid of backache?
Management options for low backache includes
- Treatment of the underlying cause, the stone, the infection, the tumors.
- Medication Management
- Muscle relaxants for strain and sprains
- NSAIDs for degenerative conditions
- Steroids for acute conditions
- Analgesics for pain relief
- Local Applications
- Corticosteroids injections
- Physiotherapeutic Management
- Rest and Ice for acute or fresh backache
- Rest and Heat for old chronic recurrent backache
- TENS or interferential therapy for radiating pain relief
- Ultrasound massage for single point originating pain (piriformis syndrome)
- Traction for radiating pain
- Massage therapy
- Spinal manipulation
- Gentle Stretches and movements providing relief
- Isometric Back– Lie supine with knees bent, press your back into the couch you are lying, hold count 5 repeat.
- SUPINE TWIST– Lie supine with knees bent, turn face towards left and rest of the torso towards right. Repeat from other side.
- Bridging– Lie supine with knees bent and no pillow under the neck, lift trunk up from hip, hold count 5, repeat.
- Leg Raises-Lie supine with legs spread, raise from hip, one leg at a time.
- Ergonomic Advice and general precautions
- Practice any form of physical activity daily at least for 20 minutes
- Maintain a healthy body weight and neutral posture
- Take hourly breaks from any single posture
- Use firm surfaces to sleep
- Follow proper professional ergonomic advice like how to ergonomically carry a heavyweight close to your body
- Females avoid heals
- Stay far away from smoking
- Surgical Management
- Surgery for injury management
- Diskectomy, Spinal Fusion, Laminectomy, Surgical implantation of artificial disks for disk-related pathology
There is more to surgical management for more severe back problems, but I hope and believe yours will contain well within the boundaries of this write-up!!
Dr. Lalit Kumar, Consultant – Orthopaedics, Dharamshila Narayana Superspeciality Hospital, Delhi