Experts weigh in on why you should not neglect back pain

October 16 marks the occasion of World Spine Day. Back pain issues have become very common among the young and in majority of cases, they pop pain killers, use balms and delay seeking help until their pain is unbearable. Experts tell why doing so can backfire...

Cases On The Rise

The prevalence of back pain has seen a consistent increase in the 20 to 40 age group from a mere 10 per cent a few years ago to nearly 25 per cent, currently. Around 50 per cent of orthopaedic consultation  these days are for this reason, informs Dr Mudit Khanna, Senior Consultant, Orthopaedics and Trauma, Wockhardt Hospital.  

“A lot of patients come in with complaints of lower and mid-back pain, pain in the neck, arms and legs. Usually, it’s mostly men in the 36 to 55 age group, with a sedentary lifestyle wherein they sit 10-12 hours a day or those who travel a lot,” says Dr Garima Anandani, Senior Spine Specialist and Clinical Director, QI Spine Clinic. Around 30 to 40 per cent of them are overweight or obese. They come to us when they experience acute or episodic pain.

According to a survey conducted by QI Spine Clinic, on 36,783 patients in Mumbai, Pune, Delhi and  Bengaluru, since 2015, saw 61 per cent of the total back pain cases reported are disc bulge or disc herniation. Also, disc herniation cases reported grew by 35 per cent in 2018 vs last year.

Lifestyle Factors

Besides reasons like ageing, physical injury and family history, lifestyle factors like poor posture, obesity, lack of exercise, poor nutrition — especially deficiency of calcium, Vitamin D3 and B12 — smoking, tobacco consumption and substance abuse contribute to the problem. Obesity in particular adds immense load on the lower back producing premature degeneration in the discs (shock absorbers) due to overloading. A mild mechanical issue in the back may get magnified, multiplied and reach unbearable proportions by these factors, says Dr Ram Chaddha, Consultant Spine Surgeon and  Head of Institute of Robotics and Spine Surgery at Apollo Hospitals. He adds that more than 50 per cent of the younger population have these easily correctable, treatable and modifiable lifestyle issues. 

Stress too plays a role here. Domestic, professional, financial stress all contribute to a large extent in making bearable back and neck pain appear unbearable thus, reducing the tolerance of an individual and his/her quality of life.

Many people tend to develop a disc bulge or disc herniation due to the lifestyle factors. Even if it is detected by imaging tests, not everyone experiences pain. So, there’s no need to panic on hearing such terms. It’s only when they show symptoms like pain, weakness, loss of sensation, numbness and the pain has radiated to other parts of the body i.e. when these symptoms correlate with disc bulge, that’s when they have a problem, and need treatment, adds Dr Aanandani.

Treatment

Majority of low back and neck pains do not need surgery, is what Dr Chaddha emphasises. Correction of dietary and lifestyle issues combined with specialised dedicated spine physiotherapy, is the solution for most patients with lower back and neck pain. In fact, most reported disc bulges/ contained disc herniations without the red flag signs (see box) would respond remarkably to non-surgical care. 

Dr Anandani says that treatment involves improving the quality of life, by getting the pain down by using specific technology with certain medical movements, avoiding aggravating movements (like  bending), rest, doing a digital spine analysis, identifying the root cause and strengthening the muscles.

Watchout For These Signs

Dr Ram Chaddha lists the following red flags requiring an urgent opinion of a spine specialist:

• Low back pain or neck pain with unbearable radiating leg or arm pain.
• Weakness numbness or paralysis.
• Imbalance of gait. 
• Loss of voluntary control over sphincters (urine and motions).
• Any back pain associated with trauma (accident), infection (like tuberculosis) and neoplasm (malignancy or cancer). 
• Children and adolescents with back and neck pain need early spine specialist opinions as well.