Back Pain Treatment – An overview

Nowadays almost everyone is suffering from back pain in their life. Most of the people are having lower back pain. The area behind the stomach from the rib cage to the pelvis. It is also called a Lumbar region. It resolved on its own.

Up to 80% of the public is suffering from back pain. Early young age this back pain can start and continue through adulthood if not treated properly. One should take proper treatment from an experienced doctor.

What is Back Pain?

Our spine is made up of series of bones called Vertebrae from skull to hip bone & it functions as a conduit for safe passage of Spinal Cord & nerves.

These vertebrae are separated by discs which act as shock absorbers & give mobility to the spine. This disc is made up of the outer fibrous ring called Annulus & central soft core made up of soft Jelly called as the nucleus.

Back pain is a common reason for absence from work and for seeking medical treatment. It can be uncomfortable and debilitating. It can result from injury, activity and some medical conditions. Back pain can affect people of any age, for different reasons. As people get older, the chance of developing lower back pain increases, due to factors such as previous occupation and degenerative disk disease.

Lower back pain may be linked to the bony lumbar spine, discs between the vertebrae, ligaments around the spine and discs, spinal cord and nerves, lower back muscles, abdominal and pelvic internal organs, and the skin around the lumbar area.

With our knowledge & experience of operating under local anaesthesia, we know precisely where the pain is coming from. To make it simple pain is sensation carried by nerves, so there cannot be a pain without the involvement of nerve.

Pain in the upper back may be due to disorders of the aorta, tumours in the chest, and spine inflammation.

Due to various factors like lack of nutrition, obesity, smoking, vibration, repetitive stress etc, this disc degenerates & the outer fibrous ring develops cracks & tears this gives rise to Back discomfort & pain.

As the tears extend to the periphery & start leaking the central annular jelly. This causes the nerves to swell & back pain becomes intense & goes down the leg along the nerve.

Also one can experience burning senses, tingling or numbness in the legs with time tear enlarges in size or heals. If the tear enlarges then the back pain aggravates & the soft nucleus herniates out & there can be numbness & weakness in the part of the leg supplied by the nerve. Sudden compression at a higher level can also cause a disturbance in bowel & bladder function.

Now with herniation, the disc collapses & this changes the mechanics & puts more stress on the bony facet joints causing their arthritis & it gives rise to back pain on sides. All this narrows this canal & facet bones impinge on the nerves giving rise to claudication (tingling & numbness in the legs on walking). Due to all these changes, there is a narrowing of the Spinal Canal.

Causes Of Back Pain:

The root causes of back pain are-

1. Narrowing of the spinal trench, or spinal stenosis
2. Malignancy or nonmalignant tumour in the spine
3. Loss of nerve work at the lower spinal line called cauda equina disorder (a medicinal crisis)
4. Dislodging of one vertebral body onto another, called degenerative spondylolisthesis
5. Parasitic or bacterial contamination of the spine, for example, Staphylococcus, E. coli, or tuberculosis
6. Strained muscles and ligaments often cause back pain. Strain commonly occurs with incorrect lifting of heavy objects and sudden awkward movements. Strain can also result from over-activity. An example is the sore feeling and stiffness that occurs after a few hours of yard work or playing a sport.
7. Loss of bone density and thinning of the bone, called osteoporosis, can lead to fractures in your vertebrae. These fractures can cause serious pain and are referred to as compression fractures.
8. Abnormalities of the skeleton can also cause back pain. This includes scoliosis or narrowing of the spinal canal due to arthritis.

Symptoms Of Back Pain:

Numbness: If numbness and tingling persist and there’s no obvious cause for the sensations, it could be a symptom of a disease or injury, such as multiple sclerosis or carpal tunnel syndrome.

Tingling: Tingling hands, feet, or both is an extremely common and bothersome symptom. Such tingling can sometimes be benign and temporary.

Sharp Pain: A spasm can produce sharp back pain in either the upper or lower back. Herniated disk. A herniated disk — also called a bulging disk, slipped disk, ruptured disk, or pinched nerve

Loss of continence of bowel or bladder- Incontinence is a widespread condition that ranges in severity from ‘just a small leak’ to complete loss of bladder or bowel control. In fact, over 4.8 million Australians have bladder or bowel control problems for a variety of reasons.

Pulsating Pain: Unlike other symptoms, this percentage is the same in both men and women with migraines. Those who have throbbing pain typically have more severe migraine pain than those who do not have pulsating pain.

Tenderness: In medicine, tenderness is pain or discomfort when an affected area is touched. it should not be confused with pain. Pain is the patient’s perception, while tenderness is a sign that a clinician elicits.

Pain with Movement of the Spine: When this happens, the facet joints become inflamed, and progressive joint degeneration creates more frictional pain. As your back pain progresses, the motion and flexibility of the spine decrease.

Dull ache: Like aching pain, dull discomfort occurs at a low level over a long period of time. Dull pain, however, may intensify when you put pressure on the affected body part.

Pins and needles sensation: ‘Pins and needles’ are a sensation of uncomfortable tingling or prickling, usually felt in the arms, legs, hands or feet. A common cause is leaning awkwardly on an arm or leg, which presses against the nerves.

Muscle spasm: Spasms of skeletal muscles are most common and are often due to overuse and muscle fatigue, dehydration, and electrolyte abnormalities. The spasm occurs abruptly, is painful, and is usually short-lived. It may be relieved by gently stretching the muscle.

Sciatica with shooting pain down one or both lower extremities: Sciatica is a shooting pain that begins in the lower back, radiates into the buttock and down the back of one leg. The pain is often caused by pressure on the sciatic nerve from a herniated disc, bone spurs or muscle strain

Rash: Shingles (herpes zoster) is an extremely painful skin rash caused by the varicella zoster virus, the same virus that causes chickenpox. … Pain, itching, tingling, or burning of the skin often precede the rash in an outbreak of shingles.

Yoga for Back Pain

In the event that Back Pain doesn’t leave in three months, confirm yoga can help. In one ongoing investigation, individuals who took 12 weeks of yoga classes had fewer manifestations of low back torment than individuals who were given a book about administer to back agony. The advantages endured a while after the classes were done. The examination recommends traditional extending works similarly also. Ensure your teacher is experienced at showing individuals with back agony and will adjust stances for you as required.

Treatment depends on the severity of the problem from – Rest & medication

1. Core muscles building & exercises.
2. Advice on posture & Ergonomics.
3. Simple injection in the nerve in the foot.
4. Spinal Injection
5. Stitchless – Endoscopic procedure for severe condition & in those patients where natural healing is not possible or prolonged.

Stitch-less Surgery Advantages:

Advantages of stitch-less endoscopic spine surgery are listed below-

1. Stitch-less surgery: No dressing, no stitch removal, no big scar.
2. Risk of infection is very less.
3. No nerve injury.
4. Accurate co-relation of pain & treatment in awake patients.
5. No cutting of muscles & bones.
6. No fusion with screws & rods.
7. Safely done in old aged patients.
8. Use of laser & radiofrequency makes it very accurate by extending the reach.
9. Day care surgery: No long hospital stay,
10. ICU not required.