Dr Zameer Ali
Low back pain itself is not a specific disease, but rather is a general complaint that may be caused by a large variety of underlying problems of varying levels of seriousness. The majority of LBP is referred to as nonspecific low back pain and does not have a definitive cause. LBA refers to pain arising from lumbar, lumbo sacral spine or sacro iliac joints. Low back ache is a very common problem and has an ubiquitous distribution.
It is believed to stem from benign musculoskeletal problems such as muscle or soft tissues sprain or strains. Obesity, smoking, weight gain during pregnancy, stress, poor physical condition, bad posture, and poor sleeping position also may contribute to low back pain. The full differential diagnosis includes many other less common conditions. Physical causes may include osteoarthritis, rheumatoid arthritis, degeneration of the discs between the vertebrae or a spinal disc herniation, a vertebral fracture (such as from osteoporosis), or rarely, an infection or tumor.
Women may experience acute low back pain due to certain medical conditions affecting the female reproductive system, including endometriosis, ovarian cysts, ovarian cancer, or uterine fibroids. . Back pain is also common in pregnancy. Between a half and three quarters of pregnant women suffer from back pain at some stage. Pregnant women report lumbosacral pain during their pregnancy, as changes in their posture and center of gravity cause muscle and ligament strain.
Back ache which was known as ancient curse to erect posture is now well known as modern day epidemic. Eighty percent of population is affected by this symptom at some point of time in life. In 2%of population, back ache is the most of times presenting complaint in bone and joint clinic.
Classification of low back ache
Backache has affected human beings throughout recorded history Low back pain or lumbago Low back pain (often abbreviated as LBP) may be classified by duration as acute (generally pain lasting less than six weeks), sub-chronic (six to 12 weeks), or chronic (more than 12 weeks). The condition may be further classified by the underlying cause as mechanical, non-mechanical, or referred pain. For most episodes of low back pain, a specific underlying cause is never identified or even looked for, and the pain is believed to be due to mechanical problems such as muscle strain or joint sprain.
Impairment of back and spine are ranked as most frequent limitation of activity in people younger than 45 years of age
Among galaxy of causative factors both spinal and extra spinal the most common cause of low back ache seems to be lumbar disc disease.
Bad posture seems to be very common cause and plays a significant role in genesis of this disease so much is contribution of bad posture towards this problem that one can categorically conclude that LBA is all about disc degeneration contributed by bad posture
Posture of hip is key to that of whole body because it determines the pelvic inclination and secondarily effect posture of back and if abnormal can lead to abnormal curve of spine leading to fatigue of back muscles and strain of ligaments all contributing to back ache
Tests are available to look into the cause of the pain if it does not go away with conservative treatment. Although uncommon, if low back pain is accompanied by unexplained weight loss, significant problems with feeling or movement in the legs or groin or unexplained fever, these “red flags” may indicate a serious underlying condition. In most cases, imaging tools such as MRI are not useful and carry their own risks, so generally they are not needed unless red flags or other unusual conditions are present. Despite this, the use of imaging to investigate low back pain is increasing in popularity.
Sign and symptoms
In a common presentation of low back pain, an individual will develop pain after exercise or labour that involves lifting, twisting, or forward-bending movements. The symptoms may start soon after the movements, or upon waking up the following morning. The description of the symptom itself may range anywhere from tenderness at a particular point to diffuse pain, and may or may not worsen with particular movements, such as raising a leg, or with certain positions, such sitting or standing. Pain radiating down the legs ( sciatica) may be present. Chronic low back pain is associated with sleep problems, including an increase in the amount of time needed to fall asleep, disturbances during sleep, reduction in the duration of sleep, and decreased satisfaction with sleep. As well, a majority of those with chronic low back pain show symptoms of depression.
Doctors advice
* keeping back straight
* maintaining a proper posture not only during sitting but also during standing, walking, or driving a motor car
* maintaining a proper posture while sitting in office.
* proper way to get out from bed while waking up in morning.
* eating a healthy diet
* prevention of weight gain and if overweight proper advice regarding weight reduction
* proper exercise regimen ( spinal flexion or extension as advised by your doctor) to strengthen your back muscles ( no need to go to gym just 10 minutes of exercise at home is more than sufficient for Prevention of weight gain.
Most cases of low back pain do not require urgent care, but patients should seek a doctor immediately if they experience low back pain as a result of severe trauma, or if low back pain is accompanied by any of the following:
* Fever and chills
* Unexplained recent weight loss, or recent weight loss due to trauma
* Significant leg weakness
* Sudden bowel and/or bladder incontinence – either difficulty passing urine or having a bowel movement, or loss of control of urination or bowel movement (cauda equina syndrome)
* Severe, continuous abdominal pain (abdominal aortic aneurysm)
Every case of low back ache is different consult your doctor before resorting to home remedies.
The author is Registrar Orthopaedics Skims medical college)
drzameerajliortho@gmail.com
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