LOW BACK PAIN
FREQUENTLY ASKED QUESTIONS.
Dr. Arvind Bhateja MS,MCh (NIMHANS)
Consultant Neurosurgeon and Spine Surgeon
abhateja@gmail.com
arvind@neuro-spine.com
http://www.neuro-spine.com/
98452-94701
SITA BHATEJA SPECIALITY HOSPITAL
9 O’Shaughnessy Road,
Langford Town,
Bangalore 560025
INDIA
080-40302700
Worldwide, low back pain is one of the commonest causes of disability and work days lost. Commonly pain is a result of spondylitis or degeneration of the lumbar spine.
How do I know that the pain I’m having is back pain?
If the part of your back between the lower part of your chest an the upper part of your hips, also called the lumbar spine, feels sore or stiff, then you are probably suffering from low back pain. Pain can either be in the middle of your back or to one side which might feel like a muscle pull, soreness or stiffness.
Back pain usually gets worse with movement like getting out of bed, standing up from sitting or sitting for a long time and gets better with lying down on a firm bed.
Back pain can also be a symptom of disease elsewhere, in which case it is called referred pain. Diseases in the kidney, pancreas, and the back of the abdomen can also cause back pain which can be differentiated based on the nature of the pain.
Why do people suffer from back pain?
As part of the evolutionary cycle, when humans adopted the erect posture, a change occurred in the way that body weight was transmitted to the ground.
Humans turned biped (two-legged) and so necessarily had to transmit body weight via the spine to the hip joints and the lower limbs. Unfortunately, the lumbar spine did not evolve at the same pace and has become the commonest area of the spine to be subjected to degenerative processes, also known as spondylitis. So taking care of your back by means of proper posture, spine exercises and avoiding strain assumes greater importance because of the evolutionary disadvantage.
Will I need surgery for my back pain?
Although spine surgery in the modern era has become safer and much less risky, primarily due to technological advances and improved anesthesia, most people with back pain do not need surgery. However, there are certain situations in which surgery may become necessary, when the risk of living with the disease is higher than the risk of surgery. These may include situations when there is pressure on the nerve roots arising in your back, which supply the lower limbs, manifesting as pain, weakness or numbness; when there is spinal canal stenosis or narrowing of the area for the nerves leading to pain on walking; compression of the nerve roots causing urinary disturbances; mechanical instability of the bones in the back which may lead to nerve compression in the future. The diagnosis confirmed usually after an MRI scan is done to clearly demonstrate the structures in the back, the area and cause of disease and the severity of nerve compression.
Will I be able to walk and go back to work after spine surgery?
Fallacious rumors about spine surgery abound. Admittedly, there is risk involved in any surgical procedure, but the fear of undergoing spine surgery is often irrational. With modern medical devices, newer modes of monitoring and improved techniques of anesthesia, spine surgery is as safe or risky as any other type of surgery. Moreover, the aim of surgery is to limit the degree and duration of disability. Patients are encouraged to walk on the day after surgery and return to work in about three weeks time. The operative area may remain painful for about a week but walking is still possible. During this time, I advise patients to abstain from bending, lifting weights, traveling by road particularly on two or three wheelers and sitting for prolonged periods. Most importantly, spine surgery is performed to relieve pressure on nerve roots or instability and not to reverse the degenerative changes already existing.
An MRI scan is necessary particularly when there is nerve root compression. The MRI will give your surgeon exact information about the extent and severity of spondylitis and in most cases will help decide the need for surgery.
What could happen if I wish to avoid spine surgery?
Although it is difficult to predict what could happen to an individual case if surgery is denied, medical literature suggests that in the presence of nerve compression with weakness, numbness or bladder disturbances, deferring surgery leads to irreversible changes in the nerves. Importantly, the degree and the duration of nerve compression are important factors in determining the reversibility of nerve damage. If surgery is advised for pain relief alone, it is usually so in the presence of severe radicular pain (leg pain) or pain unrelieved by rest, analgesics and physiotherapy. Surgery may also be advised if there is severe back pain in patients with instability. If surgery is avoided in the presence of a neurological deficit, it is highly likely that the deficit may progress or remain permanent and may not recover depending on the duration of the deficit.
What are the precautions I need to take after surgery and to avoid back problems in general?
Avoiding bending, lifting weights and sitting for prolonged periods in the wrong posture are definitely advisable. Losing weight if you are overweight, staying away from two wheeler and three wheeler rides, stopping smoking and performing relaxation exercises are strongly advised. Using the right type of mattress prevents bad posture when you are asleep. Performing regular exercise particularly spine strengthening exercises will go a long way in ensuring good health for your back.
SITA BHATEJA SPECIALITY HOSPITAL
9 O’Shaughnessy Road,
Langford Town,
Bangalore 560025
INDIA
080-40302700
Worldwide, low back pain is one of the commonest causes of disability and work days lost. Commonly pain is a result of spondylitis or degeneration of the lumbar spine.
How do I know that the pain I’m having is back pain?
If the part of your back between the lower part of your chest an the upper part of your hips, also called the lumbar spine, feels sore or stiff, then you are probably suffering from low back pain. Pain can either be in the middle of your back or to one side which might feel like a muscle pull, soreness or stiffness.
Back pain usually gets worse with movement like getting out of bed, standing up from sitting or sitting for a long time and gets better with lying down on a firm bed.
Back pain can also be a symptom of disease elsewhere, in which case it is called referred pain. Diseases in the kidney, pancreas, and the back of the abdomen can also cause back pain which can be differentiated based on the nature of the pain.
Why do people suffer from back pain?
As part of the evolutionary cycle, when humans adopted the erect posture, a change occurred in the way that body weight was transmitted to the ground.
Humans turned biped (two-legged) and so necessarily had to transmit body weight via the spine to the hip joints and the lower limbs. Unfortunately, the lumbar spine did not evolve at the same pace and has become the commonest area of the spine to be subjected to degenerative processes, also known as spondylitis. So taking care of your back by means of proper posture, spine exercises and avoiding strain assumes greater importance because of the evolutionary disadvantage.
Will I need surgery for my back pain?
Although spine surgery in the modern era has become safer and much less risky, primarily due to technological advances and improved anesthesia, most people with back pain do not need surgery. However, there are certain situations in which surgery may become necessary, when the risk of living with the disease is higher than the risk of surgery. These may include situations when there is pressure on the nerve roots arising in your back, which supply the lower limbs, manifesting as pain, weakness or numbness; when there is spinal canal stenosis or narrowing of the area for the nerves leading to pain on walking; compression of the nerve roots causing urinary disturbances; mechanical instability of the bones in the back which may lead to nerve compression in the future. The diagnosis confirmed usually after an MRI scan is done to clearly demonstrate the structures in the back, the area and cause of disease and the severity of nerve compression.
Will I be able to walk and go back to work after spine surgery?
Fallacious rumors about spine surgery abound. Admittedly, there is risk involved in any surgical procedure, but the fear of undergoing spine surgery is often irrational. With modern medical devices, newer modes of monitoring and improved techniques of anesthesia, spine surgery is as safe or risky as any other type of surgery. Moreover, the aim of surgery is to limit the degree and duration of disability. Patients are encouraged to walk on the day after surgery and return to work in about three weeks time. The operative area may remain painful for about a week but walking is still possible. During this time, I advise patients to abstain from bending, lifting weights, traveling by road particularly on two or three wheelers and sitting for prolonged periods. Most importantly, spine surgery is performed to relieve pressure on nerve roots or instability and not to reverse the degenerative changes already existing.
An MRI scan is necessary particularly when there is nerve root compression. The MRI will give your surgeon exact information about the extent and severity of spondylitis and in most cases will help decide the need for surgery.
What could happen if I wish to avoid spine surgery?
Although it is difficult to predict what could happen to an individual case if surgery is denied, medical literature suggests that in the presence of nerve compression with weakness, numbness or bladder disturbances, deferring surgery leads to irreversible changes in the nerves. Importantly, the degree and the duration of nerve compression are important factors in determining the reversibility of nerve damage. If surgery is advised for pain relief alone, it is usually so in the presence of severe radicular pain (leg pain) or pain unrelieved by rest, analgesics and physiotherapy. Surgery may also be advised if there is severe back pain in patients with instability. If surgery is avoided in the presence of a neurological deficit, it is highly likely that the deficit may progress or remain permanent and may not recover depending on the duration of the deficit.
What are the precautions I need to take after surgery and to avoid back problems in general?
Avoiding bending, lifting weights and sitting for prolonged periods in the wrong posture are definitely advisable. Losing weight if you are overweight, staying away from two wheeler and three wheeler rides, stopping smoking and performing relaxation exercises are strongly advised. Using the right type of mattress prevents bad posture when you are asleep. Performing regular exercise particularly spine strengthening exercises will go a long way in ensuring good health for your back.
What is spine fusion surgery and will it be harmful?
Spinal fusion is recommended when there is a condition known as instability, which may occur from a variety of diseases. The spinal column becomes weak and is unable to support the normal body weight. It usually needs to be surgically treated with implants (metallic or other devices that are implanted into the spine to make it rigid) and a bone graft. The outcomes of this surgery are usually excellent.
To know more, contact: Dr. Arvind Bhateja
98452-94701
abhateja@gmail.com
Spinal fusion is recommended when there is a condition known as instability, which may occur from a variety of diseases. The spinal column becomes weak and is unable to support the normal body weight. It usually needs to be surgically treated with implants (metallic or other devices that are implanted into the spine to make it rigid) and a bone graft. The outcomes of this surgery are usually excellent.
To know more, contact: Dr. Arvind Bhateja
98452-94701
abhateja@gmail.com
7 comments:
Really an useful article...helped me by answering so many questions of mine....
Rather than making one long, deep incision along patients spine — and having to strip muscle away from bone to insert
a corrective rod — surgeons make three smaller incisions through which they fed the rod these days. They then use
screws to align and tighten the rod immediately correcting the curve in patients spine.
New technique in spine surgery.
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Very common problems and questions which normally everyone faces these days. Thank you for sharing this post. Great job. spine surgeons nj
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