Back Pain - Can Surgery Treat It?

Back pain is a common problem that most of us have suffered from. A pain anywhere in the spine- upper, middle or lower back – are all classed under the category of back pain. It’s a large category but it’s important to note that back pain can be caused due to a number of factors.

Causes

The causes of back pain can be varied because the human vertebra is composed of a complex structure of muscles, ligaments, tendons, disks and bones. Disks are cartilage-like pads that cushion the vertebrae, and problems with any of these can lead to back pain. Some of the common causes of back pain are:

1. Changes in the bony lumbar spine
2. Problems in discs between the vertebrae like hernias, bulges etc.
3. Problems in ligaments around the spine and discs
4. Due to changes in spinal cord and nerves
5. Weakened lower back muscles
6. Problems in abdomen and pelvic internal organs
7. Osteoporosis
8. Posture and lifestyle

Some of the other factors that can cause back pain are:

• Age: You can suffer from back pain at any age but the older you get, the more your chances of getting back pain. It is significantly more common among adults aged 35 or above. Strain is the most common cause of back pain. It can be due to strained muscles, ligaments or a muscle spasm caused due to lifting something too heavy or not using the correct posture when lifting something. It can also be caused due to an abrupt and awkward movement Arthritis can also cause back pain as it may cause a narrowing of the space around the spinal cord known as stenosis. Abnormal curvature of the spine can also cause back pain.
• Other reasons: Issues such as Cauda equina syndrome which affects the bundle of spinal nerve roots that arise from the lower end of the spinal cord and cancer of the spine or a tumour located on the spine which presses against a nerve can result in back pain. Infections of the spine or other infections such as pelvic inflammatory disease in women, bladder, or kidney infections may also lead to back pain.

Symptoms

Pain in the spine is the most common symptom of back pain. Other symptoms can be tenderness, numbness, inflammation, and pain in legs or hands. The nerves of the back could be affected by structural problems in the spine such as a bulge in the disc or herniation or disc rupture. This can press against a vital nerve which controls muscles in arms and legs, causing pain.

Treatment

• Back pain can usually be managed with over-the-counter (OTC) painkillers and by applying a hot compress or an ice pack to the area to relieve pain.
• Resting also helps.
• A change in lifestyle especially by improving body posture while using the computer at work, will be effective.

If the first line of treatment doesn’t work, doctors would prescribe

1. NSAID Medication: These are non steroidal anti-inflammatory drugs such as Codeine or hydrocodone which are prescribed for short periods
2. Physical therapy: This therapy uses the application of heat, ice, ultrasound and electrical stimulation to the back muscles and soft tissues to help alleviate pain. A physical therapist would suggest flexibility and strength exercises for the back and abdominal muscles. They would also suggest ways to improve posture and hence reduce back pain.
3. Cortisone injections: In severe cases, back pain sufferers would be given cortisone injections in the epidural space, which is the space around the spinal cord, to reduce pain by reducing inflammation.
4. Surgery: This is useful for treating herniated discs, ruptured discs or a bulge. Tumours are also removed surgically to treat back pain.