The lowdown on back ache

To those who have experienced it, the symptoms need little explanation. The pain begins with a dull but persistent ache (sometimes it can be short sharp jolts) in the small of the back which can radiate almost across the back. It very often leaves its victim incapable of doing anything else other than lie in bed. In pain.

Back pain, which can be triggered by a fall, an accident or even sometimes when you move a heavy object such as a sofa or a cot, can be truly debilitating. While some kinds of back pain may subside with an over-the-counter (OTC) pain reliever, some types refuse to go away even after several days and could be symptomatic of potentially serious medical conditions.

How can you judge which pain calls for an expert's opinion and which can be relieved by a painkiller? When should you approach a doctor? Dr Zohreh Safai, family physician, Dubai Bone and Joint Centre, Dubai Healthcare City, throws light on this condition and what you need to keep in mind when the pain strikes.

What is back pain?

Back pain or lumbago refers to pain felt in the lower back. Although most back pain occurs in the lower back, it may also be in the upper or mid portion of the back. Back pain can range from a mild, dull aching pain to one that is of a severe, shooting, stabbing intensity.

In some cases, back pain can result in stiffness. The pain can be constant or intermittent.

Medically, back pain is classified into two categories: acute, which is defined as pain which lasts for a few days to less than a few weeks; and chronic if it lasts for more than three months.

Who can get back pain?

Anyone can get back pain. In fact, it is one of the most common causes of visits to the doctor and one of the leading causes of absence from the workplace.

It is estimated that nine out of ten people will experience back pain at some point in their life. I have come across web reports that each year, billions of dollars are lost in terms of work productivity and disability due to back pain.

What are the causes of back pain?

There may be many reasons. Pain can occur when the muscle, bone, joint and nerves in the back are affected. It can also occur when certain organs like the kidney are affected. In many instances, back pain is caused by the overuse or misuse of back muscles. Some other common causes of back pain: herniated disc, spinal stenosis (narrowing of the disc), spondylolisthesis (slipped disc), spondylosis or certain forms of arthritis.

Back pain can also be due to a muscle spasm, nerve impingement, degenerative disc disease, fibromyalgia, improper lifting of objects or by maintaining poor posture. Any of these can cause a simple strain of muscle or ligaments in your back.

Then there are other reasons like bone fractures, osteoporosis or scoliosis. It has been found that smoking is among the risk factors that could contribute to back pain.

Back pain can also occur due to ageing, pregnancy, lack of exercise and poor fitness levels as well.

At times, the backache can be due to a kidney infection (pyelonephritis) or due to kidney stones. You will be surprised to know that back pain can also be hereditary.

It is thus important to consult a physician to treat the issue.

How is back pain treated?

Get plenty of rest but bed rest should not exceed more than three days. You may take anti-inflammatory medication such as ibuprofen or tylenol but if the pain persists, you must consult a doctor. Applying cold or hot packs on the area may give you some relief. Sometimes stretching exercises also alleviate backache. Other non-pharmacological therapies such as acupuncture, spinal manipulation, exercise therapy, massage therapy and relaxation techniques may also work in your favour. However, these should be attempted only after consulting a doctor.

When does back pain get serious?

If you are experiencing loss of bladder control, numbness or a tingling sensation and weakness, you should consult your doctor immediately. Back pain teamed with any other symptoms such as fever, blood in the urine or drastic weight loss, also calls for immediate medical supervision. Do keep in mind, that if despite anti-inflammatory medicines, your backache is persistent, or if it is getting progressively worse, it is necessary to inform your physician. This is because the pain can be a side effect of a medical condition, such as an infection in the kidney and/or bones. It could also be the onset of osteoporosis or myeloma.

How is back pain diagnosed?

The first step in the diagnosis of back pain is a complete medical history and physical examination by your primary care physician. In most cases, routine imaging and diagnostic studies are not usually indicated. But in the case of acute, non-specific back pain, your doctor might order a urine test based on your symptoms.

He may even ask for an X-ray report if there is a suspicion of fracture. In cases of elderly patients with severe osteoporosis or acute trauma, or if the pain persists, your physician might order an MRI. This is true for cases where there is adequate evidence of a neurological deficit or other serious underlying conditions. Depending on the kidney stone analysis, your doctor might also order other tests such as the sedimentation rate in the urine, CT scan or bone scan.

Can back pain be prevented?

Yes. There are many ways to prevent regular back pain. Most forms of back pain are due to improper lifting techniques, and misuse or overuse of muscles. Learning how to lift and move heavy objects safely is one of the best ways of preventing it. Your physician will be able to tell you the best way to move/lift objects.

When to see your doctor

Steps to check back pain: