Low Backache


The commonest cause of low backache is mechanical, caused by misuse or overuse of back, bad sitting postures combined with lack of exercises. The structure of spine comprises of multiple vertebra joined together by fibro-cartilaginous discs which have an outer layer annulus fibrosus and inner gel like structure known as nucleus pulposus.

Sudden lifting of weights or chronic misuse of back leads to tears in outer layer leading to leakage of contained nuclear pulposus setting a chain of inflammation causing acute pain in back Pressure on exiting nerves causes pain to radiate into the lower limb something similar to sciatica.

Management usually consists of period of short period of rest (2-3 days ) along with medicines to relieve pain and inflammation followed by an exercise regimen to strengthen muscles of back and front.

Prevention is possible by maintaining correct sitting postures and regular fitness excercises.

In the elderly back pain is caused by combination of factors including osteoporosis, generalized muscle weakness and degenerative changes in the articulating joints leading to encroachment on the nerves causing chronic pain syndromes. Again the mainstay of treatment is excercises to control and maintain posture and strength of muscles along with nutritional supplements to augment it.

Some patients of backache do not respond to conservative treatment and develop neurological deficits in form of weakness in muscles supplied by that particular nerve which is compressed either due to disc protrusion or overgrowth of bones (spondylosis) leading to encroachment on the exit path of nerve roots or some who have instability caused by degenerative changes require surgical treatment. Microdiscectomy using small incisions , foraminotomy and spinal fusions are some of the surgeries which Dr Dave can perform to relieve the patients of severe pain and disability.