Backache is a universal phenomenon. Millions of dollars are spent and lost every year in the U.S.A. in workman's compensation and industrial absenteeism because of this seemingly untreatable malady. A high percentage of patients in any Orthopaedic clinic in India complain of backache.

The Symptom: "My back is weakit hurts", "I cannot bend because of my back; I cannot lift anything", "My back gave way at work; can you certify me for compensation?" Complaints like this challenge the Orthopaedic Surgeon everyday. The cause of pain has to lie in the area that hurts, in the nerve or surrounding the  nerve.

The structure of the spine: The bones in the spine are arranged like a column-stacked one on another. Between every two bones is a disc- which functions like a cushion or shock-absorber. The bony spine encircles the spinal canal-which accommodates the spinal cord. Branches called nerve roots come off the cord and exit from the spine to reach all the four limbs. The source of pain could be the bones, the discs, the spinal cord, roots and muscles.

Is Sciatica a dreaded disease?
Low back-ache radiating along the back of the thigh to the leg is called sciatica. It is a symptom of nerve root pressure;it is not a disease. Common Causes of Back-ache

Postural back-ache
Wrong postures at work, by adolescent girls and pregnant women can become symptomatic because of the abnormal weight distribution on the spine.

Disc Prolapse
The disc between the bones of the back is like a gel under pressure: it can come out and press on the nerve to cause back pain and sciatica.

With age, the drier disc loses it's shock-absorbing function. The bones bear increasing loads and cause pain.

Bones lose Calcium after menopause;middle aged and elderly ladies often suffer deformities and pain in the back because of the collapse of weakened spinal bones.

How does one fight back-ache?

  1. Patients in acute pain are advised rest in bed, traction and pain relieving physiotherapy.
  2. Corsets and belts are temporary measures to support the weak or painful back.
  3. Pain killers are to be judiciously used and only on medical advice. Complications of overuse can be serious- peptic ulcers and bone marrow depression.
  4. Calcium and hormones are important supportive medication for women after menopause.
  5. Proper care of the back, regular and specific exercises and weight reduction can all help fight Back-ache.

Pain in the back has now become one of the commonest symptoms of humankind. The fact that one cannot see ones back, adds the fear of the unknown. At the end of the day, careful monitoring of body weight, exercises and medical advice can help control this problem.

Dr. P. Sripathi Rao
Professor & Head, Dept. of Orthopedics
Kasturba Medical College & Hospital, Manipal - 576 119

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