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Back Trouble- Let’s dig the cause

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One of the most common mood and trip spoiler thing that could happen to you when you plan a long road trip is a sore back. So would be the case, if it comes in way of playing your favorite sport or getting naughty with your kids. Lately, the “work from home culture” during lockdown has exaggerated all our back trouble and made us feel a decade older than we actually are.  

Low back ache is a common ailment, particularly in the middle aged group. It is not a disease per say,  but a pointer of many underlying disorders. Common causes include injury/trauma, incorrect posture, age/weight related degenerative changes and rarely infection, autoimmune diseases and cancer. It is estimated that up to 90% people will experience back pain at some point of time in their life.

In majority of the cases, there is no serious underlying cause and the pain resolves on its own. In these patients, the pain arises due to mechanical strain which causes injury to muscles and ligaments. Activities like heavy weight lifting or lifting in awkward positions, sitting or standing for long periods of time may cause the pain. Lack of physical activity, long hours of driving and excess of household chores like cleaning and washing – all belong to this category.  No imaging or blood investigations are required in these patients, and over the counter painkillers provide easy relief.

However, it is the other 10%, which needs diagnostic imaging and some blood tests to dig out the cause. You may belong to this category if the pain doesn’t respond to pain killers, keeps coming back or worsens with time. Laboratory tests include ESR, CRP, Complete blood count and urine analysis. Lumbar X ray followed by MRI are ordered to look for disc prolapse, disc herniation or spinal canal stenosis. Nerve conduction studies may be ordered to rule out nerve compression.  Rarely infectious conditions like psoas abscess and cancer can also cause the backache, which are revealed on imaging.

Like with every other disease, prevention is better than cure.  Take good care of your back muscles by maintaining a proper posture. Do regular abdominal and back muscle exercises like sit ups, leg raises and crunches. Keep your weight under check as obese people are more prone to have back issues. Whenever lifting heavy weight, keep your core tight and feet apart. Then try to keep the weight close to the body. Standing desks are a new addition in the offices these days, as these help in easing back pain and being more productive.

When suffering from backache, pain killers like NSAIDS and muscle relaxants prescribed by your doctor,  provide relief. Other options like physiotherapy, hot/cold compresses also reduce pain. Avoid strenuous activities but do not go on complete bed rest. Stay mobile to prevent stiffness and weakening of muscles.

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