Backache is one of the most common ailments among people. It is characterised by the following signs and symptoms:

• Persistent aching, pain or stiffness that occurs anywhere along your spine, from the base of the neck to the hips. 
• Sharp, localised pain in the neck, upper back, or lower back, especially after lifting heavy objects or other strenuous activity.
• Chronic ache in the middle or lower back, especially after sitting or standing for extended period of time.
• Occasional visible curvature of the spine, but usually there are no apparent external symptoms.

Who can suffer from it?
On average, about 80 per cent of people will experience back pain at some point in their lives but slightly more men suffer from it than women. Backache also occurs among young people aged between 16 and 24 although it is most common among people in their middle age.

What causes backache?
The causes vary according to the type of backache that occurs:

• Acute Backache
  Acute backache may occur due to back strain from the lifting of a heavy object, from a fall, or from a violent jerk as a car suddenly stops. Acute backache can also be caused by a fracture of the spine or the dislocation of a vertebral disc (The spine is made up of a series of bones stacked on top of each other).
• Chronic Backache
  Chronic backache may be caused by spondylosis (degeneration of the spinal column when one vertebra slips forward on the one immediately below it, usually just above the hipbone) or a slipped disc. The discs act as cushions between two vertebral bones but due to degeneration in old age, or in cases when the spine has been injured before, a slipped disc may occur.
• Bad posture
  Bad posture can also lead to chronic backache. An example of bad posture is to sit for long hours in an incorrect position. A correct position is to sit up straight instead of slouching in a couch when watching TV, for instance. If the bad posture is maintained and prolonged, backache may occur.

There are other undetermined causes of chronic backache, including sprains in the muscles of the back and gynaecological problems.

How can backache be prevented?
To prevent backache, the most important thing is to maintain the correct posture at all times. When sitting, ensure that your back is kept straight instead of a slouched position. Give your back enough support and use a cushion when necessary. The right furniture can also help to prevent the occurrence of backache. Use a firm mattress when you sleep and use chairs of a proper height in relation to the table or desk.

Exercise is another good way to prevent backache. However, if you have had back injuries before such as a slipped disc, do be cautious when you exercise. Consult a doctor before you start on any strenuous exercise programme.

What to do when backache occurs
To reduce backache when it occurs, sit down and remember to maintain good posture. Ice packs or heat packs can provide relief for backaches, depending on the condition of the backache. Ice packs will help to reduce the swelling and inflammation. Heat will help circulation and reduce stiffness.
Place a towel wrapped with ice on the position of pain as frequently as you can for at least 30 minutes each time in the immediate days after injury. After a few days, change your procedure to a mix of ice and heat - 30 minutes of ice followed by 30 minutes of heat.

If pain persists, do consult a doctor.

When should you see a doctor?
You should see a doctor under the following conditions:

• When your backache is severe and acute.
• When your backache starts suddenly and is severe enough to prevent you from work.
• When your backache is accompanied with associated pain in legs or weakness and tingling in the legs or back.
• When painkillers and other therapies do not make any noticeable difference and your backache is getting worse over time.
• When the pain increases when you cough or bend forward at the waist. This may be a sign of a herniated disk. At the onset of pain, lie flat with a pillow under your knees. 
• When the pain follows an injury and is accompanied by sudden loss of bladder or bowel control. If you have difficulty moving any limb, or if you feel numbness, pain, or tingling in a limb, do not move but call for medical help immediately. You may have injured your spinal cord.
• When backache is accompanied by nausea, vomiting, fever, muscle weakness, pain down an arm or leg, or bowel or bladder disturbances, or when pain is still present after two to three days of rest.
• When pain lasts longer than 72 hours. If the pain radiates into the legs, or if other symptoms such as unexplained weight loss occur, consult a doctor immediately.
• When pain is in one side of the small of your back accompanied by a sick feeling and fever. You may have a kidney infection.
• When the pain in your back extends downward along the back of the leg. You may be suffering from sciatica.
• When you have dull pain in one area of your spine when trying to lie down or getting out of bed, especially if you are over 50 years of age. You may be suffering from osteoarthritis.
• When pain is felt in both thighs when walking. This can be a symptom of spinal stenosis, the formation of bony growth on the vertebrae that causes the lower spinal canal to narrow.

A persistent backache may also be an indication of an occult cancer of the colon. Consult a doctor for more advice.


The Apollo Clinic
Koramangala, Bangalore (India)
www.koraclinic.com