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Posted On : 09 Feb 2007

Backache is one of the most common symptoms in modern day life that brings a person to a doctor. Man has suffered from back pain since times immemorial but the recent increase in the number of cases is the result of long hours spent in front of the computer by the present generation. Sitting puts more strain on the back than standing or walking which shows the importance of taking frequent breaks while working in a sitting position.

Causes:

1. Most of the cases have mechanical back pain meaning thereby that the pain is arising from the stress on various structures constituting the back and pelvis including ligaments, muscles, fascia, bursa, facet joints, vertebral discs and sacroiliac joints.
2. Less frequent but a serious cause of backache is malignancy which should not be overlooked.
3. In some cases the pain may be psychogenic in nature without any structural body illness.

Associated symptoms:

1. One must take a note of signs like weight loss, fever, loss of control of bladder and bowel, fixed or progressive neuro-deficit like drop-foot or leg weakness and lastly a previous history of malignancy.
2. Amount of pain is not relevant to outcome. Overwhelming pain is not necessarily indicative of a more serious disease and does not necessitate investigations any more than a patient with less pain.

Investigations:
Patients with associated symptoms and those in which expected response to treatment is not there should have X-rays, MRI scan and Bone scan etc to rule out any serious cause.

Treatment:

1. Reassurance that mechanical back pain will not result in paralysis or crippling.
2. Learning correct posture for sitting and standing.
3. Specific exercises for the back.
4. Treatment devices like Short Wave Diathermy, Ultrasonic treatment, Quantum therapy etc
5. Non-steroidal anti-inflammatory drugs and pain killers.
6. Patients with progressive leg weakness or loss of bladder and bowel control may need to be referred to a surgeon.

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