DEAR DOCTOR,

I have had back pain for some time now. I sit a lot at work and I think it is what is causing the pain. What is the best way of dealing with back pain? DERRICK

DEAR  DERRICK,

I hope the pain is not severe and there is no abnormal sensation in the legs. Your guess is correct. Being sedentary, i.e. sitting for long hours continuously, is indeed a cause for backache in desk workers. A human being stands, sits and moves on two legs, thus balances the body on two legs. The force of gravity is exerted on the backbone in this process, causing strain on the muscles of the back, which causes pain. Sitting without adequate support to the back for a long time adds on the strain. Bending from the back, pushing or lifting heavy weights, are other activities which can strain back muscles or cause rupture of muscles or ligaments surrounding and supporting the backbone. This also results in backache or can   augment pre-existing pain. 

Sometimes, young individuals can develop sudden prolapse of the supporting disc between two vertebrae due to any sudden jerky movement. This causes sudden, severe backache. There may be associated tingling, numbness, and et cetera, abnormal sensations in the thighs or legs, depending on whether nerves in the backbone are compressed or not. With advancing age, backbone starts becoming brittle, hence even minimal strain causes much pain. Softening of bones due to ageing, enhances this process and pain.

Neck portion of backbone or lower part behind waist area are much more vulnerable to develop pain. This happens because these two parts of the backbone are flexible and individuals tend to use them as spring, turning them around suddenly or bending them in any direction needed.

Prevention of backache lies in keeping the back straight literally. Straight-backed chairs should be used to do office work. The back should be straight and well supported. Material used for work, whether computers or paper, should be kept such that one can reach them comfortably, without straining the back. Similarly, while driving, the back should be adequately supported and legs should reach the pedals comfortably, without straining the back. Hard, or very thin mattresses should be used for sleeping, instead of thick cushy ones, because the back is not supported well on thick cushions. If possible, one should avoid lifting or pushing heavy weights. It is advisable, that if possible, the weight to be lifted or pushed should be divided into two or three lighter packets. 

Diet rich in calcium and vitamin D3 is helpful in keeping the backbone strong and reduces risk of any spontaneous fracture in old age. Middle aged or elderly people can take supplements of calcium and vitamin D3 on advise of a medic (regarding dose and duration of treatment).

Backache if mild can improve with painkiller medicines or just hot compression. For moderate to severe back pain, it is advisable to rest on the back on a hard bed. Once pain is relieved, movements can be started and increased slowly. Pain killers are needed to improve the pain. Severe or persistent pain, can be relieved by surgical interventions. 

 Dr. Rachna Pande, Specialist internal medicine rachna212002@yahoo.co.uk