Dealing with low back pain in adults

Low back pain is one of the most common disorders in adults worldwide. About 80 per cent of people have at least one episode of low back pain during their lifetime.

Factors that increase the risk of developing low back pain include smoking, obesity, old age, female gender, physically strenuous work, sedentary work, a stressful job, job dissatisfaction and psychological factors, such as anxiety or depression.

Low back pain can have many causes. However, most people (85 per cent) have “non-specific low back pain”, which is not caused by a specific disease or abnormality in the spine. Many people attribute their back pain to diseases related to aging or arthritis, although problems in muscles or ligaments, or other causes, may be equally responsible.

Rarely, back pain is caused by a potentially serious spinal condition, such as infection, fracture, or tumour, or a disorder which causes weakness and bowel or bladder dysfunction, as well as back pain. Back pain that is associated with leg pain can be due to a condition of the vertebral column or spinal cord.

Do not assume the worst. Almost everyone gets back pain at some point. Low back pain can be scary. But it is almost never serious. It usually goes away on its own. The cases that require surgery or urgent care are rare.

One should seek medical care if the back pain is associated with other symptoms, such as numbness or weakness in any or both legs, problems with bowel or bladder control, having a fever or feeling sick in other ways, taking a steroid medicine on a regular basis, or if there’s history of cancer or bone disease.

One should also see a doctor if the back pain does not improve with resting or a change in position and is so severe that you cannot perform simple tasks, or if the back pain does not start to improve within three to four weeks.

The vast majority of people with low back pain improve within four to six weeks without treatment, or with simple measures that can be performed at home. It is not usually necessary to consult a healthcare provider if the pain improves.

The exact cause of ones back pain can be identified after taking history of the patient’s complaints, carrying out proper physical examination and some tests once the doctor isn’t convinced with examination findings.

Imaging tests, including plain x-rays, CT (computed tomography) scanning, or an MRI (magnetic resonance imaging), may be recommended for some people after assessment by the doctor.

Unless low back pain is caused by a serious medical condition, a rapid recovery is expected.

The best thing you can do is to stay as active as possible – even if you are in pain. People with low back pain recover faster if they stay active. Walk as much as you can. If you stopped working because of your pain, try to get back to your normal routine soon. But do not overdo it.

But most people do well with simpler treatments, such as pain medications, medicine to relax the muscles, medicines that numb the back and reduce the swelling, and other therapies which can be suggested by one’s doctor.

To avoid suffering from low back pain again, stay active and learn exercises that help strengthen and stretch your back. Learn to lift using your legs instead of your back. And avoid sitting or standing in the same position for too long.

Only a small minority of people with low back pain will require surgery. Surgery is often necessary if there is evidence of problems with the nerves at the base of the spinal cord, another serious back condition like a tumour or infection, or severe weakness due to spinal stenosis or compression of a nerve root.

 Dr. Ian Shyaka

Resident in Surgery, Rwanda Military Hospital,

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