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Backache

Backache is one of the leading causes of disability worldwide. The pain ranges from a dull muscle ache to sharp, shooting, burning or stabbing sensations. It can radiate down the leg, and movements like bending, twisting, lifting, standing or walking often make it worse.

Common causes

  1. Muscle or ligament strain: repeated heavy lifting or a sudden awkward movement can strain the back muscles and spinal ligaments.
  2. Bulging or ruptured disc: discs cushion the spine. The soft material inside can bulge or rupture and press on a nerve. Usually seen on an X-ray or CT scan.
  3. Osteoarthritis: wear-and-tear arthritis can cause low back pain. It can narrow the space around the spinal cord, leading to spinal stenosis.
  4. Osteoporosis: the vertebrae become porous and brittle, which can cause painful compression fractures.
  5. Ankylosing spondylitis: an inflammatory arthritis in which some spinal bones fuse, reducing flexibility and causing chronic back pain.

Risk factors

  • Age: the risk increases after the age of 30–40.
  • Lack of exercise: weak, unused muscles in the back and abdomen don’t support the spine well.
  • Excess body weight: puts extra stress on the back.
  • Certain diseases: including some cancers.
  • Improper lifting: using your back instead of your legs.
  • Psychological conditions: depression, anxiety and stress increase the risk, through muscle tension.
  • Smoking: increases coughing, which can contribute to herniated discs over time.

Prevention

  • Regular low-impact exercise: walking, swimming or cycling builds back strength and endurance.
  • Strengthen your core: exercises for the abdominal and back muscles help support the spine.
  • Maintain a healthy weight: it reduces the load on your back.
  • Quit smoking: it lowers the risk of disc problems.
  • Stand smart: keep a neutral pelvic position. Good posture reduces muscle stress.
  • Sit smart: use lower-back support. Place a rolled towel to match your back’s natural curve. Keep your hips level.
  • Lift properly: avoid heavy lifting when possible. Lift with your legs, not your back.

Referred back pain

Pain that starts elsewhere but feels like back pain. Causes include an abdominal aortic aneurysm, gallbladder infection, kidney infection, kidney stones, pancreatitis, urinary tract infections, endometriosis, uterine fibroids, spinal tumours, vertebral osteomyelitis and a spinal epidural abscess.

Management

  • Non-medical: acupressure, massage therapy, yoga, TENS (transcutaneous electrical nerve stimulation).
  • Medicines: epidural steroid injections, muscle relaxants, paracetamol, NSAIDs.
  • Surgery: for underlying structural causes, when other treatments fail.
  • Home remedies: a heating pad, ice packs, yoga poses, deep breathing.

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