Back Pain

Back Pain Treatment in Ludhiana, Punjab, Back pain, is not a disorder. It’s a symptom of several different types of medical problems. It usually results from a problem with one or more parts of the lower back, such as: Ligaments, muscles, nerves, the bony structures that make up the spine, called vertebral bodies or vertebrae. It can also be due to a problem with nearby organs, such as the kidneys.

Back pain can have many symptoms, including:

• a dull aching sensation in the lower back
• a stabbing or shooting pain that can radiate down the leg to the foot
• an inability to stand up straight without pain
• a decreased range of motion and diminished ability to flex the back

The symptoms of back pain, if due to strain or misuse, are usually short-lived but can last for days or weeks. Back pain is chronic when symptoms have been present for longer than three months.

It can result from injury, activity, and some medical conditions. Back pain can affect people of any age, for different reasons.
Mechanical problems: Common mechanical cause of back pain is a condition called intervertebral disc degeneration, which simply means that the discs located between the vertebrae of the spine are breaking down with age. As they deteriorate, they lose their cushioning ability. This problem can lead to pain if the back is stressed. Another cause of back pain is the wearing down of the facet joints, which are the large joints that connect each vertebra to another. Other mechanical causes of back pain include spasms, muscle tension, and ruptured discs, which are also called herniated discs.
Injuries: Spine injuries such as sprains and fractures can cause either short-lived or chronic back pain. Sprains are tears in the ligaments that support the spine, and they can occur from twisting or lifting improperly. Fractured vertebrae are often the result of osteoporosis, a condition that causes weak, porous bones. Less commonly, back pain may be caused by more severe injuries that result from accidents and falls.
Acquired conditions and diseases: Many medical problems can cause or contribute to back pain. They include scoliosis, which causes curvature of the spine and does not usually cause pain until mid-life; spondylolisthesis; various forms of arthritis, including osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis; and spinal stenosis, a narrowing of the spinal column that puts pressure on the spinal cord and nerves. While osteoporosis itself is not painful, it can lead to painful fractures of the vertebrae. Other causes of back pain include pregnancy; kidney stones or infections; endometriosis and fibromyalgia, which causes fatigue and widespread muscle pain.
Infections and tumours: infections such as spinal tuberculosis can cause pain when they involve the vertebrae or discs. Tumours, too, are relatively rare causes of back pain. Tumours can be primary or Metastatic.
Although the causes of back pain are usually physical, it is important to know that emotional stress can play a role in how severe pain is and how long it lasts. Stress can affect the body in many ways, including causing back muscles to become tense and painful. Untreated depression and anxiety can make back pain feel much worse. Likewise, insomnia, or the lack of sleep, can also contribute to back pain.

Surgery is Not Necessary in Most Patients: Majority of patients with back pain & sciatica do not require surgery. Treatment options include physical therapy, back exercises, weight reduction, steroid injections (epidural steroids), nonsteroidal anti-inflammatory medications, radiofrequency ablation, rehabilitation, and limited activity. All these treatment options are aimed at relieving inflammation in the back and irritation of nerve roots. Physicians usually recommend four to six weeks of conservative therapy before considering surgery.
Spinal Injections: Injections like the Cervical, Thoracic and Lumbar Interlaminar Epidural Injections and Transforaminal injection are injections into the opening at the side of the spine where a nerve root exits. These injections reduce the inflammation and swelling of spinal nerve roots and other tissues surrounding the spinal nerve root and reduces pain, tingling and numbness and other symptoms caused by such inflammation, irritation or swelling.

Radiofrequency Ablation: Radiofrequency ablation (or RFA) is a procedure used to reduce pain. An electrical current produced by a radio wave is used to heat up a small area of nerve tissue, thereby decreasing pain signals from that specific area. RFA can be used to help patients with chronic (long-lasting) low-back pain. RFA has proven to be a safe and effective way to treat some forms of pain. It also is generally well-tolerated, with very few associated complications.

Spinal cord stimulation: Spinal cord stimulation is a procedure that delivers low-level electrical signals to the spinal cord or to specific nerves to block pain signals from reaching the brain. Spinal cord stimulation is recommended when other treatments have not been successful, when surgery is not likely to help, or when surgery has failed.

When conservative treatment for low back pain does not provide relief or neurologic symptoms are worsening or severe, surgery may be needed. Candidates for surgery present any of the following:

• Reasonably good health
• Back and leg pain limits normal activity or impairs quality of life
• Progressive neurologic deficits develop, such as leg weakness, numbness or both
• Loss of normal bowel and bladder functions
• Difficulty standing or walking
• Medication and physical therapy are ineffective

If surgery is recommended, neurosurgeons have a variety of options available to help relieve pressure on the nerve roots. If several nerve roots and discs are causing the pain or if degeneration and instability exist in the spinal column, the neurosurgeon may choose: (1) a minimally invasive approach; (2) a more open decompression; or (3) fusing the vertebrae together with bone grafts and stabilizing them with instrumentation, including metal plates, screws, rods and cages, depending on the extent of disease.
The benefits of surgery should always be weighed carefully against the risks. Although a large percentage of patients with low back pain report significant pain relief after surgery, it is not guaranteed that surgery will help.