Back Pain (Backache)

Back pain is one of the commonest reasons people see a doctor. It usually affects the lower back and may feel like a dull ache, a sharp catch on movement or stiffness after sitting. In most people it settles within a few weeks with simple care, but pain that lasts or spreads into the leg needs a proper spine evaluation.

Symptoms

• Aching or stiffness in the lower or middle back
• Pain that worsens on bending, lifting, or sitting or standing for long periods
• Muscle spasm and difficulty straightening up after rest
• Pain travelling below the knee into the leg or foot, often with tingling, when a nerve is irritated (sciatica)

Causes

• Strain of muscles or ligaments from heavy lifting, sudden twisting or unaccustomed exercise
• Poor posture, long hours at a desk or behind the wheel, and lack of regular activity
• Age-related wear of the discs and small joints of the spine (lumbar spondylosis)
• A slip disc pressing on a nerve
• Narrowing of the spinal canal (lumbar canal stenosis), more common in older adults
• Forward slipping of one vertebra over another (spondylolisthesis)
• Weak bones (osteoporosis) leading to small fractures of the vertebrae
• Less commonly, infection such as spinal tuberculosis, tumours, or pain referred from the kidneys or abdomen

Diagnosis

Diagnosis begins with a detailed history and a careful examination of the spine and the nerves of the legs, including muscle strength, reflexes and sensation. Most short-lived backaches do not need any scan. X-rays may be advised to look at alignment and bone health. An MRI is recommended when pain continues for several weeks despite treatment, when there is leg pain with signs of nerve involvement, or when any warning signs are present.

Treatment

Most backache improves without surgery. Staying gently active is better than long bed rest, although a short period of relative rest can help during a severe flare. Medicines prescribed by your doctor can ease pain and spasm in the early phase. Physiotherapy, with core-strengthening and stretching exercises, helps the back recover and lowers the chance of the pain returning. Simple habits such as correct lifting technique, a supportive chair, regular breaks from sitting and keeping a healthy weight make a real difference.

If nerve pain persists, an image-guided injection may be considered in selected patients. Surgery is needed only for a small number of people, for example when a disc or a narrowed canal is compressing the nerves and causing persistent pain, increasing weakness or bladder and bowel problems. Where suitable, this can be done through minimally invasive or endoscopic techniques that use small incisions. The right option depends on your examination and MRI findings.

When to Seek Urgent Care

• Weakness in one or both legs, or difficulty lifting the foot (foot drop)
• Numbness in the saddle area: around the private parts, buttocks and inner thighs
• Loss of control over passing urine or stools
• Back pain with fever, unexplained weight loss or a past history of cancer
• Severe pain after a fall, road accident or other major injury

If you notice any of these signs, go to the nearest emergency department immediately.

If back pain is affecting your daily life, consult Dr. Prashant Sharma at Keshav Super Speciality Hospital, Meerut, for a careful evaluation and a treatment plan suited to you.

Related Conditions

• Neck Pain
• Cervical Pain
• Cervical Spondylosis
• Lumbar Spondylosis
• All Spinal Treatment ›