When we watch any television now a days, we find frequently either a young lady or an old women while working in the kitchen bending to pick up some item on the floor or to take out coffee tin from a shelf or a cupboard that is at a height, suddenly cry keeping hand on the back with a dialogue “oh pain and catch of the muscle” then immediately son or husband applies a cream on the back to relieve the back pain.
Backache or Low Back Pain (LBP) is extremely common in India, with lifetime prevalence around 66%, annual prevalence around 51%, and point prevalence near 48%, affecting people across all populations, though higher in women, rural inhabitants, and specific occupations like uncomplicated workers. The risk factors include age, physical inactivity, obesity, demanding jobs (farming, manual labour), prolonged sitting, standing, stress, and wrong posture. Of late the younger adults are also increasingly affected with backache
In India on backache prevalence, nearly ninety-seven studies were reviewed. Out of which fifty-four studies were included in the review and found (55.5%) were of higher methodological quality. The pooled point, annual, and lifetime prevalence of LBP in India broadly varies from 48%, to 66%. The pooled prevalence rates were highest among females, the rural population, and among elementary workers.
To specifically mention that the annual and lifetime prevalence rates of LBP in the Indian population are higher compared to global and other ethnic populations. The findings of this study can be the basis for formulating policy regarding the prevention and treatment of LBP in a large part of the global population, including the Indian population, according to a systematic review and meta-analysis published in the Research Gate literature review, August 2022.
The importance of back and neck pain in our society is underscored to a greater extent through the latest publications globally, though we do not have scientific data on the expenditure of back pain issue in India, the cost of back pain in the United States exceeds 100 billion US dollars annually, approximately one-third of these costs are direct health care expenses, and two-thirds are indirect costs resulting from loss of wages and productivity. The low back pain is the second most common reason for visiting a physician in the United States; and 1% of the U.S. population is chronically disabled because of back pain, according to the publication of 18th Edition Harrisons Principles of Internal Medicine, Chapter 15, P: 129-130. It is only to explain to the readers that when the impact of back pain in developing countries like United States of America has been in such proportions, one can imagine its impact how much in country like India where the labour force is long-legged.
Common causes
Back pain stems from strains, poor posture, arthritis, disc problems, and underlying conditions, often improving with rest, physical therapy (PT), exercise, correct posture, and over-the-counter pain relievers.
Disc problems, often called slipped, or bulging discs, happen when the spine’s soft inner disc material pushes through a tear in its tough outer layer, compressing nearby nerves and causing pain, numbness, tingling, or weakness in the back, neck, arms, or legs, with common types including degeneration, usually due to aging, injury, or strain, though many mild cases resolve with conservative care like physical therapy and adequate rest. In the human body, a “disc” usually refers to an intervertebral disc, a spongy cushion between spinal bones (vertebrae) that acts as a shock absorber, allows spine flexibility, and keeps vertebrae separated for nerve passage, featuring a tough outer ring and a jelly-like centre nucleus pulpous. The other causes include Muscle, ligament strain, sudden awkward movements, and heavy lifting, or poor conditioning, and poor posture, like hunching puts pressure on the spine.
Degenerative disc disease, arthritis, and spinal stenosis are the age-related changes. Arthritis means “joint inflammation” and refers to over 100 conditions causing pain, swelling, stiffness, and redness in joints, impacting movement and quality of life, with common types like Osteoarthritis (wear-and-tear) and Rheumatoid Arthritis (autoimmune) damaging joints differently, but all affecting where bones meet.
Spinal stenosis is the narrowing of spaces within in spine, putting pressure on the spinal cord and nerves, often causing pain, numbness, weakness, or cramping in the back, legs, or arms, especially when standing or walking, with relief from sitting or leaning forward. It’s usually age-related due to wear-and-tear (arthritis, bone spurs, thickened ligaments) but also from injury or congenital issues, affecting the cervical (neck) or lumbar (lower back) spine. Treatments range from physical therapy, medication, and lifestyle changes to surgery for severe cases, with most people over 50 having some degree of asymptomatic stenosis.
Spinal stenosis symptoms vary in some individuals, often slow to develop, and include pain, numbness, tingling, cramping, or weakness in the back, neck, arms, or legs, depending on the affected spinal area, typically worsening with standing/walking and improving when leaning forward or sitting. Key signs are leg pain/cramps (sciatica) in the lower back, balance issues, and, in severe cases, bladder/bowel control problems called as cauda equine syndrome, which requires immediate care and attention. Also, bulging or ruptured discs pressing on the nerves.
Brittle vertebrae, causing painful breaks, are called osteoporosis. Lack of water, unhealthy potassium levels, stress, anxiety, and diet, processed foods can trigger spasms. Other conditions, such as kidney stones, infections, and endometriosis, Endometriosis is an often-painful conditions in which tissue that is similar to the inner lining of the uterus grows outside the uterus. It often affects the ovaries, fallopian tubes, and the tissue lining the pelvis. Rarely, endometriosis growths may be found beyond the area where pelvic organs are located.
Fibromyalgia is a chronic disorder causing widespread body pain, fatigue, sleep problems, and cognitive issues such as fibro fog, or “brain fog,” causing mental cloudiness, memory lapses, poor concentration, and difficulty with language and attention, making it hard to think clearly or focus, even more distressing than pain for some. It’s more common in women, often triggered by injury, stress, or infection, and diagnosed by symptoms after ruling out other conditions, as there’s no definitive test. , impacting daily function by affecting memory, mental alertness, multitasking, and information processing, stemming from the chronic pain and sleep disruption associated with the condition. , resulting from amplified pain signals in the brain and spinal cord, often triggered by stress, injury, or infection, which can be managed by treatments like exercise, therapy, and medication to improve quality of life. The treatment, relief, and prevention of the backache will be discussed in the upcoming issue. (To be concluded).
