In recent times, myofascial pain syndrome, herniated disk, and sciatica have been reported frequently to the medical centres, which are mostly prominent causes for the backache. A herniated disc or slipped, ruptured disc means the soft, jelly-like center of a spinal disc pushes out through a tear in its tougher exterior ring, irritating nearby nerves and potentially causing pain, numbness, or weakness in the back, neck, arms, or legs.
This common spinal issue occurs when discs degenerate or get injured, leading to the inner material leaking and compressing nerves or causing inflammation, often resolving with conservative care like physical therapy, adequate rest, nevertheless occasionally needing medical intervention.
Herniated disc prevalence in India is rising, driven by sedentary lifestyles, with estimates suggesting 1-3% of the population annually, though many more up to 20% of adults, have asymptomatic herniation. Key factors include desk jobs, poor posture, and age-related degeneration, affecting those in their 30s-50s, most commonly a 2:1 male-to-female ratio, particularly in the lower L4-L5, L5-S1 regions. L4-L5, L5-S1 refers to the two lowest, most mobile segments of the lumbar (lower back) spine, where the fourth (L4) and fifth (L5) lumbar vertebrae connect (L4-L5) and the L5 vertebra connects to the sacrum (S1).
That is a triangular bone in the lower back formed from fused vertebrae and situated between the two hip bones of the pelvis. These levels are crucial for weight-bearing and movement, making them common sites for issues like disc bulges, herniations, and nerve compression (sciatica), causing lower back, buttock, and leg pain, numbness, or weakness.
Sciatica pain is nerve pain from irritation or compression of the sciatic nerve, the body’s longest nerve, radiating from the lower back and buttock down the back of one leg, often feeling burning, shooting, tingling (pins-and-needles), or numb, and can range from mild to severe, usually worsening with sitting, coughing, or sneezing. It’s typically caused by a herniated disc, spinal stenosis, or but often resolves with conservative care, though severe cases need medical attention
In the neck, C5-C6, C4-C5 refer to specific levels in the cervical spine (neck pain), indicating the vertebrae and the intervertebral discs between them, often discussed in the context of injuries like disc herniation or bulging, causing symptoms like neck pain, numbness, or weakness in the arms and hands, as these segments are crucial for movement and nerve pathways.
Herniated disks can lead to cauda equine syndrome, which is a medical emergency. It is suggested to seek medical advice when someone experiences numbness, weakness, or bowel, bladder issues, as these can signal serious underlying problems. Myofascial pain syndrome, is aching, throbbing pain, trigger points, and fragile muscles, with other symptoms. Sacroilitis inflammation leads to lower back pain, which may spread into the butt, hips, or thighs. Scoliosis, this abnormal curvature of the spine, can in severe cases cause back pain, trouble standing upright, leg pain, numbness or weakness. Spinal stenosis lumbar (lower back), where “pinched nerves can cause lower back pain, sciatica, a heavy feeling in the legs, and pain that worsens with prolonged standing or walking.
In spondylolisthesis, there can be lower back pain, muscle spasms in the back of the thigh, pain when bending over, and trouble walking or standing for long periods. The most common symptom is lower back pain, which typically spreads into the thigh and butt. The pain gets worse on move and eases when less active or resting.
Conditions that cause referred back pain
Certain medical conditions can cause referred pain. This pain is felt in one part of the body due to an issue in another part of the body. Referred back pain can happen due to a wide range of conditions affecting organs in the abdomen (belly) or pelvis. Specific examples of conditions and how back pain is experienced include abdominal aortic aneurysm can cause steady, deep pain in the lower back or belly, may also have pain in the leg, groin, or pelvic area, and a pulsing sensation in the belly. An abdominal aortic aneurysm (AAA) is a weakened, bulging area in the aorta within the abdomen, often caused by factors like high blood pressure, smoking, and atherosclerosis, typically showing no symptoms until it’s large or ruptures, at which point it causes severe pain and requires immediate medical attention, often diagnosed via ultrasound and managed with monitoring or surgical repair. Atherosclerosis is a condition in which plaque builds up inside the arteries. Plaque is a sticky substance made up of cholesterol, fat, blood cells, calcium, and other substances found in the blood. Over time, plaque hardens and causes the arteries to narrow. That limits the flow of oxygen-rich blood to the body.
Further gallbladder inflammation may produce pain in the upper right belly that may spread to the back. The pain may feel sharp, dull or crampy and worsen when a deep breath is taken. Some people feel nausea, vomiting, and a fever. Kidney infection might cause pain in the lower back or side, along with fever, chills, pain when peeing, bloody or cloudy pee, and a frequent or urgent need to pee. Kidney stones can cause pain in the lower back, belly or side that may seem like it’s extending from the groin to the side. The pain may be dull or sharp and severe, and it may worsen in waves.
Pancreatitis can result in moderate to severe abdominal pain that spreads to the back. Pancreatitis is inflammation of the pancreas, a gland behind the stomach that produces digestive enzymes and hormones like insulin; it occurs when these enzymes activate prematurely and start digesting the pancreas itself, leading to pain, nausea, and digestive issues, and can be sudden (acute) or long-term (chronic). Acute pancreatitis resolves in days, while chronic pancreatitis causes permanent damage, potentially leading to diabetes or malnutrition. The pain may feel worse when flat, cough, lie and eat a large meal, or exercise. Urinary tract infection might lead to pain in the lower back, belly, side or pelvic area. Patients may also have cloudy pee that smells bad, pain when peeing, and blood in urine, and a frequent or urgent need to pass urine. The diagnosis of the cause of back pain, back pain in women, and several other factors will be discussed in the coming issue.
