Q. How common is low back and neck pain?
Very common!!! Low back and neck pain aﬀects 8 out of 10 people at some point in their life. It is one of the top reasons worldwide for visiting a doctor and probably the most common cause of work related disability. It becomes chronic (prolonged and persistent) in about 10 percent, causing serious pain, depression and disability.
Q. Can back pain be prevented?
Yes, if eﬀorts are made. The major cause of back pain is the stress on muscles that are poorly conditioned to handle loads.
The natural process of aging cannot be reversed but steps can be taken to keep the back ﬁghting ﬁt. Prevention is better than cure.
Q. If I don’t do heavy work, can I get back pain? You may still get it.
Back pain is not always related to heavy work. There is a large sedentary population complaining of back pain.
Modern lifestyle makes us more prone to back pain.
Q. Can exercise help?
Guided exercises surely help. Strong muscles support the spine allowing it to handle greater loads. Weak deconditioned muscles make the back work less eﬃciently, shifting the load to the vertebrae and discs. The weakness of the structural spine because of ageing, wear and tear puts a lot of stress on the spinal musculature.
Speciﬁc guided exercises to strengthen these muscles take care of the fatigue and avoid back pain.
Q. What type of exercises should I do?
Consult your doctor and listen to your body. An aerobic and/or weight training program is good. Stationary cycling, walking and swimming at least thrice a week will keep the back in good shape. The exercises need to be tailored to every individual condition and physical requirements.
Weight-bearing exercises help prevent osteoporosis, a disease making bones lose strength and become soft. Osteoporotic soft bone can fracture and collapse.
Q. Can obesity precipitate backache?
Overweight persons suﬀer in more ways than one. Extra body weight puts greater stress on the back muscles and makes them work harder.
The most eﬀective weight loss program includes exercise and a balanced, nutritious diet. Increasing portions of vegetables, fresh fruits and complex carbohydrates (rice/pasta) and decreasing portions of fatty foods and sweets. A visit to a dietician is also recommended.
Some exercises may worsen intense back pain. No exercise plan should be started during an episode of acute, sharp back pain.
Exercises should be started after seeing a doctor or after back pain has subsided.
Q. Does posture have any role?
Posture plays a critical role!!!
Optimal posture involves balance and alignment. Carrying heavy weight on one shoulder should be avoided. If possible the weight should be balanced evenly over both shoulders.
Standing with feet slightly apart, as naturally as possible, reduces stress on the lower back. When standing for long periods a footrest should be used to keep one foot up with the knee relaxed.
Q. How do I sit for work?
Optimally- for short durations. If sitting for long durations, getting up every hour and walking around a bit is useful. Sitting in front of a computer monitor should be at a comfortable height, such that the head is not repeatedly tilted back and forward to view the screen.
A rolled-up towel or small pillow should support the lower back. The limbs should be kept on foot/armrests sharing the weight of the body. The desk/table should be close to the torso to avoid reaching out and straining the muscles.
Q. Can using the phone for long hurt my hurt my neck and back?
Absolutely-Yes it does! Cradling the handset of the phone between the neck and shoulder puts the neck in an awkward position and can lead to severe neck pain and back pain.
Prolonged used of smartphones for texting and playing games, besides straining the thumb, wrist, elbow and eyes.
Limited use of smartphones, use of hands-free devices and maintaining good posture is recommended.
Q. How should I lift weights?
Lift less weight and close to the body. Many back injuries are caused by lifting heavy objects improperly and putting excessive strain on discs and muscles. Keeping the back as upright (vertical) and as straight (not hunched) is recommended.
Getting under or next to the object, rather than over it with hips and knees ﬂexed is the safest. Squatting down with abdominal muscles contracted keeps the back straight while lifting. Using leg muscles to bear the load than straining the back is a better option.
Holding the object as close to lifting or carrying reduces back strain. Shifting legs while lifting, rather than twisting the body reduces torsion loads on the back.
Q: Is prolonged rest required to recover from back pain?
Very rarely is prolonged rest needed. For simple back sprain the bed rest should not exceed a few days. The goal is early mobilization within pain limits and early rehabilitation (return to work). Unless, there is a very deﬁnitive reason (disease) to continue bed rest, prolonged recumbency can result in adverse outcomes.
Q: What is ‘Slipped Disc’?
Shock-absorber in the back slipping out of place. While standing, the force of gravity presses down against the discs, causing them to lose small amounts of water. When lying down, with no gravity pressing against the discs, water is reabsorbed.
Discs lose their ability to absorb water and become less ﬂexible over time. Small stresses and strains cause tiny tears in the outer casing of the disc, these tears heal with scar tissue which is weaker and less ﬂexible than the original tissue.
If a signiﬁcant tear takes place, the soft gel within the disc comes out. This is often referred to as a ‘slipped disc’.
Q: My back pain is radiating down my legs, should I worry?
Yes- please see a Spine Specialist. Back Pain radiating down one leg or both may be neurological (nerve related) pain referred to as Sciatica / Claudication.
These cases need to be evaluated meticulously by a trained spine specialist to anticipate and prevent any impending catastrophe. Early diagnosis and proper management are the key steps for a good outcome.
Even in these cases, most of the patients do not require surgery and medical treatment followed by guided rehabilitation can help.
However, diagnosing them early can prevent an adverse event like paralysis or nerve weakness from taking place and straining the muscles.
Q: Do I need to see a doctor every time my back hurts?
Only if it is continuous or repeated. Pain often goes away with conservative treatment in most-70% in 2 weeks and in 90% in 6 weeks.
However, pain may recur in 7 out of 10 cases. Some causes of unresolved or recurrent back pain can be serious and may cause permanent damage, if left untreated.
Q: If I visit a Spine Surgeon will I get operated?
NO – you will surely get a balanced opinion. More than 90% of the cases of back pain can be treated with appropriate lifestyle alteration, dietary modiﬁcation and exercises.
Visiting a Spine Surgeon does not mean that you will end up getting operated. There is a step wise graded treatment which one needs to follow before you are advised surgery.
Few people may need therapeutic spinal injections. Even fewer need surgery. A well trained Spine Surgeon would suggest the best treatment option to beneﬁt you.
Q: Can Back or Neck Surgery result in paralysis?
Very rarely! Advanced spine surgery in expert hands is very safe. Modern tools and technology for “Safe Spine Surgery” work like seatbelts and airbags protecting against collateral damage. The risk of having a complete paralysis after spine surgery is very rare.
Q: Is Spine Surgery really safe?
‘Safer today than ever before’. Today with improvements in technology and dedicated Spine Surgeons, spine surgery has become safe.
Minimally Invasive Surgery using microscopes, endoscopes, neuromonitoring and specialized instrumentation has dramatically changed the perspective of Surgery for the Spine.
Spine Surgery is safe, standardized and suitable for all spine aﬀections not responding to non-surgical modalities of treatment.
Q: When should I see a ‘Spine Specialist’?
In Red Flag situations!!! You should see a Spine Specialist, in red ﬂag situations, if your neck or back pain:
- is following an injury howsoever trivial.
- begins suddenly, worsens quickly and / or is associated with fever or chills
- is associated with radiating arm or leg pain or tingling numbness
- is leading to weakness or paralysis in limbs or loss of urinary/motion control
- is not responding to medication and rest
- is more at rest or night and associated with weight loss
- comes at either very young or very old age
The material on this brochure is for informational purposes only and does not constitute medical advice. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment.
Always seek the advice of a qualiﬁed doctor with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this brochure.
For appointment: Low Back & Neck Pain, Institute of Orthopaedics – Apollo Hospitals
- Call /WhatsApp – +254-719581035 / +254-754680981
- Online – www.apolloinformationcentre.com