Treatment and Surgery for Back Pain in India

There are many ways to prevent low back pain problems from developing. Commonly people have created problems in their back themselves. What that means is that problems are self-inflicted, such as poor posture or poor moving and handling techniques.

Poor posture usually involves excessive flattening of the low back (slouching), and is associated with a forward slippage of the head resulting in a flattening of the neck curves. This puts extra stress on the muscles and ligaments in the neck and shoulders. Commonly this causes tension in the muscles which is felt as pain, and an increased likelihood of trapping nerves in the neck. Slouching in the low back results in the neck ligaments taking more strain on a daily basis. This results in the extra strain ultimately causing an misalignment of the spine and resultant nerve entrapment. Effects of this include low back pain pins and needles, sciatica, referred leg pains, and low back spasms and aches.

Although back pain is fairly common these days, there are times when the pain becomes unbearable. Here are the top 5 modes of treatment your doctor is likely to prescribe in case of severe back pain. 

Main Modes of Treatment

 Rest: The first step in the treatment of low back pain is to rest the spine. Because most cases of back pain are due to muscle strain, it is important to avoid further irritation to the spine and the muscles that surround the spinal column. Bed rest is fine, so long as this only lasts two to three days. Prolonged bed rest can actually lead to more persistent back pain. Once the acute back pain eases, avoid lifting, twisting, and physical exertion.

Oral Medication: Anti-inflammatory medications (NSAIDs) are helpful in treatment of both back pain and the associated inflammation. There are both over-the-counter and prescription NSAIDs, and both work well in the treatment of back pain. Side-effects of NSAIDs include problems of gastro-intestinal bleeding, and these medications should be avoided in patients with stomach ulcers. Sometimes, muscle relaxing medications are prescribed. They help to relieve muscle spasm, but may also make patients quite drowsy.

Physiotherapy and Exercises: Strengthening of back muscles is probably the most important step in treatment of most causes of back pain. By increasing strength and flexibility of back muscles, weight is better distributed, and less force is placed on the spine. Other modalities that can be used in the treatment of back pain if the exercises alone do not help include aquatherapy, ultrasound, electrical stimulation, short-wave diathermy and others.

Epidural steroid injections: They are an option for back pain treatment and inflammation around the spinal nerves. An epidural steroid injection is performed using an x-ray to guide the medication to the area adjacent to the inflamed spinal nerve.

Spine Operation: Spine surgery is rarely an initial treatment for back pain; there are a few emergencies, however, that may require surgical treatment. In the vast majority of patients, spine surgery is only considered after a long course of conservative therapy. Back pain often takes quite some time to resolve. Rushing into spine surgery, therefore, may not be the most sensible idea. Most commonly, doctors will advise at least 3 to 6 months of conservative treatment before considering spine surgery.

5 Operations commonly carried out for back pain are:

1. A Discectomy is a procedure to remove a portion of the disc that rests between each two vertebrae. A herniated disc is the most common reason for spine surgery. In this type of spine surgery, the protruding, herniated disc is removed and this relieves the pressure on the nerves.
2. A Foramenotomy is also a procedure used to relieve pressure on a nerve, but in this case, the nerve is being pinched by more than just a protruding disc. The surgery removes a portion of bone and other tissue that may be compressing the nerve as it exits the spinal column.
3. A Laminectomy is performed to relieve pressure on the spinal cord itself.  It is most commonly used to treat conditions such as spinal stenosis and spondylolisthesis, where the spinal column is seen slipping forwards. Depending on the amount of bone removed, this procedure may be done with a spinal fusion to prevent instability.
4. A spine fusion is surgery that is done to eliminate motion between adjacent vertebrae to treat a problem such as spondylolisthesis (an unstable spine), or it may be done because of the extent of other surgeries such as a Laminectomy.
5. Spinal disc replacement is a new surgery that is still quite uncommon. It is done to treat specific types of back pain, while avoiding the problems associated with spine fusion surgery.