Back Pain(कमर दर्द) in young people: Causes, Prevention & Treatment

In this video SimpliHealth expert in Orthopaedics Dr. Manpal Singh Narula will talk about Back Pain(कमर दर्द) in young people and its causes, prevention, treatment and when to see a doctor. Ouch, doc, I think I just pulled my back. Any orthopedic doctor sees this problem as very common in their practice. They say that backache is the price we pay for our erect posture. Animals don’t have backaches. This is because we stand on our legs and walk erect. And this wrong posture becomes the cause of backache and back sprains. 

Lower Backache & Neck Pain

Let’s talk about lower backache and neck pain, prevalent conditions in orthopedic practice. There are various reasons for this. And the causes are different in different age groups. So, for example, in a young patient, this is because of bad posture, long sitting hours, lack of exercise, etc. When we go to a slightly older age group, the cause can be long sitting hours, sitting jobs, lack of exercise, and wrong posture. Now in the elderly or old age, it can be because of weak bones (osteoporosis), the muscle power is less, and then, later on, there can be spondylosis and other age-related problems. 

Back Pain(कमर दर्द) in young people

The topic I will be discussing with you all today is backache in young people. And what causes it, how we can prevent it, and when to see a doctor. The common complaint that the patients come to us is that they tried to lift something or bent over and felt an acute spasm in their back. And sometimes, this pain moves lower towards the legs as well. 

Is your leg ache a sign of a slip disc? 

If it is only back pain, it is not that big of a problem. But if the pain is going to the legs, it should not be taken lightly. A muscle sprain or a back sprain always starts with simple back pain. And then, after 1-2 weeks, the pain moves towards the legs. The third stage is when the legs start feeling numb, and there is a tingling sensation in the legs, which we call paresthesia. And after that, there is a stage where the legs fail to work or other conditions like bladder and bowel. 

We will discuss a very common condition called slip disc. Back pain is a very layman term for slip disc. Keep in mind, not every slip disc causes back pain and not every back pain is a slip disc. 

What is Slip disc?(स्लिप क्या है?)

This is a model of our vertebrate column. And these are the vertebrate bones. Between every two vertebrae, there is an intravertebral disc. Inside this goes the spinal cord and at every end comes out nerves that go to our legs. 

Back Pain Causes(कमर दर्द का कारण)

Sudden movements, like bending or picking up heavy weight, as the youngsters who go to the gym do. This is a point to note that this happens in very extreme people, those who do not exercise, who are overweight or against working out, and those who do intense workouts like lifting very heavy weights. In both cases, the person may suffer from a slip disc. 

In the start, you see this jelly-like thing comes out like the paste from the toothpaste tube. And this jelly touches the nerves. When the tear is significantly less, then it only causes back pain. This back pain can be very severe. When the material from the inside leaks out, this starts to compress the nerve, which causes the pain to move from the back to the legs. 

Back Pain Symptoms(कमर दर्द के  लक्षण)

The first question I ask my patients is if the pain is moving in the legs or not. When the legs are paining then it is definitely because of the slip disc, which is the second stage. The third stage is the numbness and the tingling sensation in the legs due to the pressure on the nerves. And if this is not controlled, it can cause weakness in the legs. 

Back Pain Diagnosis 

The first thing we ask the patient is whether the pain is going down the leg. If yes then, we ask the patient to get an X-ray. But from an X-ray, we only see the posture in the young person and not the nerves or the disc. We do not get a lot of information, in young people. If the pain is going down the leg, then there is only one investigation for this and that is MRI. so this problem with the disc is mostly diagnosed only by an MRI. 

Back Pain Treatment (कमर दर्द का इलाज) 

95% of disc patients do not need any major treatment. They need rest for 5-7 days and then physiotherapy and some mild anti-inflammatory. In the 5% of cases that we see any abnormality in the MRI, like pressure on the nerves, is too much, we talk about surgery, which is very safe. 

It is a very safe and minimally invasive surgery. The next day the patient goes home walking. And there are no complications, no blood, and no pain. There is also a small category of patients that do not respond to medications or physiotherapy. These patients can be helped with an injection called an epidural injection to block the nerve. 

So there are three main Treatments

Conservative 

This is nonoperative. In this, we prescribe medication and the initial period of bed rest. 

I would like to tell you that the thought process from before was if someone has slip disc, they should lie down. But this is a very obsolete concept. People who exercise recover much faster than people who do not. So the concept of bed rest is very obsolete. Bed rest is required only for the first 5-7 days if the pain is too much. After that, the physiotherapy should be started; 80-90% of the patients get better only with the help of physiotherapy. Physiotherapy is back strengthening exercises and of course, overall exercises. 

The right posture plays a very important role. As you see, I am sitting on a chair right now. Whenever you sit on a chair, try to sit very erect. Either you sit on the edge of the seat or sit at the back like this to erect your posture. Try to have a raised stool under your feet to elevate your legs. If you have a long sitting job, this is the best posture to sit. Legs a little elevated, back supported, and try to sit erect. 

If you keep your posture correct and exercise regularly, back strengthening exercises is a special regime that you must learn from your physiotherapist. So you can get rid of 95% of your back pain and avoid disc problems. 

And if your problems escalate, and in the MRI it suggests that you should get surgery, then I would suggest you go to a specialist who is trained in spine problems. Suppose the MRI shows that your disc is not normal and the doctor suggests surgery. Then you should go for the surgery. It is very safe. If done in good time, you will have 100% recovery. There are no long-term complications. 

A good healthy diet, regular exercise, and weight reduction will always remain a very important part of the treatment in every age group. In older adults, I suggest they take calcium and vitamin supplements and control or maintain their weight. 

Prolonged standing and prolonged sitting in one place should be avoided. Walking is good, exercise is good. However, sitting in one place, especially working from home, can cause back issues. 

Stay healthy, stay safe. And visit your doctor whenever you have prolonged back problems.