What you should know about low back pain

Many people suffer from low back pain at one time or the other. Experts say different things predispose people to low back pain. According to Dr Mamman Mohammed Lawal, a consultant Orthopaedic Surgeon, and a specialist in spine surgery, low back pain is any pain one experiences at the back all the way from the […]

Many people suffer from low back pain at one time or the other. Experts say different things predispose people to low back pain.

According to Dr Mamman Mohammed Lawal, a consultant Orthopaedic Surgeon, and a specialist in spine surgery, low back pain is any pain one experiences at the back all the way from the rib bone down to where the buttocks connect with the thighs.

He said over 80 percent of those present with low back pain actually have nonspecific back pain also called  mechanical back pain because it has no known  cause and comes and goes.

Dr Lawal said less than 20 percent of other cases of low back pain are specific back pain caused by cancer,  trauma (from accidents and injuries), and infections with tuberculosis of the spine being the commonest cause in our environment.

He said: “The commonest type of low back pain is mechanical back pain, and responsible for eight out of 10 low back pains. It is described as mechanical because it has no known cause, and may just be caused by mechanical strain or stress in your lower back.

“This is the type that most people experience. If you sit too long in your office, you are most likely going to have low back pain. If you lie down on mattresses that deforms or de-shape your back while you are sleeping, you are most likely going to have mechanical back pain. Also if you use vibrating instruments in your work, you are most likely going to have low back pain. Some literature also suggests that too much sexual activity could also cause low back pain, though it has not really been implicated in it.”

The senior surgeon with the National Orthopaedic Hospital, Dala, Kano, said the major symptom of low back pain is pain. “It is either a feeling of pain, a feeling of heaviness or a feeling of dragging or discomfort in the lower back including the buttocks depending on what causes it.

The patient could experience some pains down their lower limb or that goes down their legs. This could also be associated with parastisia where patient tells you that they feel some crawling sensations, or something is pricking them like pins and needles, or feel numbness, weakness to walk. If the lower back has affected the legs so much the patient can suffer from urinary incontinence, inability to hold or control urine.

He said in men, significant problem of the lower back can cause impotence, “because all the nerves that control the sphincters and erection revolve around the lower back. The person will not be able to achieve erection, lose sensation or suffer from Neurogenic claudication where the  patient needs to rest after taking a few steps or feel like they are about to fall .”

The physician said low back pain has a lot of causes and the symptoms vary with the kind of low back pain the person has.  “Some people may have pain with fever, some experience inability to walk or stand in the morning, while others may feel more pain when they lie down, and others suffer weight loss.

He said low back pain could be caused by infection of the bone at the lower back  called vertebral osteomyelitis and also  an infection of the disc called discitis – there is a bone in the lower back and a disc in-between which may be affected, that is why people sometimes say they had slip disc.

The medical expert said patients whose back pain aggravate when they lie down are having a hallmark of a destructive lesion in the spine meaning something is destroying the spine. He said this can be caused by tumors that may or may not be cancerous. The cancerous type can spread to other parts of the body aside the spine and cause more problems, he said.

The orthopaedic surgeon said some people present with low back pain that they could not walk and experience complete or partial paralysis. This can be due to trauma and may lead to loss of the use of the legs

Dr Lawal added that “people with cardiovascular problems can develop what we call Ischemia which can affect any vessel in the body including the vessel that supplies the cord in the lower back causing them to present with lower back pain with paralysis in their legs.”

He said the treatment of low back pain depends on the cause of the pain, adding that treatment for someone who suffers back pain from cancer is not the same with someone who has back pain from tuberculosis. “For instance, for tuberculosis you give the patient  tuberculosis drug, if the tuberculosis is cured the back pain will go away, but if the tuberculosis has not gone it means it has already done some damage and it has to probably be corrected  through surgery,” he explained.

“Somebody presents with slip disc that is causing paralysis and back pain you manage either using drugs or physiotherapy or if they have started developing some weakness, you have to go and operate it,” Dr Lawal said.

He advised people to see a spine surgeon if they have an onset of pain at the age of 50 that they have never experienced before, and likewise someone less than 20 who has not had low back pain before.

He advised people to also see a spine surgeon when:

-the low back pain is worse at night.

-the pain is worse when lying down (one is supposed to experience relief when lying down).

-You cannot control your urine or faeces and are having back pain.

– You are male and touch in-between your thighs, around your scrotum and cannot feel it, as if it is not part of your body.

– Experience weakness in your legs and you have back pain.

– You have back pain and are losing weight.

– You have fever and back pain.

– When you have never been treated for cancer before and are now experiencing back pain (such as women who have suffered from breast or ovarian cancer before).

Dr Lawal said low back pain is the price humans pay for standing erect, as animals that walk on their four legs don’t have low back pain. He said the effect of gravity pushing the head, stomach, chest down to the lower back continue to cause degenerative changes in the back.

He advised that people should therefore make effort to prevent back pain by controlling their weight, bending the right way to carry weight, knowing the right way to lie down and do exercises, among others.