Lower Back Pain Doctor in Mumbai
Lower back pain is an incredibly common ailment that affects people of all ages and walks of life. At least 75-80% people suffer from significant back pain requiring some sort of treatment in their lifetime. Low back pain or Lumbago is not a disease. It is a symptom of various disorders of vertebral bones, back muscles, spinal disc, spinal ligaments, spinal cord or occasionally, abdominal organs. Lower back pain can also get referred to hip area. Whether it’s a persistent discomfort or a sudden twinge, understanding the causes, preventive measures, and effective treatments for lower back pain is crucial. In this comprehensive guide, we will explore the intricacies of lower back pain, offering insights into its various causes, risk factors, preventive strategies, and a range of treatment options to help you regain control over your spinal health
Understanding Lower Back Pain:
he lower back, also known as the lumbar region, is a critical part of the spine that plays a significant role in supporting the upper body and facilitating various movements. Understanding the anatomy of the lower back is essential for comprehending the causes of pain and developing effective treatment strategies. Here’s an overview of the key components of the lower back anatomy:
- The lumbar spine consists of five vertebrae, typically labeled L1 to L5.
- These vertebrae are the largest and strongest in the spine, as they bear the majority of the body’s weight.
- The vertebrae are separated by intervertebral discs, which act as shock absorbers and provide flexibility to the spine.
2. Intervertebral Discs:
- Situated between each pair of vertebrae, intervertebral discs are fibrocartilaginous structures composed of a tough outer layer (annulus fibrosus) and a gel-like inner core (nucleus pulposus).
- Discs function to absorb shocks, distribute pressure evenly, and allow for spinal movement.
3. Spinal Cord and Nerves:
- The spinal cord runs through the vertebral canal, formed by the stacked vertebrae of the spine.
- Nerve roots extend from the spinal cord and exit the spine through small openings on each side, forming the peripheral nervous system.
- These nerves control various functions and transmit sensory and motor signals between the brain and the rest of the body.
4. Facet Joints:
- Facet joints, also known as zygapophyseal joints, are paired joints on the back of each vertebra.
- These joints allow for smooth movement and provide stability to the spine.
- Ligaments are strong, fibrous tissues that connect bones to bones, providing stability to the spine.
- In the lower back, the ligaments include the anterior and posterior longitudinal ligaments, ligamentum flavum, and interspinous ligaments.
- The lower back is surrounded by a complex network of muscles, including the erector spinae, quadratus lumborum, and various abdominal muscles.
- These muscles work together to support the spine, control movement, and maintain posture.
7. Blood Vessels:
- Blood vessels, including arteries and veins, supply oxygen and nutrients to the lower back structures.
- Adequate blood circulation is crucial for the health and function of the lower back.
8. Sacrum and Coccyx:
- The sacrum, a triangular bone at the base of the spine, connects the spine to the pelvic bones.
- The coccyx, commonly known as the tailbone, is a small, fused bone at the very bottom of the spine.
Understanding the intricate interplay of these anatomical structures in the lower back is essential for healthcare professionals when diagnosing and treating conditions that may cause pain or discomfort in this region. Additionally, individuals can benefit from this knowledge to make informed decisions about their spinal health and engage in preventive measures to maintain a strong and resilient lower back.
Reason of back pain:
Lower back pain can be attributed to various factors, and its causes are often multifaceted. Here are some common contributors to lower back pain:
- Muscle Strain or Sprain:
- Overuse or improper use of the muscles and ligaments in the lower back can lead to strain or sprain, causing pain. This often occurs due to lifting heavy objects, sudden movements, or poor body mechanics.
- Herniated Disc:
- A herniated or slipped disc occurs when the soft inner material of an intervertebral disc leaks out, irritating nearby nerves. This condition can result in localized or radiating pain.
- Degenerative Disc Disease:
- Over time, the intervertebral discs can degenerate, losing their flexibility and shock-absorbing capabilities. This age-related condition can lead to chronic lower back pain.
- Spinal Stenosis:
- Spinal stenosis is a narrowing of the spinal canal, leading to compression of the spinal cord and nerves. This can cause pain, numbness, or weakness in the lower back and legs.
- Osteoarthritis is the degeneration of joint cartilage and the underlying bone. When it affects the lower back, it can result in pain and stiffness.
- This condition occurs when a vertebra slips forward over the vertebra below it. It can cause lower back pain and may result from a fracture or degenerative changes.
- Sciatica refers to pain that radiates along the path of the sciatic nerve, which runs from the lower back through the hips and down each leg. It is often caused by compression or irritation of the nerve roots.
- Muscle Imbalances:
- Weakness or imbalance in the muscles supporting the spine can lead to improper alignment and increased stress on the lower back, resulting in pain.
- Sacroiliac Joint Dysfunction:
- The sacroiliac joints, located at the base of the spine, can become dysfunctional, causing lower back pain. This may occur due to injury, pregnancy, or degenerative changes.
- Traumatic Injuries:
- Accidents, falls, or sports injuries can cause fractures, dislocations, or other traumatic injuries to the lower back, leading to acute pain.
- Lifestyle Factors:
- Sedentary lifestyles, poor posture, and obesity can contribute to lower back pain by putting additional stress on the spine.
- Psychosocial Factors:
- Stress, anxiety, and depression can contribute to the perception and exacerbation of lower back pain.
- Muscle spasm: Muscle spasm is most common cause of back pain. When there is a primary pathology in spine or nearby structures, muscles tighten to create an internal brace to support spine. Most of the time, acute pain of the primary pathology subsides with time; however, muscle spasm continues. This becomes a chronic source of pain.
- Patients with poor sitting posture, especially those who work in sitting position for long time are prone to muscle spasm.
- Spinal deformities cause uneven loading of muscles and may lead to back pain from overloading of one side of muscles.
- Heavy weight lifting or sports activities can cause muscle or ligament strain and pain the back.
- Abdominal pathologies: Various abdominal organs are located in the back side of abdomen (near spine), e.g. kidney, pancreas, uterus, ureter and urinary bladder etc. Any pathology involving these organs can lead to lower back pain.
It’s important to note that individual experiences of lower back pain can vary, and a combination of factors may contribute to the condition. Seeking medical evaluation is crucial for an accurate diagnosis and the development of an appropriate treatment plan tailored to the underlying causes of the pain.
Risk factor for lower back pain:
- Several risk factors and contributing elements can increase the likelihood of experiencing back pain. Understanding these factors is crucial for prevention and early intervention. Here are common risk factors and contributing elements for back pain:
- Aging often leads to wear and tear on the spine, including conditions such as degenerative disc disease and osteoarthritis, which can contribute to back pain.
- Occupational Factors:
- Jobs that involve heavy lifting, repetitive movements, or prolonged sitting can strain the back and increase the risk of pain. Poor ergonomics in the workplace can also contribute.
- Lack of Physical Activity:
- Sedentary lifestyles and a lack of regular exercise can weaken the muscles that support the spine, making the back more susceptible to pain and injury.
- Excess Body Weight:
- Obesity or being overweight places additional stress on the spine and can contribute to conditions such as herniated discs or osteoarthritis, leading to back pain.
- Poor Posture:
- Incorrect posture, whether during standing, sitting, or lifting, can strain the back muscles and lead to pain over time.
- Some individuals may be genetically predisposed to certain spine conditions, such as scoliosis or disc degeneration, which can contribute to back pain.
- Smoking is associated with a higher risk of developing back pain. It can restrict blood flow to the discs in the spine, impair healing, and contribute to disc degeneration.
- Psychosocial Factors:
- Stress, anxiety, and depression can contribute to the perception and exacerbation of back pain. Emotional factors may also influence pain tolerance and coping mechanisms.
- Pregnancy-related changes, such as weight gain, hormonal fluctuations, and changes in the center of gravity, can contribute to back pain in expectant mothers.
- Medical Conditions:
- Certain medical conditions, such as arthritis, scoliosis, and spinal stenosis, can increase the risk of back pain.
- Poor Lifting Techniques:
- Lifting heavy objects without proper body mechanics, such as bending at the waist instead of the knees, can strain the back muscles and lead to pain.
- Traumatic Injuries:
- Previous injuries or accidents, such as falls or car accidents, can increase the risk of developing chronic back pain.
- Inactivity and Weak Muscles:
- Weak core muscles and a lack of physical activity can lead to poor spinal support, making the back more susceptible to pain.
- Occupational Stress:
- High-stress jobs and demanding work environments can contribute to muscle tension and back pain.
Understanding these risk factors can empower individuals to make lifestyle modifications and adopt preventive measures to reduce the likelihood of developing back pain. Maintaining a healthy weight, staying physically active, practicing good posture, and addressing psychosocial factors are essential components of back pain prevention.
Treatment of back pain:
In majority of the patients, back pain is a self-limiting symptom. Following treatment can be taken at home for recent onset mild back-pain.
- Local application of heat/ cold
- Local application of analgesic gel
- Gentle massage can help
- Lumbar belt (if available) while sitting, standing, traveling
- Paracetamol or locally available pain killer
- Avoid heavy activities for few days
In 1-2 weeks, patients usually get significant relief. However, it is recommended to consult a doctor for back pain, orthopedic surgeon, spine specialist, neurosurgeon or physiotherapist in following situations:
- Back pain not subsiding with above treatment (significant pathology)
- Back pain associated with sciatica (spinal nerve pressure)
- Back pain with loss of sensation/ weakness in legs/ urinary problems (spinal cord damage)
- Back pain with fever (infection)
- History of fall (suspected fracture)
- History of cancer (could be spine metastasis)
Back pain specialist doctor will examine the patient and will decide if further course of medicine and physiotherapy should be tried or patient need further investigations. Usually following medical treatment is given:
- Powerful pain medicines to reduce pain
- Muscle relaxant to reduce muscle spasm
- Nerve medicines (Pregabalin, Gabapantene etc.) if there is associated nerve related symptoms
- A physiotherapy is usually added to reduce muscle spasm and strengthen back muscles
If patient does not recover in a reasonable period of time, further investigations are required. Usually following tests are done.
- X-ray: It’s a baseline study to detect any bone abnormality.
- MRI Scan: MRI will assess internal structures of spine (disc, nerve, joints, ligaments etc.)
- CT Scan: A CT is required if detailed bone assessment is required.
- EMG NCV: These tests will assess functioning of the nerves.
- Blood tests: Various blood tests to detect infection, tumors, osteoporosis etc. are required based on suspected pathology.
- Other tests: DEXA scan (Osteoporosis), abdominal ultrasound (abdominal pathology), x-ray of knee/ hip joints.
If a significant pathology is detected in investigation, further treatment with spinal injection or surgery (decompression with/ without fusion) might be required based on the severity of the symptoms and patient’s recovery with non-surgical treatment.
For back pain which doctor to see?
Patients are often confused about which doctor to visit for back pain. When grappling with back pain, the choice of the right healthcare professional becomes crucial. Various specialists can address back pain, and the decision hinges on personal comfort and the specific nature of the condition. A back pain specialist doctor can be –
- Spine Surgeon:
- Specializes in surgical interventions for spinal conditions.
- Consult if surgery is a potential consideration for your back pain.
- Orthopedic Surgeon:
- Deals with musculoskeletal issues, including spine-related problems.
- Appropriate for a broad spectrum of back pain cases.
- Focuses on surgical treatments for neurological conditions, including spine issues.
- Consult for complex cases involving neurological aspects.
- Non-surgical specialist dealing with neurological aspects of back pain.
- Suitable for cases requiring a comprehensive neurological assessment.
- Offers non-surgical, exercise-based treatments to improve mobility and alleviate pain.
- Ideal for rehabilitation and non-specific back pain.
- Focuses on spinal adjustments to address musculoskeletal pain.
- Suitable for those preferring non-traditional, manual approaches.
The key lies in finding a back pain doctor with whom you feel comfortable and can access prompt and consistent treatment. Consider the nature of your back pain, whether surgical intervention is a consideration, and your personal preferences. Ultimately, collaboration with a healthcare professional who aligns with your needs ensures a comprehensive and tailored approach to managing back pain.
If you are looking for a lower back pain doctor specialist near you in Mumbai, please feel free to contact us: