This column is dedicated to all those who suffer from neck and low back pain.
Pain involving the spinal column is a topic vast enough to fill a book. The causes include muscular spasms and sprains, ligament injuries, fractures, tumors of the vertebrae or spinal cord and degenerative diseases of the spine. Since the last named is the major offender in cases of chronic back pain and neck pain, I will confine myself to this topic.
Degenerative diseases of the spine are commonly described to the patient according to the particular features that are present in that individual. It may be spondylosis orspondylitis or slipped disc or wear and tear of the spine. Usually a person goes to a doctor with neck pain or back pain. Some times the pain may be radiating to the hand or leg. He or she may have numbness or tingling(pins and needles sensations) over a part of the hand or leg, or weakness of the hand or leg(especially the big toe). Rarely, there may be difficulty in passing urine, or a feeling of incomplete evacuation(you feel as if some urine is left behind in the bladder, even though nothing more comes out) or impotence.
If the patient only has pain localised to the back or neck, a course of pain killers with local heat application will usually be curative. More important than medicines, however, is rest. Absolute bed rest for a week, where the patient does not get up from the bed* at all, * will be curative in nearly 80% of those with low back pain or neck pain. Once the pain subsides, the patient should start an exercise programme, tailored for that individual by a physiotherapist, to build up the muscles of the back or neck. This is extremely important for preventing a relapse. Lifestyle modifications are also essential to prevent a recurrence of pain, and include refraining from lifting heavy weights, maintaining a good posture at all times, using the correct technique to get up from a lying position or to pick an object from the ground, using a firm mattress with a small pillow etc.
If you are overweight and have a back problem, try to shed that excess flab! The importance of posture cannot be over-stressed. If you tend to slouch or stoop, STOP that now. If you have to travel long-distance or spend hours on a chair at your office, take a 5 minute break every 30-60 minutes, walk around and stretch your neck/back. Computer users should avoid stooping and staring at the screen continuously-look around for a minute every 5-10 minutes, so that you dont get a wry neck!
If the pain keeps recurring, and is associated with radiation to the limbs, or with weakness, numbness, tingling or urinary symptoms, you may merit an MRI scan of the relevant area. If there is a disc prolapse, with compression of the spinal cord or nerves, the symptoms are likely to be relieved by a surgery. However, be warned that some degree of back pain may persist after surgery (back pain is your friend for life; you had better learn to live with it). This surgery is fairly simple and straightforward, and can be done by any Neurosurgeon with experience in microsurgery. While many people still do disc surgery without a microscope, it is not as safe as using one. The use of a microscope also allows minimisation of the size of the incision and extent of bone removal.
Remember
Go for surgery only if bed rest has failed or if you have significant weakness, numbness or urinary symptoms.
Surgery will not give 100% relief
Ayurveda and alternative forms of medicine dont help if you have a slipped disc with neurological deficits(weakness, numbness and what not)
If surgery is indicated, dont dilly-dally; it may have disastrous consequences
You still have to do exercises, lose weight etc.