Dr. Murali Mohan S, Senior Consultant & HOD, Neurosurgery, SAGAR HOSPITALS. http://www.drmuralimohan.com

Back problems have increased in great proportions among the general population across the globe. It has not spared any community or race. The lifetime incidence is as high as 80%, which is the percentage of individuals, who would suffer from back pain sometime in their life. Low back pain is one of most common disorder that has been cited as a reason for absence from work, according to most statistical studies. Since they involve the working population to a large extent, they are associated with economic burden not just secondary to medical expenses, but largely from absence at work and hence, the reduced productivity.

Standing is a simple act, we often fail to realize its importance. We humans have been bestowed upon with this unique gift from nature.  We are the only species designed to walk on two feet. This feat has been achieved due to the ‘curvature’ that are exclusive to our Spine. World Spine Day – 16^th October, celebrated for the 5^th time since 2012, should serve as a reminder to all of us to realize our Nature’s gift, which we fail to nurture appropriately.

Why is the back pain such a burden to mankind? What are the reasons? It is necessary to answer these questions so that remedial measures could be adopted before it is too late. 

The current situation of back pain issue is alarming and is short of becoming an epidemic. The reasons can be largely attributed to the life style changes that we are witnessing in our Time. As Humans, we were designed to be active – physically. The current century has provided comforts of communication and transport, which has taken away the majority of the physical activity component from our day to day life to a significant extent and at the same time has also increased our mental pressures and tension!

Our spine, the backbone of the body is the pillar that supports the body weight. Apart from providing stability, unlike the pillars of civil construction, our spine also has the function of flexibility! In addition, it provides structural protection to the spinal cord and nerves that courses within it. The Spine is not a single long bone, rather it is composed of multiple small and stout bones – the vertebra, which are linked to each other through discs, the shock absorbers. The ligaments and muscles that surround and attach to the spine serves as the concrete of our pillar and provides the strength.

The natural curvatures of our spine are maintained by the muscle strength in the neck and the back. Lack of activity can lead to reduced tone in spinal muscles which would consequently alter these very important curvatures. This would accelerate the aging or the degenerative process, commonly referred to as spondylosis.

The world today recognizes the importance of Yoga and flexibility, but what we need to understand is that the flexibility in question here is that of the flexibility of SPINE. The ability to bend down and reach the toes or a reverse stretch – are decided by this very flexibility.

How not to abuse our Spine?

• Eat healthy. We can’t survive on junk and fast food. We need nourishment to maintain good strength in our bones and muscles.
• Regular Exercise & physical activity. Walking for 30 to 45 minutes a day is recommended. This physical activity has to be in addition to the regular work, a person does. Brisk walking is better than jogging / sprinting.
• Avoid Obesity. The height of an individual would decide the body weight that can be supported. Obesity increases the load and burdens the spine. This would quicken the degenerative process in the spine.
• Concentrate on Posture! (a) Sitting: We need to use the full seat of the chair, such that the back is supported. While sitting, it is important to maintain all the curvatures of the spine. The foot has to be supported. The knee should be at the same level or below the hip level. It should not be reverse!(b) Standing: While standing, the feet should be shoulder width apart. Knees locked and all the curvatures of the spine should be maintained. The shoulders should not be shrugged in. The shoulder droop would again directly affect the spinal curvatures.(c) While at work, make yourself comfortable and adopt postures that would cause least strain to your spine. Prolonged bending postures would result in damages to spine. 
• Tobacco, either smoking or chewing would prevent and prolong the healing process  in the degenerated discs and bones. It is prudent to quit smoking. Smoking is not just harmful to your heart and brain, but also significantly weakens your spine.

When to seek medical attention?

Spinal problems and back pain are common. Few questions that often arise are when is the time that is critical enough and important to escalate to seek medical attention. The second question is, whom to consult. The society has mixed views about spinal health and treatment. As a Spine surgeon, my advices are as follows:

• Pain that is severe enough to restrict the daily activities of a person should serve as an alarm to seek medical attention.
  • Localized pain in the neck / back
  • Shooting pain from the neck to hand / from the low back down to the legs (Sciatica).
• Numbness and tingling sensation, or Loss of sensation in limbs / hands /foot. These symptoms can have varied reasons, but they are important enough to seek attention. They can be the earliest symptoms of spinal disorders.
• Often elderly people are faced with unique problem. They can walk uphill, but cannot walk down. They can cycle for long distances, but just cannot walk few meters otherwise! A few also experience pain, abnormal sensations and or weakness in the feet after walking a short distance, but are perfectly normal at rest. These need attention as they can be suffering from spinal canal stenosis.
• Emergency Situations – the red flags!:
  • (a) Obvious weakness / paralysis.
  • (b) Loss of bladder control – Inability to feel the bladder fullness or difficulty to empty the bladder.

Whom to consult is a difficult question to be answered as a lot depends upon the availability of a specialist in various geographic regions. It is ideal to consult a spine surgeon or a neurosurgeon. Definitely, quack’s and traditional bone setters are not the people to be treating spine, as Spine is not just a bone!

‘Your Back in Action’, the theme of World Spine Day, October 16, 2017, should serve as an eye-opener to all.  Get ‘back’ into action, maintain spinal health and nurture it, The Nature’s unique gift to us, Humans!