When should we consult a specialist for backache?
Backache is a common ailment which affects adults of all age group and it is the most common ailment responsible for loss of man hour from the office. Usually we don’t pay much attention to the pain unless it becomes severe or debilitating. Usual approach to treat the backache is over the counter analgesics and analgesic gel application. Most of the times, it suffices. Little attention is paid to the posture and life style, which in most of the cases is the cause of the pain.
A specialist consultation must be sought if u suffer from any of the following conditions:
- Chronic Backache: Any pain lasting long enough to affect your quality of life.Recurrent Backache: If one is having frequent recurrent attacks of backache.
- Severe Pain: If the pain is so severe that oral analgesics are not helping you.
- Pain Radiating to Legs: Any pain which is going in the lower limbs( thighs or legs) on one side or both sides.
- Pain Associated with other Symptoms: Pain associated with tingling or numbness in the distribution of the nerves ( lower limbs).
- Pain Worsening with Activity: Pain which aggravates in activities like bending forwards, coughing, sneezing, straining for stool etc ( due to increased intra spinal pressure.
- Pain along with Bladder or Bowel Symptoms: Backache associated with loss of bladder / bowel control is a neurosurgical emergency.Immediate help must be sought.
- Pain Associated with Weakness: Any weakness in lower limbsassociated with pain should raise alarm. Usually the weakness comes in foot and great toe (rarely in thighs and legs) where it becomes difficult to lift the foot or great toe up.
- Backache Associated with Minor Trauma: elderly patients are prone to having osteoporotic fractures in even minor trauma. Even in healthy adults, a minor trauma can cause fracture if the vertebra is diseased ( due to infection or malignancy).
- Backache which is Worst at Night : Certain cancers are prone to spread to spine. Eg: Carcinoma of breast and Prostate being most common, and the backache in these patients are typically worst at night.
- Backache Associated with Loss of Weight or Appetite: Tuberculosis spine is a common disease in India and in most of the cases present simply with backache.
On consultation, your specialist would take your history and examine you to define the origin and cause of the backache. The most common investigation ordered is X ray of the spine. If the specialist is suspecting a disc prolapse or any other pathology then he/she might ask for an MRI of the spine (usually a non contrast MRI suffices but if any suspicion of infection or malignancy is there then contrast MRI would be required).
Questions for your Neurosurgeon
- What is the cause of my backache?
- Is it related to my lifestyle?
- What is the recommended treatment?
- How long would it take to be treated?
- How serious is the condition?
- Would physiotherapy help?
- What precautions do I need to take?
- Would it need any intervention like surgery?
- If surgery is required then what type of surgery?
- What would be the recovery time after surgery?
- Would I be able to return to normal activities after surgery?
- What are the risks?
- What are the chances of recurrence of symptoms?
- What are the lifestyle changes I need to do to avoid recurrence?
