Pain in the back is a very common complaint in any age group! We often attribute this pain to a problem with the back muscles, or a ligament sprain or blame the back bone or the disc. Often we are treated with home remedies and grandmother’s concoctions and if the pain persists for days, then we go to the doctor.

Behind back pain

At the outset I must enlighten you that back pain can be either due to the back or due to problems in the organs which lie close to the back. Back pain may also be due to problems in the lungs in the pleura (tissue covering the lungs) in the heart or covering the heart (pericardium), windpipe or the food pipe. The back pain may be due to diseases in the abdomen, ulcers in the stomach, duodenum, pancreas, instestines, uterus, ovaries, bladder and the prostate in men. Any disease in these organs can present itself as back pain.

So, doctors classify back pain as:

  • Spondylogenic – due to problems in the vertebrae or ligaments and muscles attached to the vertebra.
  • Discogenic due to problems with the disc.
  • Viscerogenic diseases connected with organs that lie close to the vertebral column.
  • Vascular back ache due to diseases of the blood vessels, like aneurysms of the abdominal aorta.
  • Neurogenic – conditions affecting the nerves or spinal cord.
  • Psyhcogenic – problems connected with the mind.

Some common causes

Each one of the problems stated above may be due to the following conditions:

  • Congenital defect in the bone or various organs
  • Developmental disorders
  • Metabolic problems
  • Nutritional problems
  • Infections like Tuberculosis or pygenic infections
  • Parasitic infections like hydatid cysts, cysticercosis, brucellosis
  • Hormonal changes
  • Osteoporosis
  • Tumours – benign or malignant
  • Spinal injuries or abdominal viscera
  • Degeneration (wear and tear)

So if you have a backache that persists you have to seek the opinion of a knowledgeable doctor who can put his finger on the particular cause of the pain.

Is Surgery required??

In young people, it is often the disc (slipped disc) which causes a problem and this can give an annoying ache in the back, throughout life. When I was a Professor at the Medical College, I graded disc lesions depending upon the severity, so that doctors will have a guide as to what treatment they should advise the patient.

Grade I – rupture of the outer covering of the disc
Grade II – bulge without causing pressure on the nerves behind
Grade III – bulging of disc with pressure on the nerve roots causing numbness or weakness of the muscles
Grade IV – bladder paralysis
Grade V – chronic disc with instability of the vertebrae itself I advocated treating Grade I and Grade II with rest, painkillers, massage, lumbo sacral belt etc. Grade III, I advocated surgery.
Grade VI – treated as an emergency requiring immediate and urgent surgery. Grade V requires surgery – decompression and stabilization of the vertebrae.

I am glad that we have dedicated this Maruthuva Vivekam to spinal disorders and I hope readers will benefit from this volume.

Prof. Dr. P.V.A. Mohandas

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