Lower back pain is one of the most common universal disorders. The pain is associated with reduction in quality of life, sometimes leading to major depressive illnesses. Treatment of low back pain is simple. You just need to understand the cause. More than 95% of the low back pain is related to the bad postures, being over-weight and the type of the working activities and age. There is a general concept that most of the back pain is associated with nerve entrapment, bony erosion etc and this will lead to serious complications in activities of daily living. It should be emphasized that degeneration is a natural process occurring in all living beings. Degeneration of back bone also causes nerve entrapment. But these changes should not be the reason to worry about. These changes will not cause paralysis or cancer or require surgical intervention in majority of cases. Majority of the back pain is not to be worried about. People get better with simple measures in due course of time and usually will never require surgery. After exhausting all these conservative measures if it is not improving then you might have to consider surgery. There are conditions when you need to worry about your back pain. There are red flag signs consisting of night pain (pain that wakes you up from your sleep), fever, weight loss, loss of appetite, weaknesses in the lower limbs and dysfunction in bowel, bladder and sexual activities. If you have these features then you must go through investigations and more aggressive treatment. There is also a general concept that spine surgery is posed with serious complications so we should never go for surgical treatment. This is a myth. We need to analyze risk/benefit ratio in surgery versus conservative treatment. There are specific indications when you must undergo surgery on time otherwise the condition may get worse. If appropriately indicated then the surgical treatment does have the best result as compared to non-surgical treatment. Finally, most of the low back pains are managed conservatively. You don’t have to refrain from your regular work, but if one could apply methods that make you comfortable while working, it will reassuringly help to get rid of pain. Surgery does have a role if indicated properly. Most of the joints and bone can be replaced today but not the spine.

Dr. Bijukachhe is a consultant orthopedic and spine surgeon