"You are only as young as your spine is flexible"
Martha Graham
Low Back Pain
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What is causing my Back Pain?
Low back pain is a very common problem. In fact, up to 80% of the population experience lower back pain at some stage of life. The majority of lower back symptoms may be due to simple causes This is known as mechanical lower back pain.
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In general, it is expected that mechanical lower back pain will resolve within a few days or weeks with appropriate treatment. The source of your pain may arise from one (or more) of the following sources: muscles, joints, discs, ligaments or bony vertebrae of the spine.
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Although all the simple measures must be tried first. This is usually managed under guidance of your doctor and physiotherapist. The main initial steps normally include: painkillers, exercises, stopping smoking and weight loss. In a small number of people who experience lower back pain, symptoms may fail to respond to the simple measures. This group may benefit from further referral to spine specialist for investigation and treatment.
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Can my Back Pain be serious?
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Very occasionally, back pain can be related to serious underlying problem. This may include infection, tumours or fractures. Anyone with any of these problems may experience features of what is known as “non mechanical back pain”. The so called, ‘Red Flag Signs’ are used to help identify people who may have one of these causes for their back pain. These RED Flag Signs include:
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- Pain in the middle (thoracic) or upper (cervical) spine.
- Progressive lower (lumbar) spinal pain.
- Severe lower spinal pain, not improving with using painkillers.
- Spinal pain while you are at rest.
- Localized spinal tenderness.
- Night time pain preventing you to sleep.
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Cauda Equina Syndrome
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This is a 'Spinal Emergency'. It occurs when the nerves below the spinal cord are compressed. These nerves supply the
bladder and bowels also supply sensation to the skin around the bottom and back passage.
The syndrome is a complex spectrum of symptom and signs. The diagnosis is confirmed with MRI scan
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If you have numbness around the anus or back passage and any alteration of control of bladder function or
bowel function you should be assessed urgently by some one of suitable training and experience to reassure
you or to arrange suitable urgent tests such as an MRI scan.
Many patients delay in presentation to health care professionals as they do not recognise the significance of their symptoms. Further delay in obtaining specialist spinal care can result in devastating disability which can lead to medical negligence litigation.
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Timely referral after thorough assessment may result in better outcomes for patients.
The literature currently suggests the outcome of surgical decompression is better if decompression occurs within 48 hours of the onset of symptoms.
Most surgeons would prefer to carry out surgery as soon as it is safe to do so , if surgery is required.
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This condition requires emergency referral to the secondary care specialist that can confirm the diagnosis and treat the condition.
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Neck Pain
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Your neck (cervical spine) is made up of vertebrae extending from the skull. Cervical disks absorb shock between the bones. The bones, ligaments, and muscles of your neck support your head and allow for movement. Any inflammation, or injury can cause neck pain and stiffness.
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Many people experience pain or stiffness in the neck. In many cases, it is due to poor posture, normal wear, or overuse. Sometimes, neck pain is caused by injury from a fall, contact sports, or road traffic accident.
Most of the time, neck pain is not a serious condition and can be relieved within a few days or weeks. In rare cases, neck pain can indicate serious injury or illness and require a specialist doctor’s care. If neck pain continues more than a week, or is accompanied by other symptoms, ask your doctor for advice immediately.
Spinal Deformity and Scoliosis
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Scoliosis is a curved spine. It may affect children and teenagers. Scoliosis often does not have any noticeable symptoms. The curve of the spine does not cause pain, and if it is mild, it can be unnoticed.
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While a healthy spine, when viewed from the side, has natural curvatures, when viewed from the back the spine appears as a straight column. Any person with scoliosis, however, will appear to have a curve in their spine when viewed from the back.
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Does my child have scoliosis?
Without an X-ray of the spine, there are several common physical symptoms that may indicate scoliosis.
The medical professional will observes for one or more of the following signs of scoliosis:
. One shoulder is higher than the other
. One shoulder blade sticks out more than the other
. One side of the rib cage appears higher than the other
. One hip appears higher or more prominent than the other
. The waist appears uneven
. The body tilts to one side
. One leg may appear shorter than the other
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Any type of back pain is not usually considered a scoliosis symptom.
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