The first chronic health problem in Spain is back pain. Between 60 and 80 percent of the population will experience back pain at some point in their lives. Every year, almost 15 percent of the population goes to a doctor for this problem. Most people who suffer from back pain usually locate it in the lumbar area, although there are also patients who come to consultations for cervical and dorsal pain. Low back pain is the first cause of physical activity limitation, especially in adults under 45 years of age, and the main cause of work absenteeism.
Lumbago or low back pain is located in the lower back area between the last ribs and the gluteus and is usually caused by alterations in ligaments, muscles, vertebral discs or vertebrae found in that area of the back.
When low back pain is caused by a disease or some problem in the structure of the spine it is known as specific low back pain, however, when the pain cannot be identified with any of these causes it is called non-specific low back pain, 90 percent of cases are related to this type of low back pain. If the pain caused by low back pain lasts less than a month, it is called acute low back pain, if it lasts between one and three months, it is called sub-acute, and if it lasts more than 12 weeks, it is called chronic. The World Health Organization (WHO) considers that by 2050 chronic low back pain could reach more than 800 million cases, being one of the main causes of disability worldwide.
One of the main causes of disability
The WHO believes that by 2050 chronic low back pain could affect 800 million people worldwide.
Low back pain is not the only pain that affects the back. When this pain is accompanied by weakness, tingling and numbness, then it is sciatica, a problem that occurs when there is pressure or damage to the sciatic nerve. The sciatic nerve begins in the lumbar region and runs down from the buttocks to each of the legs. It controls the muscles at the back of the knee, lower leg, and provides sensation to the back of the thigh, lower leg, and sole of the foot. “Sciatica usually occurs when a herniated disc or excessive bone growth (osteoarthritis) puts pressure on the nerve roots of the spine. This occurs ascending from the sciatic nerve, causing pain, inflammation and, frequently, some numbness in the affected leg,” explains Dr. Juan Antonio Aguilera, care manager of the Spine Unit of the Quironsalud Hospital Badalona. “Most people recover completely from sciatica caused by herniated discs with medical treatment, however, sciatica can damage the nerves,” adds the doctor.
Doctor Juan Antonio Aguilera, care manager of the Spine Unit of the Quironsalud Badalona Hospital
The treatment of low back pain and sciatica focuses mainly on reducing pain and inflammation, so the specialist will begin by indicating analgesics or non-steroidal anti-inflammatory drugs. In the case of low back pain, treatment also depends on the cause of the pain. Once the pain is controlled, physical therapy is recommended to strengthen the abdominal, lumbar, gluteal and spinal muscles. Physical therapy also corrects postural problems, improves range of motion and thus, the patient can resume physical activity and exercise. In severe cases, “myofascial or joint infiltrations, that is, injecting the anti-inflammatory or analgesic medication directly into the affected area, provides short-term pain relief.
On the other hand, epidural infiltrations are applied like an injection of steroids in the epidural space of the spine to reduce inflammation and pain,” points out Dr. Miriam Puyo, care manager of the Pain Unit at the Quirónsalud Badalona Hospital. They can use “high-frequency electrical currents to control the transmission of pain through the affected nerves at the level of the disc, ganglion or vertebral joints. This treatment can be an effective option for patients with low back pain. chronic that have not responded to other conservative treatments” continues Dr. Puyo.
Different solutions
If conservative treatments do not work, in the case of severe low back pain, surgical treatment can be used.
When conservative treatments do not give the expected result, in case of severe low back pain, which causes structural damage, it can be resolved through surgical treatment. In cases of sciatica, “90 percent of patients who have a herniated disc improve without surgery; only in cases of failure of conservative treatment or in the presence of neurological deficit should surgery be performed,” says Dr. Aguilera. Surgery is only done when sciatica causes severe weakness, loss of bowel or bladder control, or if the pain does not go away with other treatments. In these cases, the surgeon removes the bone spur or the part of the herniated disc that puts pressure on the nerve.
Doctor Miriam Puyo, care manager of the Pain Unit of the Quirónsalud Badalona Hospital.
To avoid the appearance of low back pain problems, it is important to maintain a series of preventive measures such as maintaining a healthy weight, since excess weight can cause greater pressure on the spine and joints; Do exercises to strengthen the lower back, for example Pilates or yoga, which improve posture, increase flexibility, and reduce the risk of injury. Also, to control weight, it is advisable to eat a healthy and balanced diet and practice regular physical exercise.
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