Back pain ‘epidemic’ – will I need surgery?

Back pain ‘epidemic’ – will I need surgery?
Back pain ‘epidemic’ – will I need surgery?

The lower back is an intricate set of excellently engineered bones, cartilage, muscles, ligaments and nerves which provide us with the opportunity to conquer life and… be active. This complex structure is susceptible to injury which may lead to pain with this key to fulfilling life turning into something that can drag you down.

The lower back ensures the upper part of the body stays in place whilst allowing us to twist, turn and strive for our goals in every way possible. Nerves in this sequence allow us to feel and use our legs and hips.

Acute pains and aches can come from a spectrum of different structures. Some of these are ligaments, intervertebral discs and muscles. In response to such injuries the human organism reacts with inflammation which can lead to increase in severity of pain in the lower back.

As the lower back is a maze of nerves our brains may struggle to determine the exact origin of such a pain. A pull of a ‘minor’ muscle may have the same symptoms as a herniated disk. This is why consultation with a specialist is vital to direct and streamline care for the fastest recovery, especially when symptoms are not resolving on their own.

Of course, ligament or muscle related pain would be unlikely condition requiring surgery. Appropriate pain management and early rehabilitation can improve the person’s quality of life and help to return to a relative normality as fast as possible.

It is needless to say that every human being is different. We are not clones and there is much variety between each and every one of us. Some people may feel barely any pain when they have a pulled muscle and see it as a mere annoyance. Some may feel trapped in their own body being unable to move because of the intensity of pain - same condition but different grade of symptoms.

Most common types of back related pain is mechanical and/or radicular.

Mechanical pain is the one that occurs most often. It usually increases once more pressure is applied through one’s spine - when moving or when doing more strenuous activity. Usually it is concentrated in the lower parts of the back, buttocks and/or top of legs. Most commonly NO surgery is needed to manage this type of problem even though it may feel like one’s back is falling apart! Once again early review by a specialist may help alleviate anxiety and, importantly, streamline individual care towards a speedy recovery.

‘Radicular’ or nerve related pain happens when the nerve root in the lower spine becomes trapped and inflamed. The person may experience burning and tingling sensations down the leg – often referred to as ‘sciatica’. The pain may arise in the spinal location and travel to the part of the limb innervated by this particular nerve – most commonly well below the knee. The good news is that even this problem often settles without surgery with only small proportion of patients ending up in an operating theatre. Some ‘more robust’ forms of pain management, like spinal injections or epidural blocks, may be considered to speed up rehabilitation.

Problems with bladder or bowels control associated with sciatica may be a reason for an emergency surgery. Weakness of the leg accompanying pain is often another reason to consider a speedy intervention.

University of Leeds British Orthopaedic Association Royal College of Surgeons Swansea University NHS Royal College of Surgeons of Edinburgh