From lavanguardia.com
Between 60 and 80% of the population experiences back pain at some point in their life
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. Each year, nearly 15 percent of the population visits a medical consultation for this issue. Most people who suffer from back pain usually locate it in the lumbar area, although there are also patients who seek consultations for cervical and dorsal pain. Lumbar pain is the leading 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 buttock, and is usually caused by alterations in ligaments, muscles, vertebral discs, or vertebrae in that area of the back.
Low back pain can involve different types of injuries, so it is essential to correctly diagnose them before applying treatment
When lower back pain is caused by a disease or a 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 nonspecific low back pain, with 90 percent of cases related to this type of low back pain. If the pain that causes 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 considered sub-acute; and if it persists for more than 12 weeks, it is termed chronic. The World Health Organization (WHO) estimates that by the year 2050, chronic low back pain could affect more than 800 million cases, making it one of the leading causes of disability worldwide.
The WHO believes that by the year 2050, chronic low back pain could affect 800 million people worldwide
Low back pain is not the only pain that affects the back. When that 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 starts in the lumbar region and runs down from the buttocks to each leg. It controls the muscles in the back of the knee, the lower leg area, and provides sensitivity to the back of the thigh, the lower leg region, and the sole of the foot. “Sciatica usually occurs when a herniated disc or excessive bone growth (arthritis) puts pressure on the nerve roots of the spine. This travels up from the sciatic nerve causing pain, inflammation, and often some numbness in the affected leg,” explains Dr. Juan Antonio Aguilera, clinical head of the Spine Unit at Quironsalud Badalona Hospital. “Most people fully recover from sciatica caused by herniated discs with medical treatment, however, sciatica can damage the nerves,” adds the doctor.
Doctor Juan Antonio Aguilera, healthcare coordinator of the Spine Unit at Quironsalud Badalona Hospital
The treatment of low back pain and sciatica focuses mainly on reducing pain and inflammation, so the specialist will start by prescribing analgesics or nonsteroidal anti-inflammatory drugs. In the case of low back pain, the treatment also depends on the cause of the pain. Once the pain is controlled, physical therapy is recommended to strengthen the abdominal, lumbar, gluteal muscles, and the muscles of the spine. Physical therapy also corrects postural problems, improves range of motion, allowing the patient to resume physical activity and exercise. In severe cases, “myofascial or articular injections, 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 as a steroid injection in the epidural space of the spinal column to reduce inflammation and pain,“ emphasizes Dr. Miriam Puyo, healthcare manager of the Pain Unit at Quirónsalud Badalona Hospital. Additionally, ”high-frequency electrical currents can also be used to control the transmission of pain through the affected nerves at the disc level, the ganglion, or the vertebral joints. This treatment can be an effective option for patients with chronic lower back pain who have not responded to other conservative treatments," Dr. Puyo continues.
If conservative treatments do not yield results, in the case of severe lower back pain, surgical treatment may be necessary
When conservative treatments do not yield the expected results in cases of severe low back pain causing structural damage, surgical treatment may be necessary. In the case of sciatica, “90 percent of patients with a herniated disc improve without surgery; only in cases of failed conservative treatment or the presence of neurological deficits should surgery be considered,” according to Dr. Aguilera. Surgery is only performed when sciatica causes severe weakness, loss of bowel or bladder control, or if the pain does not respond to other treatments. In these cases, the surgeon removes the bone spur or the part of the herniated disc that is putting pressure on the nerve.
Doctor Miriam Puyo, healthcare provider at the Pain Unit of Quirónsalud Badalona Hospital
To avoid the onset of lower back problems, it is important to maintain a series of preventive measures such as maintaining a healthy weight, as excess weight can cause increased pressure on the spine and joints; exercising to strengthen the lumbar area, for example, Pilates or yoga, which improve posture, increase flexibility, and reduce the risk of injuries. Additionally, for weight control, it is advisable to follow a healthy and balanced diet and engage in regular physical exercise.
