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Devyani’s story
Devyani* is a 61-year-old first-generation American Indian who lives in Flint, Michigan. She has a sedentary desk job as a clinical social worker. For the past three months, she has been having severe low back pain in the lower part of her spine and hips that comes in bouts. It is aggravated after sitting for a long period of time and is dull, achy. She has difficulty falling asleep due to pain, but the pain gets better in the mornings after sleeping. She is worried and is wondering if she should consult a healthcare provider, and has, in the meantime, contacted us for guidance on dealing with this condition.
*Name changed upon request
D: What is the cause of this low back pain? How common is it?
Dr. S: Devyani, low back pain is a very common condition, especially in middle-aged and older people. According to the World Health Organization in 2020, 619 million people were affected by it. It is projected that this number will continue to grow and by 2050 will affect more than 843 million people due to aging and poor lifestyle choices. It is more common in women.
The causes can be specific, such as injuries causing muscle spasms or muscle strains or spinal fractures, problems with spinal disks, which are cushions between spinal joints, osteoarthritis or joint damage due to aging, and certain occupations like weightlifters, etc., and so on.
There are also non-specific causes that account for almost 90% of cases and are precipitated by factors such as aging, obesity, sedentary lifestyle, smoking, depression, and stress. Since your pain has persisted for over three months, it can be classified as subacute, and it would be a good idea to consult your primary care provider, who can refer you to a specialist or a physiotherapist.
D: What tests may be prescribed?
Dr. S: Devyani, typically after taking your history and physical exam, your physician may prescribe spine X-ray (to detect age-related changes and other abnormalities), blood tests (to rule out conditions like ankylosing spondylitis, a type of arthritis that affects joints of the spine and is associated with skin rashes and diarrhea), and urine test (to rule out kidney stones). Sometimes, a follow-up CT scan (that provides 3-D images on X-rays) and an MRI (that uses a magnet and radio waves to create pictures) may be ordered to get a clearer picture of the spine and surrounding areas.
D: What are the treatment options for low back pain?
Dr. S: Devyani, many cases of low back pain are self-limited and get better with time and lifestyle changes. Being active with sedentary people, like you, is quite helpful. Recently, I published an evidence-based news story on walking between 7,000 to 10,000 steps every day as a helpful way to remain active.
Regarding treatment, your healthcare provider can prescribe medications. Physical therapy is the cornerstone of treatment as it strengthens muscles. If you cannot attend regular in-person physical therapy sessions, there are virtual physical therapy services available these days. Several other medical options are available for more complicated cases. Please be sure to consult a physician before starting any treatment.
D: What are some ways to prevent it?
Dr. S: Yes, that is a great question. First, one must try to reduce weight if overweight or obese. Maintaining a healthy weight is essential to reducing the possibility of lower back pain. Then, if one is a smoker, they must quit smoking. Next, one should build core abdominal, back, and hip muscle strength through regular strength training. Next, one should exercise great care while lifting heavy objects by avoiding such lifts as far as possible and, if needed, following one’s body’s capabilities and lifting objects by keeping them close to the body. Finally, warming up the body before undertaking exercise is an important precaution.
D: Can yoga and meditation help?
Dr. S: Yoga is very helpful in dealing with low back pain. Yoga helps strengthen core muscles, improve flexibility, reduce tension, improve posture, and establish a healthy mind-body connection (which is an added benefit over simple physiotherapy). Some low-physical-impact postures (asanas) for low back pain in English terminology are the cat-cow pose, child’s pose, supine twists, standing forward bend, and others.
Meditation has also been found to be effective as an adjuvant therapy for dealing with low back pain. It is also helpful in reducing stress, which can aggravate low back pain, and in enhancing the mind-body connection.
D: Can you share some additional resources?
Dr. S: Here are some additional resources from which you can find more information:
- Cleveland Clinic’s website on lower back pain, including information on management and treatment.
- Harvard Health’s website on the safe way to do yoga for back pain.
- Mayo Clinic’s website on back pain.
- Stanford’s website on back pain with a video
- World Health Organization’s website on low back pain.
If you have questions, reach out to Dr. Manoj Sharma at editor@indiacurrents.com.