Dr Nikhil Juneja

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The spine is a complex interconnecting network of nerves, joints, muscles, tendons and ligaments which are capable of producing pain.
It could be consistent or intermittent. The sort of pain felt could be sharp pricking or burning type. The pain could radiate to the legs. Pain in the back anywhere below the ribs and up to the hips is called low back pain.
Why is it so common?
The lower back bears at least one half of the whole body weight. There are two curvatures in the spine i.e. the cervical and the dorsal spine. Both these curves are the weakest points in the spine. Hence they are under stress and strain. The most common cause of back pain is poor posture.
The pain is triggered by sudden lifting of weights, a sudden turn, a fall on the back, sitting in a wrong posture for a long time, horse-riding etc.

Classification of Back Pain

* Acute back pain:: The pain is usually sudden in onset, short lasting, often for few days or few weeks, usually occours in lower back.
* Subacute pain
* Chronic back pain:: Long lasting pain which persist for few months; deep, aching dull pain, which may extend to the leg.

Causes of backache

* Stress or strain to the spine.
* Herniated Discs (disc prolapse)
* Injuries and fractures of the vertebrae (backbone)
* Compression of the spinal cord itself (Spinal stenosis)
* Deformities like kyphosis or scoliosis
* Due to a certain kind of occupation
* Arthritis
* Degenrative bone condition
* Infection of the spine
* Ankylosing spondilitis
* Pancreatitis
* Kidney stone
* Pregnency
* Tumour
* Metastasis

Symptoms Associated with Back Pain

* Sharp pain in the neck and back after lifting heavy objects.
* Difficulty in walking or standing straight due to muscle spasm and stiffness.
* Pain aggravated by movement, prolonged overwork, sitting
* The pain may radiate especially to the buttocks, back of thigh, calf muscles.

Other symptoms sometimes associated with low back pain

* numbness and/or tingling of the lower extremities,
* incontinence of urine or stool
* inability to walk without worsening pain
* lower extremity weakness
* atrophy (decreased in size) of the lower extremity muscles
* rash, fever, chills,
* weight loss
* abdominal pains
* burning on urination
* joint pain

How is low back pain diagnosed?

* history of injury and associated symptoms (fever, numbness, tingling, incontinence, etc.)
* Physical examination - Includes posture, gait, movement, extension of the pain, modalities of the pain, and examination of the related joints like sacroiliac joint.
* Straight leg test
* complete blood count
* test for tumor markers where malignancies are suspected.
* Radiographic evaluationMagnetic Resonance Imaging and Computed Tomographic Scanning.
* Bone scanning
* Needle electromyography and nerve conduction studies
* Physical examination - Includes posture, gait, movement, extension of the pain, modalities of the pain, and examination of the related joints like sacroiliac joint.
* Bone density examination or densitometry to detect osteoporosis.
* X-ray spine to diagnose fracture and arthritic changes.
* CT scan, MRI of spine to detect any nerve compression. Urine culture – To diagnoses urinary track infection.

Homeopathic treatment of back pain

The selection of remedy is based upon the theory of individualization and symptoms similarity. The aim of homeopathy is not only to treat pain in back, but to address its underlying cause and individual susceptibility of the patient. Some important homeopathic remedies for the treatment of back pain o r lumbago are given below:
Brynoia alba. – When the pain is worse on every movement and better by absolute rest and pressure.
Rhus tox. – pain is relieved by walking and worse at rest or at first motion. There is marked stiffness and warm application gives relief. Rhus toxicodendron is an effective remedy. It is also helpful for lower back pain caused by damp weather.
Hypericum – remedy for nerve pain especially after injury.
Colocynthis- the pain in the back is so severe that makes patient unable to walk or stand which finally settles down on the upper part of the thigh and buttock. Bending forward often ameliorates.
Kali carb. – Lumbosacral backache, pain goes down the back to the legs. Pains, stitching, darting, worse during rest and lying on affected side. Backache after abortion, she must give up and lie down. It’s a remedy that relieves a person from the lower back pains that wakes them up during the night.
Nux vomica - Backache due to chill, which aggravate in the morning and better from heat. Especially suited to people working for long hours in an air-conditioned office and sitting in a chair for long periods. Irritability is often increased.
Arnica mont. – Acute pain after an injury along with sore bruised feeling. Slight touch aggravates.
Actea racemosa - Pain in the muscles with intense restlessness and sleeplessness.
Gnaphalium. – Sharp cutting pain in anterior cervical nerve, aggravation on lying down and relieved when sitting.
Aesculus hip. – Severe dull backache in lumbo-sacral region; affecting sacrum and hips. Back “gives out” during pregnancy, prolapsus, leucorrhoea; when walking or stooping; must sit or lie down. Sensation of heaviness and lameness in back. Paralytic feeling in arms, legs and spine. Its used by homeopathic practitioners to treat muscles weakness and dull pain in the lower back. Its usefully for patient who after rising from a sitting position feel worse. These people also tend to suffer from hemorrhoids and venous congestion.
Arnica Montana - When lower back pain is caused by trauma
Calcarea carbonica - Calcarea carbonica is used as a remedy for overweight and flabby people who have lower back pain and weakness. Calcarea carbonica also helps in chronic lower back pains, aggravated by dampness and cold.