--​Dr Gaurav Raj Dhakal

 

Low back pain is considered to be chronic if it has been present for more than three months. The pain can arise from a disease or injury and can affect either the muscles of the back, the bone (vertebrae) or the spinal cord and the nerves. The pain may be dull aching, burning, stabbing, sharp or diffuse in character. It may be mild or severe in nature.

 

Evaluation of chronic low back by a spine surgeon is essential to rule out any disease process that could place you at risk if not treated appropriately. The spine surgeon will take a good history and also perform a thorough examination. Much of the disease process can be diagnosed from a good patient examination alone. Further investigations are done to support the diagnosis. Blood tests, X-ray, CT scan and MRI are important diagnostic tools in spine surgery. Specialized test such as Bone Mineral Density, Bone Scan and Nerve Conduction Studies are ordered as deemed necessary.

 

Sometimes, the exact cause of the pain may not be well defined. Yet, an evaluation is necessary to rule out those processes that could place you at risk if not treated!

 

Treatment can vary depending on the cause and the source of pain. If a treatable cause is found, then appropriate interventions are carried out. When the underlying cause is not found, then the symptoms are treated. The aim of treatment is to reduce the pain, improve quality of life and increase function.

 

Patient education and counseling, appropriate exercises, therapies and modalities are initiated. These are performed under the supervision of a trained physical therapist. Medication used for the treatment of pain are multiple and are customized for one’s need. Chronic pain directly affects one’s daily life. It has a direct bearing on your mood and the ability to interact with other people. Majority of patients with chronic pain suffer from an element of anxiety, depression, irritability and frustration. All of these symptoms and signs reflect on one’s work potential and decrease efficiency. 

 

Procedures ranging from injections to surgeries are used in indicated patients. However, all surgeries are associated with potential risks and benefits and it is important to discuss these with your spine surgeon. The most important aspect of managing chronic low back pain is ruling out the potential serious causes and taking timely treatment!

 

The author is a Spine Surgeon at Norvic International Hospital and can be reached at spinegaurav@gmail.com