'Back pain is not simply a part of growing older' The main causes of low back pain include weak muscles, age-related wear and tear, bad posture, desk jobs, lack of exercise, and stress. Fortunately, most cases of low back pain are not serious and can be managed. In an interview with HT Lifestyle, Dr Sumanth Madan, consultant rheumatology, KMC Hospital, Mangalore, said, "When patients walk into my clinic with low back pain, the first thing they often say is 'Doctor it's just old age'. However, that is a misconception. Back pain is not simply an inevitable part of growing older. It can affect teenagers, young people, and the elderly." Dr Sushanth B Mummigatti, consultant orthopaedic and trauma surgeon, Manipal Hospital, Goa, added, "We all have a notion that lower back pain is something that everyone has, and as we age, it would always become a burden, but this notion is now changing. As long as we understand our body better and have a scientific and logical approach to things, the outcome has been good." Dr Kasinath Swain, consultant, orthopaedics and spine surgery, Manipal Hospital, Bhubaneshwar, further explained, "Low backache is one of the leading causes of disability worldwide. It is usually an age-related degenerative process of the spine, but it can also result from an injury in younger populations due to heavy weightlifting or if they are not following proper ergonomics in their workplaces." Understanding the pain The good news is that most cases of low back pain are not dangerous, Dr Madan said. Low back pain is not a life sentence - with early care and simple lifestyle changes, most people regain mobility, avoid complications, and keep their spines strong for years to come, he added. "Most (low back pain cases) are 'mechanical', that is, arising from weak muscles and age-related wear and tear. As specialists, we look for inflammatory causes like ankylosing spondylitis, which often starts in young adults. These patients would greatly benefit from early treatment to prevent permanent stiffness," he said. According to Dr Mummigatti, back pain is most often caused by bad posture, a desk job, lack of exercise, weak core muscles, stress, and long hours of work. "If we correct these things by practising better posture, ergonomic workplace, meditation and yoga, physiotherapy with back strengthening exercises, mobility exercises, most back issues can be solved," he said. What to do about the pain? Dr Swain said, "People usually respond very well to non-surgical procedures, and surgery is the last resort. Physical therapy, such as core strengthening, stretching and flexibility exercises, along with meditation like yoga, is very helpful in alleviating pain." He added, "One should avoid refined sugars, stop smoking, and maintain a proper body mass index. There are several types of injection therapies like epidural steroid, selective nerve root block and nerve ablation, etc. For acute low back pain, non-steroidal anti-inflammatory drugs are beneficial. You should consult a spine surgeon when you observe the following red flag symptoms, such as weakness of limbs, bowel and bladder issues, unstable gait, and abnormal lower limb reflexes."