Back Pain

Understanding the Back

Your back is a strong but flexible structure made to support your body and allow movement. It is made up of: Bones (Vertebrae), Discs: Soft, jelly-like cushions between the bones. These discs act like shock absorbers. It also Ligaments and Muscles to support the discs.

What Causes Back Pain?

The hard-outer part of the Disc gets damaged and the soft inner part of the disc leaks out (this is like removing the cap and squeezing toothpaste). This is called a slipped or herniated disc and this presses on nearby nerves. This can cause pain to travel down the leg, a symptom called sciatica.

What Causes damage to discs?

Natural aging, extra body weight, weak core muscles, poor posture (sitting, standing, sleeping, lifting objects in a wrong posture), doing exercises with wrong techniques – all these put pressure on the discs and cause damage.

How Back Pain Feels

Pain can be sharp or dull in back or buttock areas
It may be only in the back or spread to the buttocks, thighs, or legs.
You may feel stiffness, making bending or twisting difficult.
Sometimes there is tingling, numbness in the legs with no back pain

Managing Back Pain – Step by Step

Pain relief – by drugs as prescribed by doctor. However, remember tablets are only taken for pain relief. Certain drugs can be taken long term while others only short term, so always follow doctor’s prescription. If pain doesn’t settle, injections can be used – note injections are done to reduce pain.

Lumbar corsets (back supports):
Wear during walking, household work, or travel in the acute phase
Avoid long-term daily use, as this can weaken muscles

Long term measures to control the disease

Once the pain settles, it’s very important to do these to prevent back pain coming back.

1. Weight Control

If you are overweight, reducing weight can greatly reduce stress on the spine.
Weight loss should be achieved mainly through a healthy, balanced diet, not just exercise.
Even losing 5–10 kg of body weight can make a difference.

2. Correct Posture

When sitting: Keep your ear, shoulder, and hip in one straight line.
Computer work: Keep the monitor at eye level.
Avoid slouching, sitting in bed to work, or bending your neck forward for long periods.
Take a standing or walking break every 15 minutes.
When standing: Keep your weight evenly balanced and avoid leaning to one side.
While sleeping: Use a firm mattress and avoid very soft beds.

3. Activity Modifications

Avoid bending and twisting the spine — especially when lifting.
Avoid lifting more than 5 kg; if something heavy must be lifted, ask for help.
Avoid low chairs and sitting for long periods without a break.
During pain episodes, avoid high-impact activities such as running, jumping, twisting sports, or exercises like sit-ups and crunches.

4. Household Care

For cleaning, use a mop with a long handle instead of bending.
Keep objects at waist height when working to avoid bending or reaching overhead too much.

Exercise & Strengthening

Begin gentle movement as soon as pain allows; complete rest for long periods slows recovery.
Follow a muscle strengthening program for your core and back muscles:
Provided by your physiotherapist
Or follow our video exercise guide
Exercises should be low impact – walking, swimming, or stationary cycling can be good options.
Avoid sudden, jerky, or twisting movements during recovery.

When is Surgery Needed?

Surgery is rare and only considered if:

Pain is severe and not improving despite several months of treatment
There is a large disc pressing on nerves causing weakness or loss of function

When to Seek Urgent Medical Help

See your doctor immediately if:

Pain spreads down both legs
Weakness or numbness in legs
Loss of control over bladder or bowel
Fever, chills, or unexplained weight loss

Summary

Most back pain improves with:

Correct posture
Avoiding activities that strain the back
Maintaining a healthy weight
Strengthening back and core muscles

With the right steps, many patients can avoid surgery and keep their back strong and pain-free.

Rheumatology