Back Pain: Q&A with Mr Rajiv Bajekal
Q: Why do I have back pain?
A lot of different conditions cause back pain and it can be difficult to say what the cause is. It is a very common problem like a cold. In general we think of back pain as being of serious causes if there are ‘red flag’ symptoms or signs. Your Doctor or Specialist will be able to decipher this from discussing your medical history and/or examining you. In general mechanical causes originate from the discs or joints of the back and usually respond to simple measures such as exercise and medication, with the passage of time. If issues persist then further investigations may be required.
Q: What is Sciatica?
Sciatica is pain going down the leg from the back, usually beyond the knee. The most common cause is a nerve under tension or pressure, often from a slipped disc in the back. It is often a condition that is very painful and limiting. In general nearly 80% of people will experience a reduction in pain after 6 weeks but if it is difficult to manage the pain, seeing a specialist for pain relief will offer further options, such as pain management injections.
Q: What is Stenosis?
Spinal stenosis is a condition where the nerves are trapped in the spine, usually as a result of wear and tear allowing new bones to grow inwards onto the nerves. It is a common diagnosis in people above the age of 60years and may cause symptoms such as pain down the legs when walking. In general this progresses slowly but pain relief could be achieved by exercise, injection or surgery if the pain becomes more severe.
Q: When should I worry about my back pain?
Most back pain is benign however if you are sleeping poorly, are awake through the night after waking up in pain, if you have weakness or numbness in the legs or bottom areas, if you feel unwell, have a temperature or have lost weight without intending to and if there is a history of you having suffered with cancer in the past – it is definitely worth seeking medical help.
If you find that pain killers have to be increased frequently by your doctor and despite this, pain is poorly controlled, there is cause for concern.
Q: What is Cauda Equina Syndrome?
This is a constellation of symptoms that should be taken very seriously but is fortunately very rare. In this condition a large slipped disc compresses the nerves going down to the legs and the organs such as the bladder and bowel. It typically presents with severe pain in the back and both legs, numbness in the back passage area, difficulty in passing water and sometimes incontinence of the bowel and urine.
This is a surgical emergency and it is advisable to attend the nearest hospital A&E department if this problem occurs. Delay in seeking medical attention could be catastrophic. In this condition, surgery is mandatory to get a good outcome.
Mr Rajiv Bajekal is a Consultant Orthopaedic Surgeon at Highgate Private Hospital specialising in lumbar spine problems, disc problems, spinal stenosis, sciatica and back pain. He also specialises in hip and knee replacement.