Back Pain — Causes, Slipped Disc, Sciatica & Treatment
Quick Summary: Back pain affects 8 out of 10 adults at some point. Most cases get better with rest, physiotherapy and posture correction. Persistent, severe or radiating pain may signal a slipped disc, sciatica or other spine condition. Hope Hospital's orthopedic and spine team offers complete diagnosis and treatment from physiotherapy to minimally invasive spine surgery.
What is Back Pain?
Back pain is discomfort, ache, stiffness or sharp pain felt anywhere along the spine — neck, mid-back or lower back (most common). It can be sudden (acute, lasting under 6 weeks) or persistent (chronic, more than 12 weeks).
Most back pain is mechanical — caused by muscle strain, poor posture, weak core or lifting injury — and resolves with conservative treatment. A smaller proportion is due to structural problems like a herniated disc, sciatica, arthritis, or osteoporosis-related fracture.
Common Causes
1. Muscle and Ligament Strain
Caused by sudden heavy lifting, twisting awkwardly, or prolonged poor posture (e.g. desk work). The most common cause of acute lower back pain.
2. Herniated or Slipped Disc
The soft inner cushion (nucleus pulposus) of a spinal disc bulges out through a tear in the outer ring. It can press on nearby nerve roots, causing radiating pain, numbness or weakness in the leg.
3. Sciatica
Sharp burning pain that starts in the lower back or buttock and radiates down the back of one leg, often to the foot. Caused by compression of the sciatic nerve, usually from a slipped disc or piriformis muscle tightness.
4. Spinal Stenosis
Narrowing of the spinal canal that pinches the nerves. More common in older adults, causes back pain that worsens when standing or walking and improves when sitting forward.
5. Osteoarthritis of the Spine
Wear-and-tear arthritis affecting the facet joints between vertebrae. Causes chronic back pain and stiffness.
6. Osteoporotic Compression Fracture
Vertebral fracture from weakened bones — common in elderly women after menopause. Causes sudden severe back pain after a minor strain or fall.
7. Other Causes
- Spondylolisthesis (slipped vertebra)
- Ankylosing spondylitis (inflammatory spine disease)
- Kidney stones or kidney infection (referred pain)
- Spinal infections or tumors (rare but serious)
Symptoms
- Dull, aching pain in the lower back
- Sharp, shooting pain that may radiate to buttocks, legs or feet
- Muscle stiffness, especially in the morning
- Numbness, tingling or weakness in legs
- Pain that worsens with bending, lifting, sitting or standing for long
- Difficulty straightening up or walking
Red flag symptoms — seek urgent care: sudden bladder or bowel incontinence, saddle-area numbness, progressive leg weakness, fever with back pain, severe pain after fall, or unexplained weight loss. These can indicate cauda equina syndrome, infection or tumor.
Risk Factors
- Age 30–60 (most common age range)
- Sedentary lifestyle and weak core muscles
- Obesity and excess belly weight
- Heavy manual labor or improper lifting
- Smoking (reduces disc nutrition)
- Poor posture (desk work, smartphone use)
- Pregnancy
- Psychological stress and depression
Diagnosis
- Clinical examination: Range of motion, neurological exam, straight-leg raise test
- X-ray: Identifies bone problems, fractures, alignment
- MRI: Best test for soft tissue — discs, nerves, spinal cord
- CT scan: Detailed bone imaging when MRI not possible
- Blood tests: Rule out infection, inflammatory diseases
- Nerve studies (EMG/NCV): Assess nerve damage
Treatment Options
Conservative (First-line) Treatment
- Rest then gradual movement: Short rest, but prolonged bed rest delays recovery
- Pain medications: Paracetamol, NSAIDs (ibuprofen, naproxen)
- Muscle relaxants: For acute muscle spasm
- Hot/cold packs
- Physiotherapy: Core strengthening, posture correction, stretches
- Posture and ergonomics correction: Sitting, lifting, sleeping technique
- Lifestyle changes: Weight loss, smoking cessation, regular exercise
Interventional Procedures
- Epidural steroid injection: Reduces nerve root inflammation
- Facet joint injection for arthritis
- Nerve block for diagnostic and pain relief
Surgical Treatment
Reserved for severe, persistent pain or progressive neurological deficits:
- Microdiscectomy: Minimally invasive removal of the herniated disc fragment
- Laminectomy: Removing part of the vertebra to relieve nerve compression in spinal stenosis
- Spinal fusion: Joining vertebrae for instability
- Disc replacement: Artificial disc for select cases
- Minimally invasive spine surgery (MISS): Tiny incisions, faster recovery
Prevention
- Maintain a healthy weight
- Strengthen core muscles (planks, bridges, yoga)
- Practice good posture while sitting, standing and sleeping
- Lift correctly — bend the knees, keep the back straight, hold the load close
- Take short walking breaks every 30–60 minutes if you sit a lot
- Use ergonomic chairs and a supportive mattress
- Avoid smoking
- Stay active — walking, swimming, cycling
When to See a Doctor
Consult a doctor if:
- Pain lasts more than 4–6 weeks
- Pain is severe or worsening despite rest
- Pain radiates down one or both legs
- Numbness, tingling, or weakness in legs
- Bladder or bowel control changes
- Fever, chills, or unexplained weight loss
- Back pain after a fall or accident
Frequently Asked Questions
Expert Spine Care at Hope Hospital
Hope Hospital's orthopedic and spine team — led by Dr. B.K. Murali (MS Orthopedics, 19+ years, 5,000+ surgeries) — offers comprehensive back pain care: clinical diagnosis, MRI imaging, physiotherapy, epidural injections, microdiscectomy, laminectomy, and minimally invasive spine surgery. Treatment is covered under Ayushman Bharat, MJPJAY, CGHS and all major insurance schemes.
Call 071-22980073 / +91-9823555053 or visit the orthopedics department to book a consultation.