What Causes Back Pain?
Q: Dr. Nene, tell us about back pain. What does it encompass?
The world is made up of three kinds of people: those who are having back pain, those who've had back pain, and the rest who will have back pain.
Back pain is one of the top three reasons to consult a doctor worldwide. That's quite telling. It shows us how common it is.
There is often a misconception that back pain is for the rich, or for the urban, but we've done a study where tribal Indians also voted back pain as their biggest problem after infant mortality and malnutrition. Back pain is a huge problem across communities, and across profiles of people.
As a back surgeon, I define two categories of pain. The first comes from the physical structure. The pain comes from bones, joints, muscles, and ligaments. It is physical and mechanical in nature. It is not always urgent, but it is a nuisance.
The second category of pain comes from the neural system, the nervous system. It is more urgent, and so a person often needs to seek medical help.
Posture
Q: What are the implications of having bad posture?
Take sitting as an activity. Most people are either leaning toward a computer monitor, looking at their mobile, snoozing at the table, or slouching. You might feel that you're chilling in your chair, but you're actually loading your back. Most of us load our backs over days, months, and years on end, without really servicing them. We use our backs for up to eighteen hours a day, and mostly we abuse them.
There's almost nothing that you do functionally where your back remains straight. That's where posture comes in. If you load your back in a way that it was not designed to take loads, it's gonna wear out faster. Posture is a neutral state in which your body takes loads.
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