Back Pain 

Everyone experiences back pain at some point in their life. It can be acute (short-term) or chronic (long-term spread over several months). ​

There are numerous sources of pain in the back. ​Your backbone is composed of bones, joints, muscles, tendons and ligaments. Disturbance or pressure in any of these local structures can result in what is known as axial or mechanical back pain. 

When a nerve is bothered as it makes its way out of the spine, like we see in sciatica for example, it may cause radicular back pain. 

If the pain is transmitted from disorders unrelated to the back (such as that seen in pancreatitis, perforated peptic ulcer, kidney infection, ectopic pregnancy or herpes zoster) it is labelled as referred back pain. 

At times, a psychiatric illness can also present as back pain. ​

However, the most common type is mechanical pain which is prevalent in most members of the population. Prolonged poor posture while sitting or sleeping, muscle strain, spondylosis, compression fracture, spinal stenosis and pregnancy are often the underlying cause. ​

Many other diseases affecting the skeletal system can involve the backbone too; for example osteoporosis, osteomalacia, Paget's disease of bone, rheumatoid arthritis or osteomyelitis. Although tuberculosis is primarily a lung disease, it can spread to the spine, as can certain cancers that disperse to various parts of the body. Furthermore, an injury to the back may lead to any of the above types of pain.

Backache can come forth in multiple ways – It may occur suddenly or gradually; it may be mild or excruciating; it may be fixed at a specific point or travel to other body parts. Additional characteristics include:

  • Spasmic (contraction-like) pain usually in lower back

  • It might be more noticeable when bending down or lifting heavy objects​​

In the majority of cases, backaches improve after rest. But if the pain is intense and constant that you are bed-bound for more than two days, it is always best to come and meet the faculty of the Family Health Service Line or Musculoskeletal and Sports Medicine Service Line at The Aga Khan University Hospital. Additionally, be sure to get an appointment with a doctor if your back pain:

  • spreads down your leg(s).

  • Is enhanced at night.

  • Is accompanied by redness or swelling on the back.

  • occurs with unintended weight loss.

Some high risk scenarios call for urgent medical attention. Do not hesitate to contact the 24/7 Emergency and Acute Services at The Aga Khan University Hospital when your back pain is prominent:

  • after a sports injury or car crash.

  • following a recent fall.

  • gives rise to weakness, numbness or tingling in legs.

  • is accompanied with a fever.

  • is accompanied by loss of bowel or bladder control.

  • leads to loss of feeling in the ‘saddle’ region (inner thighs, back of legs and area around rectum).​​

Your time with your doctor maybe limited, so makes sure to prepare for your visit beforehand. Here are some tips to help get y​ou started.​

A discussion on the history of your symptoms and physical examination will contribute greatly towards pinpointing the most likely cause. Your physician may check your muscle and nerve function by asking you to perform certain movements in sitting and lying positions. Most of the time, mechanical back pain does not warrant any further testing, but if your doctor suspects other causes, the following investigations may be ordered:

  • Blood test - to determine any signs of infection

  • Urine test - to check the levels of body minerals

  • X-ray, Computerized Tomography (CT) scan or Magnetic Resonance Imaging (MRI) of the back, to help get images of the bone structure

  • Bone scan - to assess the probability of damage, infection or cancer

  • Electromyography – evaluates the muscle response to nervous stimulation ​

Mechanical back pain usually heals in a matter of few weeks. Your family doctor from the Family Health Service Line or physician from the Musculoskeletal and Sports Medicine Service Line at The Aga Khan University Hospital will attend to you with commitment and discuss the best possible treatments. Here are some treatment options your doctor may suggest:

  • Short term bed rest

  • Physical activity – maintaining your normal daily schedule with some modification

  • Heat/cold therapy

  • Painkillers (oral/local application) – anti-inflammatory and/or muscle relaxants

  • Physiotherapy​​

  • Surgery – (if needed) to relieve the compression on nerve

If you go to the 24/7 Emergency and Acute Care Service Line, your immediate issues shall be taken care of and according to your diagnosis; the respective specialized service line will be involved in your management.​​

The Aga Khan University Hospital offers various support services to help with managing or recovering from the disease or condition. These include but are not limited to nutrition, physiotherapy, rehabilitation, specialized clinics and some patient support groups. Your doctor or nurse will advise you accordingly.

 The Aga Khan University Hospital offers financial assistance to those who are in need and fulfil the eligibility criteria. For further information, you can contact the Patient Welfare Department. You can find the contact number of the Patient Welfare Department in the 'Important Numbers' section on the website homepage.

 The financial counselling staff is available during office hours, at the main PBSD (Patient Business Services Department), to answer your financial queries on treatments' costs and authorize admissions on partial deposit as per hospital policies allow. The financial counsellor in the emergency room is open 24/7. You can find the contact number of the Patient Business Services in the 'Important Numbers' section on the website homepage.​

Your doctor and or nurse will give you specific instructions about the prescribed medication. Please ensure that you take or use the prescribed medicine as advised. It can be dangerous to your health if you self-prescribe. Please inform the doctor or nurse beforehand if you have experienced any adverse reactions to any medications in the past. If you experience any symptoms of drug poisoning, overdose or severe reaction please contact the Pharmacy Service at The Aga Khan University Hospital immediately. You can find the contact number of the Pharmacy Services in the 'Important Numbers' section on the website homepage

The information provided on our website is for educational purposes and not intended to be a substitute for medical advice, diagnosis or treatment. You should always seek the advice of your doctor or other healthcare professional provider. ​