In the workplace, precious work hours are lost and manpower efficiency is compromised. At home, normal daily activities are left unaccomplished, all because of a sore back. Back pain, therefore, does not allow the average person to enjoy their life to the fullest.

Back pain can be classified as either acute or chronic, depending on its duration. Acute cases
are resolved within a matter of days or a few weeks, with minimal to moderate use of pain relievers
and occasional use of adjunct therapy. If a person suffers from back pain for more than a month or so, their condition is said to be chronic.

Generally, chronic back pain may not respond to common over-the-counter medications, and it may require extended therapy.

According to studies, the most common cause of chronic back pain is degenerative disc disease, or spondylosis. To understand the mechanics of spondylosis, the form and functions of the backbone should be underscored.

The backbone, or spinal column, is made up of bones called vertebrae. Each of the vertebrae is cushioned by intervertebral discs that act as shock absorbers. These discs per-mit the painless movement of the joints.

As we age, our body goes through a natural process of wear and tear. The joints in our vertebral column are no different. Excessive use of the spine through normal activities like sports and work, speeds up the otherwise slow degenerative process. The intervertebral discs are first to suffer damage. When the damage continues to be unresolved, our backbones’ protection is depleted.
Without the cushion between each vertebra, they may grind against each other when the body is in motion. Even with the slightest movement, back pain results. Normal mobility and stability are then eventually lost. Therefore, if the problem is not addressed immediately, it is difficult to restore the backbone’s form and function.

There are known factors that contribute to spondylosis.

Ageing is the predominant factor in the cause of spondylosis, especially for a person who is aged between 40 and 80 years old. Degenerated discs are further damaged by bending and twisting.
Improper body mechanics such as repeatedly maintaining an inappropriate posture, or slouching or twisting one’s body while carrying weight, adds unnecessary stress on the spinal column.

Trauma due to sport or falls causes undue stress on the intervertebral discs, causing the vertebrae to break or deviate from their normal position.

Congenital or acquired vertebral abnormalities predispose a person to spondylosis compared to the average person.

However debilitating spondylosis can be, help can be extended by both classic and modern medical technology.

To relieve pain caused by degenerative disc disease and slow down its effects on the body, lifestyle modification is needed. Patients are expected to provide support for the spine by improving their posture and strengthening their core muscles through exercise.

If the pain persists for more than six months regardless of physical therapy and medication, surgical procedures may be offered to the patient. One option would be the insertion of a prosthesis or an artificial vertebra. By replacing the damaged vertebra with a sturdier one, the backbone may move normally again. The patient will be able to bend, lift or turn.

There are significant advantages to choosing a prosthesis. First, the artificial joint is made of a strong alloy of cobalt and chromium. It is not known to stimulate allergic reactions in most people. With regard to recovery, the patient can get back to work within a few days of the surgery.

With a prosthesis, spinal mobility and elasticity are not affected, unlike traditional jointed-column operations. Likewise, they do not cause upper joint degeneration. Furthermore, the artificial joint lasts for more than 20 years, so there is less chance of a repeat procedure being necessary.

This operation is appropriate for patients who are less than 40 or 50 years old, have a level 1 or 2 degenerated vertebral column, and with back and neck pain caused by degenerative disc disease that
has persisted for more than six months with ineffective conservative treatment.

However, this operation is not appropriate for patients with a displaced spine (Spondylolithesis), thin and/or bent and distorted bones.


The writer is assistant professor at the Musculoskeletal Center, Phyathai Hospital 2, Bangkok, Thailand. Articles in this column, which will appear every two weeks, are provided by a panel of doctors from www.flyfreeforhealth.com, a leading multimedia medical tourism platform.
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