Back pain – A growing concern in urban Indian housewives

Mrs Vanita a 32 year old lady, married since 7 years and a mother of 2 kids is suffering from back pain since last 5 years. She has undergone a MRI as well as has taken multiple physiotherapy session for back pain but still suffers from back pain on & off.

“My all reports are normal, doctor has suggested me to do regular back exercises, but because of my demanding schedule I am not able to exercise regularly” explains Vanita.

Back pain was not a very common issue in Indian housewives 15 years ago from now. However, due to rapid urbanisation and unhealthy lifestyles it has become more common these days. Around 80 percent are mechanical type of back pain, 10 percent are post- pregnancy back pain, 7 percent are due to pathology related like disc or accident (which actually require treatment in the form of surgery) and remaining 3 percent are psychological in origin.

In the outpatient department of hospitals it has increased by almost 3 times in last five years only.

Suicides rate amongst Indian housewives has already been a major concern in the past followed closely by subclinical depression and fibromyalgia (vague pains in body).

However in the recent past, back pain is becoming a major concern too.

“Very often we see urban housewives with back Pain in our OPDs. They are mostly under 40 years of age, slightly obese and not regular in exercises. Psychological back pain is another common entity we come across. Third most common type of back pain in young urban female is post pregnancy back pain “explains Dr Hitesh Garg, Head of Spine surgery unit at Artemis.

An analysis of reasons leading to back pain in our urban housewives lead us to some unaddressed issues like poor sleep pattern (getting up early in morning) followed by long car drives for dropping and picking up kids from schools or spending the entire forenoon cleaning the house which often requires frequent bending forwards and lifting weights Use of standing mops help a lot in reducing back pain as against the conventional floor mops which requires bending down for cleaning the floors. Housewives often fail to give adequate attention to their personal diet as a result most of them have low Vit D levels and hemoglobin levels. Evenings are equally hectic for housewives, taking care of husband & kids and probably they are last to retire to bed.

“Majority of them have a very hectic schedule throughout the day. Diet is often not the best, very minimal sunlight exposure and almost no exercise. All these factors make them high risk for back pain. Sometimes we see young housewives with persistent back pain complaint but near normal MRI, in such situations an occasional facetal injection or intradiscal radio frequency ablation followed by exercises help a lot “explains Dr Himanshu Tyagi, senior consultant spine & Orthopedic surgeon.

Surgery is almost never required in such cases. Lifestyle modification in the form of 10 minutes daily back exercises, loosing few extra kilos, 20 minutes brisk walk along with proper sleeping posture would suffice in 95 percent of cases.

A special type of back pain with increasing incidence these days is ‘psychological back pain’. It is most difficult to diagnose and often requires a multidisciplinary approach for management including a team of Orthopaedician, pain specialist, psychologist,psychiatrist and sometimes a marriage counselor.

“This type of pain has no structural cause and is over perceived by the patients. The X-Ray and MRI is normal in these cases. Often the reason is overexertion, disturbed married life, personal frustration or psychological trauma due to family pressure” explains Dr. Rajat Gupta, Consultant Pain Medicine and Palliative Care, Artemis Hospital, Gurugram.

The third type of persistent back pain is the post pregnancy pain. Almost 70 percent of women suffer from back pain during and after pregnancy for 1 year. Medically the reason for this is weight gain during pregnancy, excessive loading of spine, child birth related trauma and poor ligament/muscle tone post pregnancy.

“We give a lot of emphasis on pregnancy and post pregnancy exercises. Also, we recommend regularly nutritional supplements like Vitamin D and calcium to these during child feeding phase. We also teach them proper Brest feeding positions, how to use a feeding pillow and proper posture of handling baby. This training/education is of paramount importance in alleviating post pregnancy back pain “adds Dr Hitesh Garg.

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