I am Dr. Padmaja, Senior Gynecologist, Noida. Aaj hum log baat karenge ek bohot common se topic ke baare me: low back ache. Jisko ki hum log chronic lumbar pain ya lumbago bhi bolte hain.
Low back ache kya hota hai, hamari kamar ka neeche ka hissa, jo hamaare shareer ke upar ke hisse aur neeche ke hisse ko connect karta hai usko hum log lumbar region bolte hain. Iss region me hone wale kisi bhi pain ko hum log lumbago bolte hain. Now, lumbar region is very very important. Why this is very important ? Because ye kai saare functions perform karta hai. Ye structural link form karta hai hamare body ke upar aur neeche ke hisse me. Ye hamaare body ke bahut saare organs ko protect karta hai saath hi isi ke upar hamare body ke movements hote hai, jaise ki hum forward bending wagairah karte hain. Is hisse me jo pain hote hain, multiple kaarano se ho sakte hain.
Ye vertebral column ki wajah se ho sakte hain, pain spinal origin me ho sakte hain, disc ki problems me ki wajah se ho sakte hain. Is area me jitne muscles aur ligaments ho sakte hain uski wajah se ho sakte hain ya ye pain is area me body ke internal organs ko jo protect karte hain indirect diffraction unka bhi hota hai. Now, lumbar pain can affect both male and female, but today we will be talking about lumbar pain especially in relation to females. Female me hone wale lumbar pain ke samasyaon ke baare me baat karte hain. Pehle ye samjha jata tha ki lumber pains, ya chronic low back ache 40-45+ menopause ke aas paas wali ladies ko pareshan karte hain but actually it is not so. Aaj ke time pe with the kind of lifestyle we are leading, no age group is left unaffected. Because hum log offices mein baithe bohot der tak kaam karte hain. Our exercises and different kind of strains lead to different kind of problems in females.
Gyne opd me hamein 2 tarah ke patients aate hain. Aksar patient directly hamare paas aata hai, ki bohot dino se kamar me dard hai ya interdisciplinary approach ki tahat hamein different departments se especially orthopedic department se bahut saare patients aate hain to rule out gynaecological problem ki internal check-up kar lijiye koi Gynecological problem to nahi hai. If the clearances given, fir unka orthopedic ya medical point of view se evaluation hota hai. Now pain of gynaecological origin: Normally jo striyon me hone wali samasyaon se related pain hota hai it is usually diffused and dull ache. Dheema aur Constant pain hota hai which is chronically present all time. Koi bhi pain jisko aap finger se pin point kar sakte hain normally gynecological origin ki wajah se nahi hota hai. Kuchh age groups ya causes jinme problems aksar dekhe gye hain unke nimn prakar hain: young girls me menstruation ke time pe because uterus, ovaries aur Parietal peritoneum ki nerve supply aise hoti hai jab menstruation ke dauraan uterus me cramps hote hain to usually wo back pe bhi refered hote hain aur is tarah ke pain long lasting nahi hote hain aur ye menstruation ke saath saath khatam ho jaate hain. Second most common group which is affected by this back ache is in the child bearing age group especially during pregnancy. Now pregnancy me kya hota hai aapka because you are carrying a baby, apka posture jo hai lumbar curvature badh jata hai there is lumbar lordosis. So there is constant strain jo kamar ke muscles hain unpe constant khichav rehta hai.
Is kaaran se aksar lumbar pain rehta hai. Then after child bearing, kuchh log hote hain jinko deficiencies ki wajah se ya muscles spasm even after delivery persist karta hai and chronic back ache me badal jata hai to child before child delivery and even after the child delivery people can have pain. Second important to this is post operative. Kuchh logo ko operations ke baad kamar me dard rehne lagta hai. Kuchh log aise bhi hote hain jinme operation ke dauraan spinal anaesthesia wagairah dene se back ache lage rehta hai. Ek bahut important group jisme ki chronic back ache dekha gya hai. That is because of age related problems especially around the age of menopause. 45, 50, 55 years ki jo age group hai unme aksar ye pain dekha gya hai. Ye pain jyadatar hamare bodies me estrogen ki deficiency ke kaaran hone wale changes ki wajah se hota hai. In changes ki wajah se hamare muscles jo hain wo loose ho jaate hain, hamare bone mineral density kam ho jaati hai. To at this age backache is multifactorial. Other than this, people who are very active jo bahut exercise karte hain, yoga karte hain, bad postures me baithe rehte hain, unsupervised exercise karte hain especially in gyms and all, people are very active these days. Un cases me bhi bahut sara muscles spasm ya strain ki wajah se backache ho sakta hai. Another very important cause of backache in female is chronic genital infections. Females jinme ki internal organs me swelling rehti hain, infections rehti hain unme bhi chronic backache dekha gya hai.
In common causes ke alawa kabhi kabhi age related jab body me laxity ho jaati hain, aapke muscles power loose karne lagte hain, tone loose karne lagte hain jinme private parts me prolapse hone lagta hai, uterus thoda khisak kei neeche aa jata hai, peshaab ki thaili neeche khisak jaati hai , Cystocele wagairah hoti hai ye ya bahut cases me mass koi andar rasauli wagairah hai, un cases me bhi constant pressure ki wajah se aapko backache rah sakta hai. Now, these are very very common causes of chronic low backache. Ek sabse badaa important cause aaj ke time pe irrespective of sex and age is nutritional deficiencies. Because of our lifestyle, hum log raat me kaam karte hain din me sote hain, ghar se ac me gaadi me, gaadi se office me, office se ac me, fir gaadi me, fir wapis ghar me. So there is a lack of exposure to the sun and sun is an important factor for generating vitamin D in our skins and vitamin D is very very important for the density of bones. Vitamin D ko hum log vitamin D zaroor bolte hain but actually its not a vitamin it is a pro hormone which gets converted into our skin and is very very important hamari body me calcium metabolism ke liye, hamari body me homeostasis ke liye, nerves signals ke liye and man a times ye deficiency itni subtle hoti hai ki hum log usko overlook kar jaate hain. Saari cheezon ki investigations karte hain baar baar doctor ke jaane ke paas bhi humein koi diagnosis nahi milti hai.
Aksar in cheezon ka diagnosis banana thoda mushkil hota hai but agar aap aware hain aap time se test karaye, to you will find in indian population rather all over the world, Vitamin D is gradually developing as an epidemic. So nutritional causes also one of very important cause of backaches or rather ache throughout the body. Now how to deal with it. Do not overlook any pain. Koi bhi pain jo aapko kuchh hafton se jyada pareshan kar rha hai usko overlook mat kariye. Go and visit your doctor. Doctor ke yahan jaane se pehle kuchh chhoti moti remedies aap ghar pe bhi kar sakte hain jaise ki, fermentations hain, postural check karna, try to sit in the right posture. Try not to bend forward. Doctor ke paas jaane ke baad, jo bhi aapka test hota hai treatment me jo kaaran nikalta hai, uske hisaab se aapka treatment kiya jaayega. Par kuchh basic norms har cheez ke hamesha baraabar rehte hain, chaahe wo orthopedic ho, chaahe gynaecological problem ho. Agar wo menstruation ke dauraan hai to aapko simple chhota painkiller medicine se, right exercise, right posture, good eating habits. Aur agar infection ki wajah se hai to infection ka treatment hona chahiye. Agar aapko chronic problem hai, endometriosis wagairah ki to unka medical ya surgical management ho sakta hai.
In sab cheezon ke saath saath investigations ek bahut badaa important role play karte hain jinme ki aapka age related investigations hote hain. If you are young, you may not require so many investigations. If you are towards the menopause, you may require little more investigation. Jaise ki aapka blood counts kya hai, aapka sugar level kya hai, aapka glyc se related haemoglobin kitna hai, aapki bone mineral density kitni hai. So these will all help in determining the cause and the treatment of the disease. So, carry home message for you is, kisi bhi backache ko lightly na le, postural collections ka dhyaan rakhein, take good nutrition, visit your doctor and do take medicine on time. Physiotherapy has a very very important role to play, do your exercises and last but not the least, human body is not made for sitting. So if you are in an office, sitting for a very very long time, try to take regular breaks at desired intervals which may be a doctor can tell you.
So have a good day ahead! That's all from me.