Back pain is one of the most common medical complaints among adults but if left untreated the condition can deteriorate over time and become debilitating for sufferers.
Doctors in the UAE said patients who present with back pain are most often diagnosed with a herniated or compressed disc, with five to 20 cases per 1,000 adults annually.
Most commonly seen in people in their 30s, 40s and 50s, the condition affects twice as many males as females.
Dr CV Gopalakrishnan, spine surgery consultant at Medcare in Dubai, said ageing, increased BMI or an injury may cause a herniated disc.
“The incidence of disc herniations is on the rise not only in the UAE but also worldwide,” he said. “There are several factors that have contributed to this increase in back problems.
“An elevated body mass index is a risk factor for lumbar disc herniation and it is thought to be due to the increased axial load on the lumbar spine.
“Other medical comorbidities such as diabetes, hyperlipidemia and smoking have also been reported as possible risk factors for lumbar disc herniations.”
He said a sedentary lifestyle, without regular core muscle-strengthening exercises, has contributed to an increase in cases in recent years.
And while most cases of herniated discs heal, some cases may require “interventional procedures or surgical repair”.
Dr Mohamed Elzoghby, consultant neurosurgeon at Burjeel Medical City, said fewer than 5 per cent of patients with back pain are diagnosed with disc disease.
However, as disc material degenerates over time and the ligaments that hold it in place begin to weaken, it can become a long-lasting and debilitating condition for some.
“As this degeneration progresses, a relatively minor strain or twisting movement can cause a disc to rupture,” Dr Elzoghby said.
“Symptoms vary greatly case by case, depending on the position of the herniated disc and the size of the herniation.
“If the herniated disc is not pressing on a nerve, the patient may experience a low backache or no pain at all.
“If it is pressing on a nerve, there may be pain, numbness or weakness in the area of the body to which the nerve travels.”
Typically, Dr Elzoghby said a herniated disc is preceded by an episode of lower back pain or a long history of intermittent episodes of lower back pain.
From walking to wheelchair
Leslie Pableo, 52, was diagnosed with herniated discs in September.
Working as a photographer in Dubai, the Filipina resident has had to use a wheelchair when out on long assignments as standing for long periods causes too much pain.
“I was diagnosed with my condition last September but prior to that, prior to the pandemic, I had symptoms,” she said.
“I noticed that when I would be carrying my photography equipment I’d regularly fall over.
“At first, I put it down to being clumsy but then it started happening more and more.
“During the pandemic, I was sitting doing nothing most days which is when it got worse. If I was sitting down then stood up, I’d experience this awful leg pain.”
Soon after, she said she started using a cane to help her walk, then a walker and eventully a wheelchair as walking became too painful.
After consulting a doctor, Ms Pableo was diagnosed with several back-related issues, including early degenerative changes to her lumbar spine.
Due to it being an continuing issue, she was advised that surgical intervention would be the best course of action to get her back to walking again.
But as a freelance photographer with basic insurance, she said it has been difficult to secure the right treatment covered on her insurance.
“I’ve tried to change to a new insurance but they won’t cover the costs of the treatment as it’s an existing condition,” she said.
“To pay for it myself will cost about Dh200,000 [$54,450], which is money I don’t have, so I just feel in a state of desperation. I just want my normal life back.”
Treatment for herniated discs
The initial treatment for a herniated disc is usually conservative and nonsurgical.
A doctor may advise the patient to maintain a low, painless activity level for anything from a few days to several weeks.
Dr Elzoghby said this helps the spinal nerve inflammation to decrease.
A combination of painkillers and physiotherapy may suffice to relieve the patient’s symptoms and control pain in approximately nine out of 10 people and the time to improve varies, from a few days to a few weeks.
“Patients with no improvement and those who experience motor weakness or sphincter control problems require surgical intervention,” Dr Elzoghby said.
“There is a wide range of surgical procedures that can be used ranging from an epidural steroid injection, micro-discectomy, artificial disc placement and fusion techniques.
“The choice of surgery is tailored according to the extent of disease in each individual patient.”
Updated: June 10, 2022, 9:31 AM