Dr (Brig.) B. K. Singh,a joint replacement surgeon, who established the joint replacement centre in Army R & R Hospital, Delhi.

Dr (Brig.) B. K. Singh,a joint replacement surgeon, who established the joint replacement centre in Army R & R Hospital, Delhi.

 

Foreword

The back is a complex structure made of multiple bones separated by discs and held together by strong ligaments and muscles. It is designed to provide flexibility in all directions through facet joints while protecting the spinal cord within it and nerves exiting through the neural foramina at each level. Each of its components is a possible source of pain which can be acute or chronic, of differing severity and sometimes associated with neurological deficit such as weakness, numbness or bladder/bowel incompetence.

Unfortunately, treatment today is based on Magnetic Resonance Imagings (MRIs), which, though extremely useful in eliminating serious disorders such as tumours, trauma and infections such as tuberculosis, are of little value in the common causes associated with day- to-day strain such as disc pain or age-related degeneration. Most of these can be managed conservatively by a good chiropractor or physiotherapist under the guidance of an orthopaedic surgeon to avoid complications.

Unfortunately, the tool which revolutionized diagnosis of the back is now being used to scare unsuspecting patients into surgery without informing them of the complications. This is often more disabling than the original problem especially in the elderly. Keep an eye on your back—knife-happy surgeons are waiting to literally stab you in the back!