Fit & Proper: How to prevent or manage spondylitis

Rajesh M (name changed), a mid-level executive in his 40s with a desk job, recently woke up with a catch in his back. He ignored it for a few days, particularly at work. He went to a doctor after 10 days and began medication but there was no improvement. Finally, he was found to have weakness in one leg and an X-ray revealed that he had advanced spondylitis. An MRI scan revealed a large disc prolapse compressing on a nerve. The doctors have advised surgery. They told him that he could have prevented surgery had he taken adequate precautions early on.

Spondylitis is an inflammation of the spine and is mainly an age-related ailment, though other factors such as physical inactivity, nutritional deficiencies and stress can also contribute to it. The symptoms of lower back and neck pain are common and, like many other diseases, spondylitis is on the rise. Earlier, it used to affect people in the 60-80 age group, but now we get more patients in the 30-50 age group.

Symptoms include pain, numbness and tingling and, in some cases, weakness of the limbs. Stress might make you feel the pain even more, enough to start affecting your activities. As one gets older, back and neck pain recurs repeatedly if one neglects it. With repeated unattended episodes, the body's natural healing capacity reduces and the risk of recurrence and persistence of pain increases.

Normally, one can wait for a few days before consulting a doctor. The exception is if you also feel a weakness in the limbs and incontinence of bladder or bowel, in which case you need to see a doctor immediately because that is the cry of a dying nerve. The earlier you release the pressure on the nerve, the better your chances of recovery.

Patients are put on anti-inflammatory medications to relax the muscles and soothe the nerves, and an X-ray is recommended if there is no improvement after two-three weeks. The treatment is changed according to the results. Normally, an MRI scan is only advised if there is no improvement even after six weeks.

QUICK TIPS

• The spine consists of 33 bones and every two bones are connected with each other by three joints (bearings). For these joints, movement is life. So, the permanent solution is to keep all the spinal joints mobile daily through exercise. Yoga and swimming help.
• At work, take breaks to keep moving. Get up and walk around. When sitting, do some stretches.
• Yoga has been proven scientifically to be the best way to cure chronic back/neck pain. Iyengar yoga increases the flexibility of the spine, as well as reduces stress. Start on yoga once the pain subsides and practise it for the rest of your life.
• Smoking is directly linked to back and neck pain because of its role in causing and accelerating disc degeneration. So, quit smoking.

Vidyadhara S
Head of department and consultant spine surgeon, Manipal Hospital, Bengaluru