Dr Niraj Vasavada, HOD, Department of Spine, Shalby Multispecialty Hospitals & Director, SIRS – Shalby Institute of Rehabilitation Sciences
The spine is the body’s most central support structure, and is literally the ‘backbone’ of a healthy human being. The spine helps one sit, stand and move and is the most important bone in the body. Stretching down the midline of the trunk from the base of the skull to the coccyx, the structure is responsible for posture and mobility, and also provides strength to one’s upper body. Hence, naturally, it is an integral part of orthopedics, which focuses on the care of the musculoskeletal system.
The human spine consists of 32 bones called vertebrae (7 cervical, 12 thoracic, 5 lumbar, 5 sacral & 3-4 coccygeal – sacral & coccygeal vertebrae are fused together), which protect and support the spinal cord and nerves. A number of conditions and injuries can affect the spine, which can damage the vertebrae, cause pain, and limit mobility. Spinal problems are one of the leading causes of disability all across the world, and can be a major barrier to leading a healthy, fulfilling life. Through the years, the Indian population has continued to witness an alarming rate of orthopedic spinal conditions, owing to sedentary lifestyle, lowered immunity and inappropriate living conditions.
One of the most widespread spinal problems that can disrupt the quality of life, in the long term is back pain. An extremely common phenomenon across the world, healthcare for back pain costs people across the world billions of dollars each year. Practicing poor posture and having a sedentary lifestyle are the major contributors of this common health problem, which is a major cause of disability. Back pain is not a disease but a constellation of symptoms, with an increasing prevalence amongst those aged 35 and above. The leading cause of activity limitation and work absence across the world, back ache cases are rising substantially across the world, due to the wear & tear (degeneration) of the intervertebral discs in older people. With a long way to go globally in terms of proper diagnosis and treatment for this degeneration, it is important to follow simple steps such as regular exercises and stretching regularly to help reduce the risk factors.
Spinal injuries are another major cause of disability in the general population. A spinal cord injury can often cause irreversible problems and cause permanent changes in body functions such as strength and sensation leading to paralysis. The spine can get injured due to various causes, ranging from motor vehicle accidents to sports injuries. In most cases, the causes are preventable. Patients with a spinal cord injury are two to five times more likely to die prematurely, in comparison to those with an uninjured spine. According to WHO, close to 2,50,000 – 5,00,000 people suffer from a spinal cord injury (SCI), of varying degrees, around the world every year. Furthermore, according to the WHO, the severity of disability after a skull fracture is estimated at 43%, whereas for a spinal cord injury, it is a whopping 72%. Addressing root issues such as inadequate medical care, lack of awareness about road safety protocols and rehabilitation, can do wonders to treat someone with a spinal injury.
Spinal infections are another reason for patients to attend hospitals and can often go undetected for long periods of time. The commonest spinal infection in India is Tuberculosis, however other bacteria or even fungus can infect a spine. The symptoms may range from simple back pain to grotesque paralysis. Majority of spinal infections (known as Osteomyelitis of spine or spondylodiscitis in medical language) can be treated with simple course of properly selected antibiotics, if diagnosed early. If neglected, spinal infections not only require surgery but sometimes leave behind residual disability due to damage to vertebrae or spinal cord.
Lastly, posture is extremely important to one’s spinal health. Poor posture often directly impacts mobility, and prolonged hunching can pose many problems ranging from back pain, to severe weakness. A complication that can be easily avoided through awareness, exercise and improving one’s ergonomics during our daily activities, it is one of the silent causes of morbidity, particularly in adults.
The health of the spine, and one’s mobility indeed go hand in hand. A healthy spine not only assists in movement and daily tasks, but also controls the body’s vital functions. Building awareness about the common mobility problems caused by spinal conditions can go a long way in safeguarding one’s well-being and physical fitness in the long run.
