Over 30 years and suffering from backache, knee pain? Mumbai doctors tell you why

Most people who have crossed their 30s are not shy anymore to admit that they suffer from chronic back pain or knee pain. The internet's growing meme culture has even made fun of this in various formats by showing hilarious versions of skeletons highlighting knee and back pain. While it is funny, the pain is real, and Mumbai doctors say there are quite a few reasons for it. More than that, they say Mumbaikars should not take it for granted.

Dr Mayank Vijayvargiya, consultant, Orthopedics Joint Replacement Surgeon, P.D. Hinduja National Hospital and MRC in Mahim, explains, "Back and knee pain in individuals in their 30s often results from a combination of factors rather than a single cause. Common contributors include poor posture, lack of exercise leading to spinal stiffness and weak muscles, and a range of injuries, conditions, or diseases. Specific causes may include muscle strains, disc issues, structural abnormalities like scoliosis, infections, cancer, and arthritis." On the other hand, knee pain in one's 30s can arise from a variety of causes like overuse activities, injuries to ligaments or meniscus, and patellofemoral syndrome.

With more people above 30 years old around us complaining about back aches and knee pain, mid-day.com spoke to Prof. (Dr.) Ali Irani, head of the department - Physiotherapy & Sports Medicine, Nanavati Max Super Speciality Hospital in Mumbai and Vijayvargiya. They not only stress the causes and effects of back aches and knee pain but also

What is the reason for people in their 30s and above complaining of back ache and knee pain?
Irani: As individuals enter their 30s and beyond, they often start experiencing back and knee pain due to a combination of factors. Degenerative changes, such as the natural wear and tear of joints and discs, become more pronounced with age. A sedentary lifestyle, characterised by prolonged sitting and lack of regular exercise, contributes significantly to musculoskeletal discomfort. Weight gain, common in this age group, adds extra stress on the back and knees. Previous injuries might resurface or worsen over time, leading to chronic pain. Additionally, occupational hazards that involve heavy lifting or repetitive motions further exacerbate the issue.

What are the causes of back pain for people in their 30s and above? How is it different from people of other age groups?
Irani: Back pain in individuals in their 30s and above are primarily caused by degenerative disc disease, where the spinal discs lose hydration and flexibility, making them more prone to issues. Herniated discs, where discs bulge or rupture, pressing on nearby nerves, are also common. Muscle strain from overuse or sudden movements can lead to significant discomfort. Arthritis, including osteoarthritis or spinal arthritis, results in inflammation and pain. This differs from younger people, who often experience back pain related to acute injuries or postural problems, and older individuals, who are more likely to suffer from severe degenerative conditions and chronic illnesses affecting the spine.

Vijayvargiya: Common causes of back pain in this age group include:
1. Muscle or ligament strain: Heavy lifting or sudden awkward movements can strain back muscles and spinal ligaments, especially in those with poor physical conditioning.
2. Bulging or ruptured discs: Discs between the spine's bones can bulge or rupture, pressing on nerves and causing pain that may radiate down the legs.
3. Infections: Musculoskeletal infections can arise from direct exposure or spread from another source.
4. Inflammatory conditions: Non-infectious inflammatory conditions such as ankylosing spondylitis and sacroiliitis, as well as chronic inflammation leading to spinal arthritis, can contribute to back pain.
5. Metabolic disorders: Conditions like osteoporosis and osteosclerosis, which affect calcium and bone metabolism, can also be factors.
6. Referred pain: Pain from visceral organ inflammation, such as biliary colic or aortic issues, can be referred to the back.
7. Postural issues: Prolonged periods of sitting or standing, pregnancy, and certain jobs can lead to postural back pain.
8. Congenital conditions: Inborn conditions like kyphoscoliosis and tethered spinal cord can cause back pain.
9. Degenerative changes: Osteoarthritis and spinal stenosis, which narrow the spinal canal, can also contribute to pain.

What are the causes of knee pain for people in their 30s and above? How is it different from people of other age groups?
Irani: Knee pain in people in their 30s and above can be attributed to several causes. Osteoarthritis, a condition where the cartilage in the knee joint breaks down, leading to pain and stiffness, is common. Patellar tendinitis, the inflammation of the tendon connecting the kneecap to the shinbone, often results from overuse. Meniscus tears, which involve the cartilage in the knee, are typically due to sports or sudden movements. Ligament injuries, such as those to the ACL or MCL, can also cause significant knee pain. In contrast, younger individuals usually experience knee pain from acute injuries or sports-related incidents, while older people face more chronic conditions due to long-term wear and tear.

Vijayvargiya: Common causes of knee pain in this age group include:
1. Overuse injuries: Repeated stress on the knee from activities like running or sports can lead to conditions like tendinitis or bursitis.
2. Injury: Damage to ligaments, tendons, cartilage, or bursae surrounding the knee joint.
3. Arthritis: Types of arthritis affecting young adults include inflammatory arthritis such as rheumatoid arthritis and gout.
4. Osgood-Schlatter's Disease: This condition, typically affecting adolescents, involves pain and swelling below the kneecap, often exacerbated by exercise.
5. Patellofemoral Pain Syndrome: This condition involves pain around the kneecap, often triggered by activities like stair climbing, running, or sitting with bent knees.
6. Previous injuries: Old injuries or surgeries can cause lingering pain or complications that affect the knee over time.
7. Poor Biomechanics: Issues with gait or alignment, often exacerbated by improper footwear or muscle imbalances, can lead to knee pain.
8. Weight and activity level: Excess weight or sudden increases in physical activity can put additional stress on the knees.
Are the reasons different for men, women and other genders for back pain and knee pain?
Irani: The reasons for back and knee pain can differ among men, women, and other genders due to biological, lifestyle, and occupational factors. Women may experience back and knee pain related to hormonal changes, pregnancy, and childbirth, which can affect the musculoskeletal system. Men might be more prone to pain from physical labour or sports injuries. Occupational roles and societal expectations can also influence the prevalence and type of pain experienced. For example, individuals in certain professions might experience higher rates of repetitive strain injuries.

Vjayvargiya: Back or knee pain can affect anyone, including children and teenagers. Factors that increase the risk include:
1. Age: Back pain becomes more common starting around ages 30 to 40.
2. Lack of exercise: Weak, unused muscles in the back, leg and abdomen can lead to pain.
3. Excess weight: Additional body weight places extra stress on the back.
4. Diseases: Conditions like arthritis and cancer can contribute to back or knee pain.
5. Improper lifting: Using the back rather than the legs can cause pain.
6. Smoking: Smokers are at a higher risk of back pain.

What are the effects of suffering from back pain and knee pain respectively and how does it hamper daily life?
Irani: Suffering from back pain can significantly affect an individual's quality of life by limiting mobility, reducing the ability to perform daily activities, and causing chronic discomfort or disability. It can interfere with sleep, lead to absenteeism from work, and impact mental health, contributing to conditions like depression and anxiety.

Knee pain similarly hampers daily life by restricting movement, making it difficult to walk, climb stairs, or participate in physical activities. It can also lead to a sedentary lifestyle, which further exacerbates health problems.

Vijayvargiya: Both back and knee pain can significantly impair daily activities and quality of life, leading to:
1. Decreased mobility: Reduced ability to move freely.
2. Inability to exercise: Difficulty engaging in physical activities.
3. Appetite changes: Potential effects on eating habits.
4. Challenges with household chores: Difficulty performing routine tasks.
5. Social and community participation: Limited ability to engage in social functions.
6. Mood changes: Increased risk of mood swings and depression.
7. Cognitive impact: Potential effects on concentration, memory, and overall cognitive function.
8. Sleep disruptions: Trouble sleeping due to discomfort.

Should people take back pain and knee pain seriously? If yes, why should it be done?
Irani: Yes, people should take back and knee pain seriously. Ignoring these pains can lead to worsening conditions, chronic pain, and long-term disability. Early intervention can help manage pain effectively, prevent further damage, and improve the overall quality of life. Addressing these issues promptly can also reduce the risk of complications and the need for more invasive treatments in the future.

Vijayvargiya: Yes, back and knee pain should be taken seriously, especially if:
1. The pain persists: Lasting more than a few weeks.
2. Severe pain: Pain that doesn't improve with rest.
3. Radiating pain: Pain spreading down one or both legs, especially below the knee.
4. Neurological symptoms: Weakness, numbness, or tingling in the legs.
5. Unexplained weight loss: Accompanied by weight loss without known cause.

While there are several reasons for back and knee pain, could travelling on Mumbai's roads or bad roads, in general, be one of the reasons?
Irani: Travelling on Mumbai's roads or bad roads in general can indeed contribute to back and knee pain. Poor road conditions lead to jolts and vibrations that can strain the back and knees, especially during prolonged commutes. The constant uneven movement can exacerbate existing issues or cause new injuries, particularly for individuals with pre-existing conditions.

Vijayvargiya: Yes, frequent travel on poorly maintained roads can cause repeated jolts to the back, potentially leading to chronic pain. These jerks can exacerbate disc issues and may also contribute to severe muscle spasms and nerve-related pain.

How does bad infrastructure affect people's backs and knees? What can they do to prevent it?
Irani: Bad infrastructure, such as uneven roads and lack of proper seating in public transport, can cause significant strain on the back and knees. To prevent pain, individuals can use supportive seating, take frequent breaks to stretch during long journeys, maintain good posture, and use ergonomic supports where possible. Strengthening exercises for the back and knees can also help mitigate the impact.

Vijayvargiya: Poor infrastructure can increase the risk of accidents and injuries due to frequent jolts and vibrations. Improving infrastructure can reduce these risks, thereby decreasing the burden on healthcare systems. To prevent injury, individuals should exercise caution and use appropriate safety measures when navigating poorly maintained roads.

What are the common misconceptions about back pain and knee pain for people in their 30s and above?
Irani: Common misconceptions about back and knee pain in people in their 30s and above include the belief that pain is a normal part of aging and must be endured. Many assume that rest is the best remedy, whereas regular, appropriate physical activity is often more beneficial. Some think that surgery is the only solution, ignoring the potential effectiveness of physical therapy, lifestyle changes, and non-invasive treatments.

Vijayavargiya: Here are some of the myths that people have:
Myth: Exercise causes back pain
Exercise can help prevent and treat back pain by strengthening core muscles and improving flexibility. It's important to adjust activities based on pain levels.
Myth: Bed rest is an effective treatment
Prolonged bed rest can worsen back pain; gradual movement and physical activity are often more beneficial.
Myth: Back pain can't be cured
Back pain often improves with time and appropriate treatment. Addressing factors like sleep quality and stress can also help.
Myth: Back pain is always due to serious conditions
Most back pain is caused by muscle strains or sprains and resolves without extensive medical intervention.
Myth: Surgery is the only solution for chronic back pain
Many cases of chronic back pain respond well to non-surgical treatments, such as physical therapy, medications, and lifestyle changes.
Myth: Poor posture doesn't contribute to back pain
Poor posture, such as slouching or looking down at devices, can strain muscles and joints, leading to pain. Good posture and ergonomic practices can help alleviate this.

What are some of the other orthopaedic issues that people can face once they cross their 30s?
Irani: Other orthopaedic issues that people may face after crossing their 30s include plantar fasciitis, hip bursitis, and carpal tunnel syndrome. They might also experience shoulder impingement, rotator cuff injuries, and tendinitis. Osteoporosis can begin to develop, increasing the risk of fractures, and conditions like sciatica can become more prevalent. Maintaining a healthy lifestyle, staying active, and seeking timely medical advice can help manage these conditions effectively.

Vijayvargiya: These are some of the other orthopaedic issues that people can face:
1. Arthritis: Joint problems can begin around age 30, often due to prolonged poor posture or repetitive strain.
2. Drying Tendons and Cartilage: Aging can lead to decreased hydration in tendons and cartilage, impacting joint function.
3. Muscle Loss: Muscle may decrease in size and number (sarcopenia), increasing the risk of injury, especially in sedentary individuals.
4. Bone Mass Loss: Bone density may decrease over time, leading to weaker bones.
5. Reduced Ligament Elasticity: Ligaments become less flexible with age, increasing the risk of injury.