Health Talk: Unveiling the secrets of the spine – our body's pillar

Lower back pain (LBP) affects people of all ages and most individuals at least once in their lifetime. It impacted 619 million people worldwide in 2020, and cases are projected to rise to 843 million by 2050, according to the World Health Organization.

LBP is closely tied to spinal health. Modern work patterns and lifestyle habits increasingly strain the body. Prolonged desk work and constantly looking down at electronic devices put significant pressure on the spine, leading to common complaints such as neck pain and LBP. Conditions like cervical spondylosis and lumbar disc herniation have also become widespread.

"Most people on buses or trains are hunched over their phones, which is one of the worst positions for the spine," said Liu Xiaoguang, vice president of Peking University Health Science Center and president of Peking University International Hospital.

Humans can stand upright thanks to a strong muscle group along the back known as the erector spinae. Liu, a spinal surgery expert, recommends swimming, particularly breaststroke or backstroke, as an ideal way to train these muscles while giving the spine a chance to relax.

Lumbar disc herniation is not only common among older adults but also increasingly seen in younger people. The youngest patient Liu has treated was just 9 years old.

A simple way to assess whether LBP is caused by disc herniation is to check if the pain radiates down the leg.

"If the pain does not go past the knee, it is more likely referred pain caused by a bulging disc. But if the pain goes beyond the knee into the calf or foot, it usually means the corresponding nerve root is involved – that's when it becomes a lumbar disc herniation," he said, adding that in such cases, patients should lie down immediately and go to the hospital while keeping the body flat.

Many patients fear surgery for lumbar disc herniation. "About 70 percent of lumbar disc herniation cases can be treated conservatively," Liu said. He outlined four situations in which surgery is recommended:

1. When conservative treatment fails, typically assessed over about one month for acute cases.

2. When conservative methods aren't feasible – for example, when patients cannot lie flat to rest.

3. When leg muscle weakness appears, indicating motor nerve involvement.

4. When cauda equina syndrome develops, affecting bowel or bladder function or causing foot drop.

As for safety and success rates, Liu said the surgeries are generally very safe, but that does not guarantee a perfect outcome in every case.

"Surgeons can relieve the compression, but nerve recovery is another matter," he said, adding that in qualified hospitals with experienced surgeons, the risk has been reduced to a very low level, on par with global standards.

Executive Producer: Zhang Jingwen

Producer: Yang Sha

Director: Guo Meiping

Videographer: Zhu Yonggen

Graphic designer: Yin Yating