Q: I had an IVP test done for stones. It was found that I have spina bifida s1. At the same time my SGPT (132), SGOT (52), Gamma Glutamyl transferase (67) and Alkaline phosphate (136) values too were checked for. I feel constant upper back pain since years. One year back I developed lower back pain too. Various blood tests were done like Hepatitis b and c, LKM antibody, Anti nuclear antibody, Anti smooth muscle antibody, DLC, Seruloplasmin, Serum and were found normal except for ESR which is 30 instead of 13. I also get pain on the knees.

A:Pain in the back and knees is commonly associated with aging and is often caused by osteoarthritis that appears after many years of stress or damage from such activities as sports. The back condition can be worse with underlying abnormalities, such as a minor degree of spina bifida. After one or two years of symptoms, in the absence of progression or other signs of increasing disease, the diagnosis is not likely to be more sinister, i.e., it is unlikely to be cancer. Two diagnoses are sometimes responsible for cases of chronic back pain: tuberculosis and brucellosis. The presence of an increased blood sedimentation rate may not be relevant, but might suggest a need for further effort to rule out these two treatable infectious diseases.