Q: I am a 24 years old man weighing 72 kg and 173 cm in height. I have chronic pain since 1.5 years in the lower lumbar region on the right side only. The left side is completely pain free. It worsens while flexing forward, sneezing, coughing. There is no radiation of pain in the leg but sometimes I feel it (though occasionally). I have HLA B27 positive. My ESR is 3 mm and there is no fever, RA factor is negative, the TLC & DLC are within range and my blood profile is also within range. I have no morning stiffness rather feel relief in the morning. While doing exercises the pain worsens. I got an MRI of the sacro-iliac (SI) joint which is normal. I have also got MRI of lumbo-sacral (LS) spine which shows minimal desiccation at two places at L4/L5 and L5/S1 (more). I want to know what are the exercises and precautions I should follow. as I am a student and have to sit for long hours in class.

A:Nonspecific low back pain occurs at some point of life. It has been documented in approximately 80% in the people. Brief period of rest (4-7 days) without exercises with painkillers like T. Voveran 75 mg twice a day followed by rapid progression to active exercises regime (Spine strengthening exercises) produces full return to activities and symptomatic relief are expected. Generally, patients treated in this manner improve significantly in 4-8 weeks. Avoid sitting for longer time and take a break if you want to do so. About 20-36% of people take unnecessary CT scans, MRI which shows disc herniation in otherwise normal healthy people. If you do not get better with this treatment, then I would like to re-examine you for new information and clinical findings. Please do not rush to put yourself in certain groups called HLA-B27. It is a different entity with different presentations, which affects the spine, eye and colon. The ankylosing spondylitis (96% association with HLA B-27) has male predominance with early morning stiffness and can cause various disfiguring and disabling spinal deformities