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Back pain- a lifestyle disease

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Back pain is common and is prevalent even among young children in this pandemic situation triggered by prolonged sitting before screens. While most cases of back pain episodes improve with self-care and lifestyle modifications, in certain rare cases they could signal a serious medical problem. In an interview with the Sunday Island, Consultant Rheumatologist and Specialist in Sports Medicine from Nawaloka Hospital, Dr. Harindu Wijesinghe throws light on multiple causes of back pain and management strategies.

BY RANDIMA ATTYGALLE

The human back is made of a complex structure of bones, muscles, ligaments, tendons and disks which work together to support the body and enable us to move around. Problems with any of these components can lead to back pain. Although back pain could be felt anywhere along the spine- from the neck down to the hips, pain in the lower back or lumbago is the commonest.

“The reason why the pain is common in this region is because all the load in the spine when we sit, bend, do exercises etc. is felt on the lower back and this region is most prone to be damaged,” explains Dr. Wijesinghe.

Commonest cause of back pain is what is known as ‘non-specific’ back pain which occurs when the muscles and ligaments which surround the spine are overstretched. Next comes back pain caused by the disc bulging or herniation in the spine. In between the bones of the spine (vertebrae) is the intervertebral disc. The gel-like substance inside the disk can sometimes come out of the disk and press on the nerves in the spine which causes back pain and a pain down the leg called ‘sciatica’.

Fractures in people with osteoporosis could also lead to back pain says the Rheumatologist. “Although osteoporosis per se doesn’t cause back pain, a fracture could trigger a back pain.”

Certain types of arthritis (where the immune system starts attacking the spine) could damage the spine. ‘Ankylosing spondylitis’ is such a condition. This condition, Dr. Wijesinghe explains, causes back pain which is worst upon waking up in the morning and mainly occurs in young people below the age of 40 years. “Very often this condition is missed and unless treated on time, one could end up with a fixed immobile spine and a stooped posture due to the calcium formation around the spine,” he warns.

Infections of the spine such as tuberculosis and cancers in the spine too can cause back pain, although they are not common.

Risk factors

*Ageing –

wear and tear of cartilage and weakness of muscles is common in old age

*Being overweight

*Weak core muscles

“If your muscles in the stomach are weak, you are more prone to wear and tear of the disk. Exercises which are done while keeping the spine in the neutral position are encouraged.”

*Wrong posture

Sitting or standing in a wrong posture for prolonged hours is one of the most significant risk factors for back pain. “Sometime ago there was an issue with heavy school bags children carried. Today in this pandemic situation even in young children back pain is very common as they tend to spend a considerable time before screens. A lot of children and adults also tend to work in beds and sofas which is a bad habit,” remarks Dr. Wijesinghe.

Neutral Spine position or correct spine posture

Neutral spine is the position in which your back and neck are placed under the least amount of stress and strain. In this position, the natural curves of the spine are maintained. “Try to maintain this position while sitting, standing, lifting or doing exercise. There are many methods to find the exact neutral position. However the easiest way is to maintain your ears, shoulders and hips in one line.”

When sitting for prolonged hours, make sure:

 

*

You sit in a proper ergonomically designed chair- preferably an office chair

*

When using laptops, that the top of the screen is at eye level.

*

Your ears, shoulders and hips are in one line

*

Your feet touch the ground and your knee and hip are in 90
degrees

*

You take a break every 15 -20 minutes. Standup for a few minutes or walk a short distance. Use an alarm or a computer programme which reminds you to take breaks.

Lifting objects

Avoid lifting heavy objects. You should always be assisted by someone and also use proper lifting techniques (such as bending the knees while lifting heavy objects) or using machinery meant for lifting such objects.

*Smoking

*Regular use of high heels

“These could be worn once in a way but not recommended for daily wear as they could alter the posture. Shoes with a good ‘arch support’ are recommended and whenever you need a raised shoe to wear on a regular basis, a platform shoe is recommended so the angle between the heel and the ball of the foot is reduced and your posture is not changed that much,” explains the physician.

When to see a doctor

 

*

When back pain is not settled in a few weeks

*

When the pain is severe and doesn’t improve with rest

*

When there is a feelings of numbness tingling going into legs

You need to see your doctor urgently when there is

 

*

Back pain with fever or weight loss.

*

Causes new bowel or bladder problems

*

weakness of legs

How to treat back pain

Although back pain is common, the good news is that more than 90% of them can be managed with certain short-term drugs, injections and local applications for pain relief. This is followed by posture correction, weight reduction, core strengthening exercise and low impact cardiovascular exercise to prevent recurrence.

Back pain is a lifestyle disease which can be managed with a healthy routine, observes Dr. Wijesinghe. “There are no quick fixes here. It is important that one religiously and diligently does core strengthening exercises which helps in strengthening the muscles in the back, stomach and buttocks. Combine these with low impact cardiovascular exercises such as walking, cycling, swimming and elliptical training. We don’t encourage too much of bending, twisting and jumping when a person is over 40 or in someone with back pain because such vigorous movements could cause damage to the spine.”

Maintaining a healthy weight could also ease the load on the spine for which dietary discipline is required, he says. “Exercise alone can’t help one maintain body weight, one need to be conscious of the diet as well.”

Other lifestyle changes such as using proper chairs, a firm mattress and a soft pillow which enable the spine to be kept in the neutral position are also recommended by the physician. “We encourage people to sleep looking up so that the spine is kept straight and if at all they sleep to a side, it is important not to curl up.”
Myths to be busted

Since back pain is so common there are so many products in the market claiming to cure back pain and consumers should be cautious of these, warns Dr.
Wijesinghe. “Many believe that local applications, medicine and certain milk powders and formulas can bring your cartilage back to normal. It is like asking a person to reverse his age which cannot be done,” he remarks.

A lot of women think that the epidural given in pregnancy causes back pain. “This too is false. The reason for back pain after delivery or later is usually due to weak muscles, weight gain and poor posture.”



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Nanda Malini Ascocenda: A flower that carries the name of a legendary voice

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By Ifham Nizam

A flower named after one of Sri Lanka’s most celebrated voices has become a unique tribute to the country’s cultural heritage, with the Nanda Malini Ascocenda orchid carrying the name of veteran singer Dr. Nanda Malini.

The orchid was named in honour of Nanda Malini, recognising her outstanding contribution to Sri Lankan music and culture. She is among the country’s most acclaimed singers, with a career spanning several decades and a repertoire deeply rooted in Sri Lankan social and cultural experiences.

The striking illustration, released by the Ministry of Environment on August 21, features the veteran singer surrounded by colourful orchids and musical notes, bringing together two important elements of Sri Lankan identity — the country’s rich natural heritage and its musical tradition.

The Nanda Malini Ascocenda is particularly significant because it represents an unusual meeting point between art and nature. Orchids have long been associated with Sri Lanka’s botanical wealth, while the naming of individual hybrids after distinguished personalities provides a lasting link between the country’s natural and cultural heritage.

According to published accounts, the Nanda Malini Ascocenda was named in 2004 in recognition of the singer.

A recent profile described her as possibly the only Sri Lankan artiste to have an orchid named after her by the Orchid Circle of Sri Lanka.

Nanda Malini’s contribution to music has been recognised through numerous awards. She has also performed internationally and remains one of the most recognised figures in Sri Lankan music.

Her association with songs reflecting social realities, human emotions and national identity has given her a special place in the country’s cultural landscape.

The orchid, therefore, represents more than a botanical curiosity. It is a living tribute to an artiste whose voice has accompanied generations of Sri Lankans.

The Ministry of Environment’s presentation also serves as a reminder that conservation is not limited to forests, wildlife and ecosystems. Sri Lanka’s natural heritage is closely intertwined with its history, culture, art and the people who have enriched the nation’s identity.

As the colourful blooms of the Nanda Malini Ascocenda evoke the beauty of Sri Lanka’s orchid heritage, the name attached to them ensures that the contribution of one of the country’s most distinguished musical voices continues to live on in an entirely different form — through nature itself.

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The Best of Malkoha celebrates half a century of Sri Lankan ornithological writings

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Distinguished gathering

By Ifham Nizam

The launch of The Best of Malkoha: Half a Century of Ornithological Writings marked a significant milestone in Sri Lanka’s birdwatching and conservation history, as the Field Ornithology Group of Sri Lanka (FOGSL) celebrated its Golden Jubilee at the Faculty of Science, University of Colombo.

The book, drawn from five decades of writings published in Malkoha, the FOGSL newsletter, brings together a rich record of observations, discoveries and experiences that helped shape modern field ornithology in Sri Lanka.

The launch formed part of FOGSL’s first-ever Founders’ Day, held on August 22, a date chosen to coincide with the 76th birthday of Vidyajothi Emeritus Professor Sarath Kotagama, one of the Organisation’s founding figures and its enduring source of inspiration.

The occasion brought together academics, conservationists, naturalists, birdwatchers, students, young birders and members of FOGSL, reflecting the broad community that the organisation has cultivated since its establishment in 1976.

Section of the invitees

Biodiversity expert Dr. Rohan Pethiyagoda, delivering the Golden Jubilee Founders’ Day Oration, used the occasion to reflect on five decades of biodiversity research and conservation in Sri Lanka, while paying tribute to Professor Kotagama and the role played by FOGSL in taking birdwatching beyond a small circle of specialists.

Pethiyagoda said the organisation’s greatest achievement had been its ability to make knowledge of birds and nature accessible to ordinary people.

He recalled how, in the early 1990s, Professor Kotagama had proposed producing an affordable field guide so that birdwatching would no longer be restricted by the high cost of existing publications.

That resulted in the publication of A Field Guide to the Birds of Sri Lanka in 1994, which Pethiyagoda published and which subsequently became a bestseller.

The collaboration later produced Sri Lanka Kurulu in Sinhala, making serious bird identification and knowledge available to an even wider audience.

Pethiyagoda recalled a particularly emotional encounter that demonstrated the lasting impact of that work.

During a recent visit to Talangama to accompany Australian birdwatchers, he encountered two boys, aged around 12 and 14, carrying a battered copy of Sri Lanka Kurulu and using it to identify birds.

“I just started crying,” Pethiyagoda said, describing the moment as evidence of how knowledge had been passed from one generation to another.

He said the achievements of the past 50 years should not be underestimated. Sri Lanka has witnessed major advances in health, education, infrastructure and conservation, while the country’s protected-area network has expanded considerably.

At the same time, however, he warned that biodiversity research and conservation continue to face serious institutional challenges.

Pethiyagoda pointed to habitat fragmentation, climate change, inadequate scientific research and restrictions on field research as major challenges facing the next generation of conservationists.

He said climate change would increasingly force species to move towards cooler, higher elevations, but fragmented habitats could prevent them from making such movements.

“Our challenge now is to connect up those little fragments so that plants and animals can migrate across these landscapes,” he said, stressing the importance of restoring ecological connectivity.

He also called for greater investment in ex-situ conservation for species facing extinction and urged the establishment of conservation facilities across Sri Lanka’s different climatic zones.

Pethiyagoda placed particular emphasis on citizen science, arguing that Sri Lanka possessed an enormous reservoir of public enthusiasm for biodiversity.

He noted that more than 20,000 Sri Lankans were now involved in citizen science through platforms such as iNaturalist, with Sri Lankan users generating significant biodiversity data.

“The appetite for science, the appetite for conservation, for exploration, for discovery is there in the people,” he said.

Pethiyagoda also paid an emotional tribute to Professor Kotagama, describing him as the constant force behind much of Sri Lanka’s modern conservation movement.

“In future generations, we will talk of conservation in this country as before Kotagama and after Kotagama,” he said.

He also acknowledged Professor Kotagama’s wife, Namali, for being the “bedrock” of his household and for supporting his decades-long contribution to conservation.

The Golden Jubilee celebrations also looked back at the origins of FOGSL.

The Organisation was founded on October 10, 1976, when four passionate bird enthusiasts—the late P. B. Karunaratne, Professor S.U.K. Ekaratne, Professor Sarath Kotagama and Rex I De Silva —came together with a shared objective of making birdwatching accessible beyond the relatively exclusive group that had traditionally dominated the field.

FOGSL was subsequently formally recognised by the University of Colombo and developed as a platform bringing together birdwatchers, researchers, students, educators and nature enthusiasts.

Its philosophy was simple: one did not need an academic qualification to become a member. Enthusiasm, careful observation, recording and sharing knowledge were enough.

That principle continues to define the Organisation.

FOGSL has since become Sri Lanka’s BirdLife International partner and has played an important role in bird research, conservation, environmental education, field studies, school programmes and citizen science.

Its work has extended from research on endemic birds and migratory species to biodiversity monitoring, conservation education and programmes aimed at children and young people.

Speaking at the event, FOGSL President Professor Nihal Dayawansa said the organisation’s founding vision remained relevant even after half a century.

The Organisation, he noted, was created not simply as a birdwatching club but as a platform through which people could study and conserve Sri Lanka’s birds while inspiring the wider public to appreciate nature.

The Founders’ Day itself was described as an opportunity to honour those who established and shaped the Organisation while celebrating the contribution of generations of members.

Professor Mayuri Wijeyasinghe, Head of the Department of Zoology and Environmental Sciences, said FOGSL had given ornithology a new meaning in Sri Lanka by taking birdwatching beyond an elite community and making it accessible to ordinary people and schoolchildren.

She noted that Sri Lanka, as a tropical island with a remarkable diversity of birds and a high level of endemism, had a special responsibility to understand and conserve its avifauna.

The Dean of the Faculty of Science, Professor I.M.K. Fernando, meanwhile, said that although his own field was physics, he recognised the common foundation shared by all branches of science—curiosity.

He congratulated FOGSL on reaching 50 years and praised its contribution to research, education, student development, wetland conservation, public awareness and science-based advice on development projects.

“The work goes far beyond publishing,” he said, noting the Organisation’s lectures, school programmes, research projects and conservation initiatives.

He also paid tribute to Professor Kotagama, describing him as a legend whose influence had extended well beyond ornithology.

Professor Kotagama, speaking after receiving tributes from colleagues and friends, said the Organisation’s foundations had been laid with a belief that people could make a difference.

He stressed the importance of taking decisions based on scientific knowledge and criticised excessive bureaucratic barriers that, in his view, prevented scientists from carrying out important field research.

Reflecting on his own period as Director of Wildlife Conservation, he said he had sought to transform the Department into a scientific institution.

“For me and for us who were working in the Mahaweli environment programme at that time, we knew that if not for science, you cannot go forward in conservation,”

Professor Kotagama said, stressing that conservation required both natural and social sciences.

He recalled the challenges faced by the Department, including inadequate staffing structures and poor career progression for wildlife officers, and said efforts had been made to introduce a more professional and scientifically grounded system.

The 50-year journey of FOGSL is closely intertwined with the development of modern field ornithology in Sri Lanka.

From the early days when birdwatching was largely confined to a small group of specialists, the Organisation helped create a culture in which students, schoolchildren, amateur birdwatchers and citizen scientists could contribute to the understanding of the country’s biodiversity.

The launch of The Best of Malkoha, therefore, served as more than the unveiling of another publication. It was a record of that transformation.

The writings collected in the volume represent five decades of observations and experiences, documenting how Sri Lankan field ornithology evolved through the work of generations of birdwatchers, researchers and conservationists.

As theOorganisation enters its next half century, the message emerging from the Golden Jubilee celebrations was clear: the future of conservation will depend not only on institutions and scientists but also on an informed and empowered public.

FOGSL’s enduring motto—”Once a member, always a member”—perhaps best captures that legacy: a lifelong connection with birds, nature, scientific observation and the responsibility to protect Sri Lanka’s extraordinary natural heritage.

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Heart that beats for humanity

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Dr Rajitha Y de Silva: Healing hearts, saving lives

Dr. Rajitha de Silva

By Zanita Careem

Dr. Rajitha Y. de Silva, Consultant Cardiothoracic Surgeon and Consultant at Sri Jayewardenepura General Hospital, has built a distinguished career around one of medicine’s most demanding discipline – surgery of the heart. With his expertise, precision and pioneering spirit, he has become closely associated with the advancement of Minimally Invasive Cardiac surgery in Sri Lanka. He joined Sri Jayewardenpura General Hospital in 2013 and is today recognised as a pioneer of Minimally Invasive Cardiacs procedures in the country.

He is particulary recognised as a pioneer of mimimallyinvasive surgery in Sri lanka,with experience in procedures including minimally invasive coronary surgery and mitral valve repair. He is recognition as a leading figure in the advancement of modern cardiac surgery in the country. With years of specialised training and experience behind him, Dr de Silva has built a reputation in cardiothoracic surgery while remaining deeply conscious of the human story behind every patient who enters the operating theatre. For him, the beating heart is more than an organ to be repaired – it represents a life, a family, a future and a second chance.

His commitment to patients extends well beyond the operating theatre. Having witnessed the financial hardships faced by heart patients who desperately needed surgery but could not afford it. Dr de Silva, together with Senior Cardiologist Dr. Ruwan Ekanayake, co-founded the Heart to Heart Trust Fund.

The initiative was created with a powerful objective, that no patient should be denied life saving cardiac treatment simply because of financial difficulties.

Perhaps one of the most striking aspects of Dr de Silva’s personality is that his concern for patients does not end when the operation is over. His vision has included creating initiatives that make the difficult journey of cardiac patients more humane, giving them encouragement, dignity and hope during a period when they are often at their most vulnerable. Abayadhana was born from a simple but powerful conviction that every patient deserves a chance to live.

Through the Abayadhana programme, he represents his compassionate approach to caring for people who need not only medical attention, but also understanding, encouragement and support. What makes this initiative particularity meaningful is the personal commitment behind it. It reflects his belief that healing is not only about medicine, but about reaching out to people when they are most vulnerable.

Away from the intensity of the operating theatre, Dr. Rajitha de Silva finds another kind of joy – his passion for cricket over the years; he has taken the field in numerous matches, playing alongside and against many well known personalties.

Dr. Rajitha de Silva’s journey is guided by compassion and success anchored in humanity. From pioneering milestones in cardiac surgery to the Heart to Heart Trust Fund and the Abayadhana initiative, he has continued to give back to the people whose lives he touches. His love for cricket, his warmth and generosity reveal the heart behind the healing hands.

A surgeon by profession, a humanitarian by choice and a cricketer by heart, Dr. Rajitha’s greatest legacy may not be measured only by the operations he has performed, but by the lives he has changed, the hope he has restored and the hearts he has touched.

The trustees of the Heart to Heart Trust Fund stand united behind the mission of saving lives and giving hope. Their collective commitment helps turn the Trust’s vision into meaningful support for patients and families in need

The Executive Director, Heart to Heart Trust Fund, Shanti Fernando, plays a hands on role in turning the Trust’s vision into action, coordinating efforts, and bringing hope where it is needed.

Behind Dr. Rajitha de Silva’s demanding life is his wife, Dr. Arunie, and children, who has been his strength and support.

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