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Ortho Neuro Physiotherapy Clinic

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Ortho Neuro Physiotherapy Clinic is known for housing experienced s. Dr. Vishwas Virmani, a well-reputed Physiotherapist , practices in Noida. Visit this medical health centre for s recommended by 79 patients.

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Clinic Address
C-163, Sector -26, Noida
Noida, Uttar Pradesh - 201301
Details for Dr. Vishwas Virmani
The Institute for the physically handicapped
Jamia Hamdard University
Professional Memberships
Indian Association of Physiotherapist
Past Experience
Spinal Physiotherapist at Ortho Neuro Physiotherapy
Spinal Physio at Holy Family Hospital
    Consultation Charges: Rs 500
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    What are Muscle Knots?

    Muscle knots are points within a muscle where contracted fibers are unable to release1, or, as the dictionary puts it: “highly irritable localized spots of exquisite tenderness in a nodule in palpable taunt bands of muscle tissue.”

    A common problem for active people, muscle knots—technically called Myofascial Trigger Points, or MTPS—feel like a small knot to your fingertips. These knots can range from the size of a pinhead in smaller muscles to the size of your thumb in larger muscles.2

    Muscle knots can cause pain in two ways: (1) latent trigger points, which are knots that only hurt when you put pressure on them, and (2) active trigger points, which are knots that actively refer pain along your neural pathways, causing it in non-localized areas.

    Trigger points in a constant state of contraction have excess metabolic waste and oxygen use because blood flow to this area stops—this sends pain signals to the brain. Because your brain wants to stop the pain, it commands the muscle to rest, which leads to under-usage of the muscle. This is what makes the muscle shorten and tighten up.

    What Causes Muscle Knots?
    The most common causes of muscle knots are:

    1) Accidents – Acute trauma, such as bad falls & sports injuries that strain you joints and muscles

    2) Postural Stress – Sitting too long with poor posture, sitting with no support, & lifting improperly

    3) Overstimulation
    The C Curve is a movement of the spine that strengthens the deep abdominals while stretching the muscles of the back. The C Curve is a basic movement in Pilates that is used in many different exercises.

    The classic C Curve is always initiated by the abdominals. Try a C Curve by sitting up tall with your legs slightly bent in front of you. Imagine someone punching you in the lower stomach, and allow your spine to round by scooping in your deep abdominals. Your upper back, neck, and head may naturally follow this motion and round forward. So you initiate the C Curve with the lower back (lumbar spine), then you add the upper back (thoracic spine), and finally you add the head and neck (cervical spine). Now your whole spine is making a capital C. This movement should feel like a big stretch for your whole spine and all the muscles that surround it.

    Here’s a little more specific information about the three natural curves of the spine and how they participate in the C Curve movement.

    Pilates Lumbar C Curve
    The Lumbar C Curve movement is always initiated by your lower abdominals. This is the most difficult spinal movement to initiate because the lumbar spine has thick vertebrae that are meant to stabilize and hold the weight of the body. When you’re standing or lying, the natural curve of your lumbar spine is in slight extension (like Neutral Spine), so when performing a Lumbar C Curve, you must pay much attention to pulling in your abdominals from the lowest part of your abdomen and attempting to reverse the natural curve of your low spine. You can accomplish this only by deep and strong low abdominal engagement.

    The Lumbar C Curve in Pilates.
    The Lumbar C Curve in Pilates.
    Pilates Thoracic C Curve

    The upper back (thoracic region) naturally curves forward in a C shape. When performing a Thoracic C Curve, think of pulling your ribs in and allowing your shoulders to round forward. Doing so creates a nice stretch in the upper back.

    The Thoracic C Curve naturally follows the Lumbar C Curve, but it is easy to do the Thoracic C Curve without actually starting from the lower back. In other words, it’s easy for people to round their upper back because the back naturally rounds in that direction. Initiating the rounding from the lower back is more difficult and takes low abdominal work. The idea in Pilates is generally to try to do more work from the belly and to move the spine starting from the lower back and then adding in the upper back afterward.

    The Thoracic C Curve in Pilates.
    The Thoracic C Curve in Pilates.

    Pilates Cervical C Curve
    The Cervical C Curve is a way to visualize the correct way to lift your head off the mat during an abdominal exercise. If you know the right way to lift your head up and understand proper neck alignment, you won’t overstrain your neck when doing the abdominal-related exercises in Pilates.

    Lie on your back with your hands interlaced behind your head to support the neck. Lift your head off the mat by lengthening the back of the neck and by imagining that you’re squeezing a tangerine under your chin to bring the head up (kind of like nodding your head yes as you lift it off the mat). Don’t lead up with your chin. Once your head is off the mat, you have created your Cervical C Curve; the C shape begins at the top of your head and ends at the base of your sternum (or rib cage). You must lift your head high enough to form the shape of the C. Think of your abdominal muscles lifting up the weight of the head, not the neck muscles. If you’re very tight in your neck or very weak in your tummy, you may not be able to make a complete C shape. But if you keep doing the work, you will!

    The Cervical C Curve in Pilates.
    The Cervical C Curve in Pilates.
    What is a Dowager’s Hump?
    The term Dowager’s Hump is a more casual term for the medical condition referred to as kyphosis. It is the uncommon curvature of the thoracic vertebrae of the upper part of the back in an outward direction.

    It is most commonly seen in women than in men. When the front part of the vertebrae becomes involved and gets compressed due to osteoporosis, it will later on result to the spine bending forward and producing a hump at the upper back portion.

    What Causes a Dowager’s Hump?
    The hump can be caused by other conditions and these should be determined in order to get the correct treatment. Based on the research of the University of Maryland Medical Center, this kyphosis problem can be caused by genetic abnormalities.

    The disfiguration in the patient’s genes can result to the inappropriate growth of the vertebral column. Other conditions linked with other congenital problems could also cause this hump.

    It is also been mentioned in some studies that it can also be due to wedge fractures wherein the front part of a vertebra collapses causing the spine to be misaligned a little. The above part of the fracture tips forwards and creating a slight back curve.

    As the vertebra over the wedge fracture is tipped forward, it puts pressure on other vertebrae that could lead to developing a wedge fracture in another vertebra. The more wedge fractures are occurring; the back gets more bowed. In severe cases, a person’s back can be extremely bent over.

    How is a Dowager’s Hump Treated?
    There are several ways to treat Dowager’s hump. The main goal of treatment for this condition is by preventing bone loss, although it can also be utilized as a management which is beneficial for patients who experience pain resulting from vertebral fractures.

    The procedure is called vertebroplasty, where bone cement is injected to stabilize the vertebrae. Another procedure for this condition is performing kyphoplasty for individuals with compression fractures in the bottom half of the spine.

    Exercises for Dowager’s Hump
    Based on some research studies in the medical society, yoga exercises can be a great contribution in treating Dowager’s hump. The upper spine curvature of individuals who did yoga for six months reduced the back problem by about five percent compared to those who did not.
    Here are some 5 easy poses that can be done to straighten the spine:

    Seated Mountain
    Sit straight at the front edge of the chair with the butt firm and flat. Secure the feet on the floor by steadying it there. Inhale and stretch out the spine upward. Bring the shoulders down along with the head placed over the spine, then breathe uniformly keeping the posture for about 30 seconds to 1 minute.

    Sit in the same seated mountain position then pull the head backward as if making a double chin. Do it again for 6 to 10 times. Do not lift or jut the chin in a forward manner. Focus on the backward movement with the shoulder rolled and lifted when inhaling, then compress the shoulder blades together at the back when exhaling. Do it 6 to 10 times in full circles.

    Seated Superman
    Sit tall. Inhale while clasping the hands behind the back. Hold the arms away from the body when exhaling. Do it all over for 3 to 6 times. Remain in the same pose by continuously breathing if desired.

    Rocking Horse
    Sit tall as above. Keep the fit firm on the floor and draw the head back. Stay in this posture, and then bend forward by not rounding the spine. The muscles in the abdomen should remain firm and shoulders should be square. Bend back as far as possible with the feel still planted on the floor. Go through again for 10 to 20 times.

    Methods of Prevention for Dowager’s Hump
    Preventive measures must be taken to avoid this condition. Tips that can prevent Dowager’s hump include:

    Daily doses of vitamins C and D
    Work-outs for coordination and balance in order to prevent spine fractures
    Eat a healthy and balanced diet
    Sleeping practices
    Training for strength and weight
    Hunch Back: Stretching Exercises for Good Posture

    This stretch vastly helps if you are suffering from a sore neck or back.
    Stretch or tilt your head in all four directions (forward, back, left, right). Don’t roll in a circle, as it can cause additional strain.
    Massage your neck gently.
    Get on your hands and knees and bend your back upwards (cat stretch). Do the opposite next.
    Repeat a few times daily. This stretch, when done in the morning, helps in relieving the sleep induced muscle lethargy. If done regularly throughout the day, it helps in boosting your energy levels

    Exercises to Improve your Posture

    Stay in shape by keeping your entire musculoskeletal system modified to support your posture. For this the following exercise are helpful:

    Lie on your back with your feet on the floor and flex your legs to about 90 degrees at the knee.
    Pull your belly-button in towards your spine and hold it at the end for 10 seconds.
    Repeat eight times daily.
    Always keep a proper posture even if it is tiring and other muscles, like the back or butt, are not being used.
    Breathe normally when doing this exercise, because you are trying to train your core to maintain this position when doing daily normal activities.
    The following exercises can be done with or without hand weights:
    Exercise 1:
    Keep your head upright and shoulders squared so that the ears are in alignment over the shoulders.
    Lift both the arms straight out, palms up and alongside your ears.
    Bend the forearms in and backwards, towards the shoulders while trying to touch your shoulder blades with your fingertips.
    Repeat 10 times with both arms.
    Do alternate ten reps for each arm individually.
    Exercise 2:
    Keep your head upright and shoulders squared so that the ears are in alignment over the shoulders.
    Lift both the arms sideward at shoulder height.
    Hold this pose for 10 seconds.
    Now slowly bring the arms to the sides while counting till ten.
    Again, slowly lift arms back to shoulder height while counting to ten when raising your arms.
    Do 10 repetitions while checking your alignment with each rep. You should be able to feel mild tiredness in the shoulder muscles.
    Good Posture for Hunchback: How to Fix Your Posture

    Good posture is very essential to maintain a healthy mind and body. It helps in aligning the spine with itself. Having a good posture also helps in alleviating common problems like back or neck pain, headaches and fatigue. Other than improving your health, a good posture also boosts your self-confidence and your carriage. The steps to develop a good posture are:
    Identifying a good posture: The first step is identifying a good posture i.e., a straight back, squared shoulders, chin up, chest out, stomach in. In a good posture, you should be able to draw a straight line from your earlobe through your shoulder, hip, knee, to the middle of your ankle. With the help of a mirror, align your ears, shoulders, and hips. These points should make a straight line; however, spine curves naturally in a slight ‘S’ shape. If you are experiencing pain, then look at your side view to see if you’re forcing your spine into an unnatural position. The two natural curves in the spine need to be maintained. These are known as the ‘double C’ or ‘S’ curves and are found from the base of the head to the shoulders and the curve from the upper back to the base of the spine. Make sure that your weight is evenly distributed on your feet when standing upright.
    Training or exercising your muscles: The next step in improving your posture is to do exercises which will help in strengthening the muscles across the upper back and shoulders so that you naturally and unconsciously maintain a correct posture all the times without feeling any fatigue.
    Pretend to be a penguin by placing your elbows at your sides and touching your shoulders with your hands. Keep your hands on your shoulders with your ears aligned. Raise both the elbows and lower them back again.
    Practicing yoga is extremely beneficial in developing a good posture. Yoga also helps in improving balance; strengthening the core muscles and helping you maintain a proper body alignment.
    Standing Posture: A proper standing posture can be achieved by finding your center. A proper standing posture also gives you an air of confidence.
    Keep your feet shoulder width apart and stand up straight. This is the key to a good standing posture and should be repeated till you develop good posture habits such that it becomes a second nature for you.
    Place your weight on the balls of your feet. When you are resting on your heels, you will tend to slouch; however, stand up and try to stand on the balls of your feet. Observe the way your rest of the body follows suit. Now tilt back so that your weight shifts to your heels and observe how your entire body shifts into a “slouchy” posture again.
    Always keep your shoulders squared and stand up straight. Initially it may feel unnatural especially if you do not have good posture habits, but keep practicing till it becomes second nature to you.
    Pull your head backwards and upwards such that you are reaching for the ceiling and keep your head square on top of your neck and spine while doing this. This technique will not only improve your posture, but will also make you look taller and leaner.
    Teach your body how a good posture feels like by standing with your back against a door or wall such that the back of your head, shoulders, and your butt are lightly touching the wall. Continue practicing this for a good posture.
    Walking Posture: A good walking posture can be achieved by a good standing posture, as walking with a good posture is simply an extension of standing with a good posture. While walking, always keep your head straight up, shoulders back, chest out, and eyes looking straight ahead and always avoid pushing your head forward.
    Sitting Posture: For a developing a good sitting posture always, sit up straight. Following are some basic guidelines for developing a good sitting posture especially if you are working at a desk all day long.
    Always use a chair that’s ergonomically designed for giving proper support and is according to your height and weight. You can also use a small pillow for lumbar support.
    Keep your back aligned with the back of the office chair, as this will help in avoiding slouching or leaning forward.
    When sitting, always keep your shoulders straight and squared, your head upright, and your neck, back, and heels should be in alignment.
    Always keep both feet on the ground. You can use a footrest if your legs don’t reach the ground.
    Your chair should be adjusted such that your arms are flexed and not straight out.
    Always take standing breaks in between even if you have a good sitting posture. Stand up in between, walk around and stretch a little for a few minutes.
    Driving Posture: A good driving posture is achieved by developing a good sitting posture.
    Rest your back against the seat and the head rest.
    Adjust your seat such that there is an appropriate distance from the pedals and steering wheel. The following are the indications that you’re too far away: If you’re leaning forward, reaching for the wheel or pointing your toes. The following are the indications that you’re too close: If you are sitting huddled up with your chin on top of the steering wheel.
    Adjust the head rest so that the center of your head rests against it. You can adjust the head rest as required. There should be a distance four inches/10 cm (and not more) between the back of your head and the head rest.
    Sleeping Posture: It is difficult to maintain a specific posture when sleeping; however, the way you sleep has a bearing on your posture when you wake up.
    A firm mattress helps in giving a good back support.
    Sleeping on the back helps in keeping the shoulders straight and is more comfortable than sleeping on the stomach.
    When sleeping on your side, keep a small, flat pillow between the knees. This helps in keeping the spine straight and aligned.
    A good pillow should be used to provide the required support and alignment for the head and shoulders. Don’t use too many pillows, as your head will be bent in unnatural position resulting in a bad posture with you feeling stiff, sore and groggy upon waking up.
    Causes and Risk Factors of Hunchback

    Hunchback results when the vertebrae in the upper back become increasingly wedge-shaped and the cause for this can be various problems such as:
    Disc degeneration.
    Cancer and treatment for cancer.
    Scheuermann’s disease.
    Congenital/birth defects.
    Risk Factors: There are certain groups of people who are at increased risk for developing hunchback such as:
    Adolescent girls who have a poor posture.
    Boys aged between 10 and 15 are at increased risk of developing Scheuermann’s kyphosis.
    Older patients suffering from osteoporosis are at a higher risk for spinal fractures which can contribute to Hunchback.
    Patients having connective tissue disorders (Marfan syndrome) are more prone to developing Hunchback.
    Signs and Symptoms of Hunchback

    Patient may not have any signs or symptoms if the Hunchback is mild.
    Abnormally curved spine.
    Stiffness in the back.
    Pain in the back.
    Investigations for Hunchback

    Physical exam.
    Neurological exam to check reflexes and muscle strength.
    X-rays to determine the degree of curvature and to detect deformities of the vertebrae.
    Computerized tomography (CT scan) for more detailed images.
    Magnetic resonance imaging (MRI) to rule out tumor or infection.
    Nerve tests are done if the patient is experiencing any muscle weakness or numbness to check the nerve impulses.
    Lung function tests are done for severe hunchback to check if the curve is affecting the patient’s ability to breathe.
    Abdominal Ball Exercises

    Here are a few tips to consider before starting abdominal exercises:

    Tighten your stomach muscles by “drawing in” your belly button to your spine – this helps stabilize your hips, pelvis and lower back as well as strengthening your deepest abdominal muscle (transverse abdominus).
    Avoid lifting with your neck muscles – make sure to keep your chin tucked in a neutral position with a space between your chin and chest.
    Avoid flexion exercises if you have been diagnosed with osteoporosis. A standard abdominal crunch is an example of a flexion exercise that can be harmful on your lower back if you have osteoporosis. Please contact your doctor first before starting any abdominal exercise program.
    If you can’t do an exercise with proper form, wait until you are stronger and start with easier exercises. You can easily injure your lower back or neck if you try to perform exercises that are too advanced. Start with the exercises you can do with good form.
    Discontinue any exercise that increases your pain. If any abdominal exercise increases pain in your lower back, abdomen, pelvis or hips, discontinue the exercise and consult your doctor or medical professional.
    Remember to exercise your abdominal muscles like you would any other muscle – about three to four times per week. There is no need to do 100 sit-ups everyday! Choose about five of the exercises below or rotate them into your routine.
    Most commonly known as a military neck a straight or forward curve of the neck is abnormal and may cause an unkind progression of symptoms leading ultimately to cervical disk degeneration.

    Reversal of cervical lordosis explained

    The anatomy of the neck features a lordotic curvature in its typical and healthy state. This means that the cervical region has a gentle curvature with the open end of that curve facing the rear of the body. The base and top of the curve will be further posterior than the mid point, which will be further anterior.

    When the lordosis is straightened, the neck becomes more upright and linear. This is more common than the next progression of atypical curvature, which is the subject of this article.

    Actual reversal of curvature means that part or all of the cervical spine develops a kyphotic profile, with the open end of the curve facing anteriorly. Usually, this reversal is extremely mild, but is still very abnormal. What we now see is the middle of the curve being positioned posterior to the top and bottom.

    In essence, picture the letter c and now turn it backwards: This is the shape of a reversed cervical lordosis.

    Reversal of cervical lordosis causes

    The spinal curvature in the neck is constantly in flux to some degree.

    Congenital conditions and developmental conditions can have lasting effects on the natural degree of curvature typically demonstrated from patient to patient. These circumstances may be explainable due to injury or degeneration, or may be idiopathic:

    Scoliosis can affect the normal lordotic curvature in the neck.

    Cervical spondylolisthesis is a major source of reversed lordotic curvature.

    Severe disc pathologies can facilitate a gradual loss or reversal of cervical lordosis.

    Vertebral irregularities, such as wedging, can definitely contribute to lordotic alteration.

    Traumatic injury, including vertebral fracture, can create the ideal circumstances for a reversal of lordosis to take place.

    Severe neck muscle spasms can actually reshape the spinal curves, although these are usually temporary expressions and not actual structural conditions.

    Effects of reversal of cervical lordosis
    The neck is designed to curve in order to balance the spine, absorb stress, distribute force and provide proper movement of the head. When this curvature is diminished or reversed, symptoms may result, although this is not an inherent part of any altered lordotic condition.

    Patients may experience stiffness and tension in the neck. Pain may be present and may even be severe in rare cases. Neurological dysfunction is possible in extreme cases, since the neuroforamen might not align properly, thereby causing a cervical pinched nerve.

    In the worst circumstances, central spinal stenosis in the neck might affect the viability of the spinal cord, possible enacting the most dire of symptoms throughout the body.

    Patients will also be more prone to injury, since the normal shock absorption qualities of the typical curvature have been lost.

    While all these effects are certainly possible, they are not usual. In fact, a great majority of patients have minor symptoms or even no symptoms at all from mild reversed lordotic curvatures.

    The pathology leading to a neck curve reversal (cervical kyphosis shown below right) may be inspired by a multitude of conditions as follows:
    Post whiplash
    Post head injury
    Stomach sleeping
    Poor sitting/working postures
    Congenital spinal curvatures
    Degenerative cervical discs (a form of osteoarthritis that can either be the cause of or the result of a cervical kyphosis)
    Compression fracture of vertebral body
    Infection of the cervical spine

    Anatomy: straight vs. Curved

    I've always heard that it was good to stand up straight.

    stand upright, stick your chest out and hold your shoulders back! otherwise you're going get widows hump.

    Are these expressions as familiar to you as they are to me? one might think that having a curved neck goes against what we heard from parents and teachers as we were growing up, but the reality is that there is a little bit a truth in both. Maintaining good posture throughout our lives is crucial to both the health of our spine and vital organs. On the contrary, a special type of curve called a lordosis is a good thing, both in the neck and lower back.

    When we look at a person from the back their spine should be truly straight, so that the left and right sides of one's body is symmetrical. However, when we view a person from the side, the front and back of their body is different and this is reflected in a coinciding curvature of the spine. Both the lower back and neck are hollowed out (concave) and the mid or thoracic spine is protrudes (convex). Thus there is an alternation of curves functioning to provide stability, shock absorption and aid in propulsion. A straight spine would be very stiff and not flexible. Imagine the plight of a pole vaulter with an inflexible pole.

    Nature's design of our spine and rib cage facilitates breathing and offers protective and supportive framework for vital organs. Spinal disks are shock absorbers and because they are in the front of the spine, lordotic curvatures keep them from having to bear weight. Kyphosis or loss of such curvatures bears weight upon the disks, leading to their ultimate degeneration. This process of deterioration is a form of osteoarthritis and in the spine is known as degenerative spondylosis.

    Although most physiotherapists or conservative orthopedists can recognize a cervical curve reversal upon viewing the patient's posture, a definitive diagnosis may be obtained via a standing lateral (side view) x-ray of the neck. Cause can often be determined by corroborating a comprehensive history, a thorough examination, x-rays and questions about sleep, work and lifestyle.

    In my professional career I found that the majority of young adults presenting with cervical kyphosis either had a whiplash or were stomach sleepers from an early age. For desk jockeys 40-60 years of age, many hours of sitting with their head flexed forward almost dictates the fate of developing kyphosis. In prior years I considered cervical kyphosis a job hazard for the careers of accountants, attorneys and often teachers because of years spent with their head in a book or paperwork. However, the digital age offers some relief in that respect. A well-planned, ergonomically-friendly office can do wonders for protecting the spine in the sedentary worker.

    Treatment for cervical curve reversal (kyphosis)
    During my chiropractic practice I had the opportunity to note a good percentage of correction toward a more normal lordosis (noted on x-ray) for 70% of patients under my care. This was almost always consistent with those patients that followed all recommendations and were model participants in their own care. Here is the recommended treat plan:

    Spinal manipulation of stiff and fixated spinal segments by a qualified physio
    Flexibility exercises for flexion and extension of cervical spine
    Resistance exercises for flexors and extensors of the neck
    Learn the Alexander technique for maintaining good posture (hint: the basic philosophy is to sit and stand like you were hanging by a string from the vertex of your skull. Liken it to a puppet on a string).
    Elimination of stomach sleeping
    Avoid standing on your head, although some yoga postures may be beneficial
    Use of orthopedic neck pillow while sleeping.
    What are muscle knots?
    Muscle knots are points within a muscle where contracted fibers are unable to release, or, as the dictionary puts it: highly irritable localized spots of exquisite tenderness in a nodule in palpable taunt bands of muscle tissue.

    A common problem for active people, muscle knots technically called myofascial trigger points, or mtps feel like a small knot to your fingertips. These knots can range from the size of a pinhead in smaller muscles to the size of your thumb in larger muscles. 2

    Muscle knots can cause pain in two ways: (1) latent trigger points, which are knots that only hurt when you put pressure on them, and (2) active trigger points, which are knots that actively refer pain along your neural pathways, causing it in non-localized areas.

    Trigger points in a constant state of contraction have excess metabolic waste and oxygen use because blood flow to this area stops this sends pain signals to the brain. Because your brain wants to stop the pain, it commands the muscle to rest, which leads to under-usage of the muscle. This is what makes the muscle shorten and tighten up.

    What causes muscle knots?
    The most common causes of muscle knots are:

    1) accidents acute trauma, such as bad falls sports injuries that strain you joints and muscles

    2) postural stress sitting too long with poor posture, sitting with no support, lifting improperly

    3) overstimulation
    Knees have surpassed hips as the number one joint that gets replaced one study from the harvard's brigham and women's hospital found that 1 in 20 people over the age of 50 had undergone surgery.

    It's really not surprising. The complicated structure of joints and cartilage coupled with a lack of protection makes knees especially vulnerable to injury. Knee injuries in turn can lead to osteoarthritis (oa), a form of arthritis that affects your joints. In fact, half of all boomers who suffer tears to knee ligaments and cartilage will develop oa in as few as five years, says patience white, m. D, a rheumatologist and vice president of public health for thearthritis foundation. Other conditions that make knees more prone to pain: bursitis, tendinitis, rheumatoid arthritis, and the inevitable wear and tear due to age.

    While you can't reverse the effects of knee damage or arthritis, you can slow them down. You may even stave off surgery forever, and save yourself thousands of dollars. The best time to do it is now before the pain gets so bad you no longer can play with your grand kids.
    Eel like your sex life is lacking a certain something worry no more, as we have the simple exercises you need to follow for a boost in the bedroom.

    It's a well-known fact exercise isn't just good for the body, but the soul and the mind too. So whack out the lycra and dust off those dumbbells, it's time to get physical.

    Swiss-ball press-up
    Works: shoulders, chest, triceps
    Best for the missionary
    Method: with your legs outstretched, put your shins on a gym ball and manoeuvre into a press-up position. Lower to the floor, then push back up and repeat a rep of 10.

    Hinge bow
    Works: quads (top of the legs)
    Best for: sex positions the aerobix (you're kneeling upright, she arches her back)
    Method kneel on a mat with your knees at 90-degrees, keeping your head and back in line with your thighs, lean back. Hold for 2-3 seconds. Repeat.

    Lying gluteal bridge/pelvic tilts
    Works glutes, hamstrings
    Best for: sex position bent over
    Method: lie on your back with your knees bent, feet flat on the floor and arms outstretched alongside you. Squeeze your bottom and raise it off the floor until your body forms a straight line. Hold for 3 seconds. Repeat.

    Works: leg and bottom
    Best for: getting the blood flowing to places that may energise your libido
    Method stand with your feet a shoulder-width apart making sure your heels stay on the floor as you bend down. Imagine sitting on a chair, holding the position and getting back up outstretch the arms for balance. Do 15-20 reps.

    Kegel exercises
    Works: pelvic floor
    Best for: women, beneficial for greater sexual satisfaction and stronger orgasms,
    Method: tighten your pelvic muscles, hold for five seconds and release. Repeat for five minutes every day.

    Plank pose
    Works: upper arms, abdominals, obliques, thighs and buttocks
    Best for: overall sexual confidence
    Method: lie face down on the floor with the palms of your hands flat to the ground, arms bent. Keeping your weight on the balls of your feet, push your body up with the help of your forearms and palms. Remember to keep your body as straight as possible, hold for 10 seconds and repeat 10 times.

    Weight lifting
    Works: muscle-building on shoulders, chest, and abs
    Best for: men, as it causes the body to produce testosterone
    Method: lift a free weight with either arm on repetitions enough to feel fatigue by the 10th rep.
    While the statistical results of the survey are important, it is essential to remember that behind the numbers are real people. People who care about their sexual satisfaction and about their partner's satisfaction. People who are currently frustrated and even depressed about the effect of back pain on their sex lives.

    So what can they do to improve their situation?
    Most experts agree that three tips can help you have better sex even with back pain:

    Tip # 1: talk it out
    For some people, talking about sex comes naturally; for others, their faces turn red even thinking about maybe talking about sex.

    Nonetheless, you and your partner need to find a way to discuss your back pain, and how it will affect or already does affect your relationship.

    Take the time to talk through the five issues below:

    Back pain: how severe is the pain? where does it hurt? what movements or positions relieve or increase the pain?

    Sex drive: is your back pain killing your sex drive? if it is, then you've got to discuss this. If you simply start avoiding having sex and don't explain why, you're your relationship with your partner can be damaged. It's better to identify that it's a problem, and not just theirs and then find a solution together.

    Emotional impact: what does back pain do to your emotions? do you feel less attractive to your partner? depressed?

    Physical limitations: living with back pain means living with physical limitations in multiple aspects of your daily life. What physical limitations do you now need to work around during sex?

    Intimacy: what physical and non-physical steps can enhance intimacy? (yes, intimacy means more than sex.) within the limitations caused by back pain, what else can you do to feel close and connected?
    Tip # 2: practical changes
    Here we go, the nitty-gritty details of what to do (or not do). (it's okay if you skipped ahead to this part, but be sure to go back and read the rest of the article.)

    Position matters
    It may not be the sexiest thing to think about, but you have to remember your diagnosis as you're having sex. Do you have spinal stenosis? a herniated disc? degenerative changes in your spine? your diagnosis is vitally important during sex because what's causing your pain influences how your body reacts to different positions. For example:

    If you have spinal stenosis, your back pain will likely get worse if you arch your back during sex.

    If you have degenerative disc disease or a disc herniation, your pain will likely increase if you bend forward during sex.
    So if you can identify which positions naturally reduce your back pain, you can then adapt your position during sex to make the experience less painful, given your particular condition. For example:

    Men who have degenerative disc disease may find their back pain during sex is diminished by lying on their back with a pillow placed under their low back, while their partner then straddles them on top.
    Change the place
    As we've learned from hollywood movies, sex doesn't happen just in a bed. And perhaps being out of bed will actually help reduce your back pain. For example:

    If you prefer lying on your back during sex, a firm surface, such as a rug on the floor, may be more comfortable for you.
    But remember, back pain is individual, and perhaps your pain is less during sex if you're on a soft mattress. You need to figure out what's best for you and your partner.

    Relax your back
    Back pain is often made worse by your muscles becoming tense and even knotted around the painful area. Going in a hot tub before sex, having a soothing massage, or even just using heat or ice packs on the affected area can all ease away muscle pains prior to sex.
    Exercise can be broadly categorized as either aerobic, anaerobic or agility training.
    Exercise improves your mood.
    Physical activity after the menopause reduces breast cancer risk.
    Regular exercise improves your sex life.
    Exercise makes you eat less by suppressing appetite hormones.
    Exercise improves your confidence
    Exercise can reduce cigarette cravings for people who are trying to quit smoking.
    Some cancer patients can benefit from exercise; one study explains how exercise can help non-small cell lung cancer patients.
    What is postpartum back pain?
    Nagging stiffness and soreness in your back that makes your postpartum recovery that much more fun (not!).

    What causes postpartum back pain?

    Those wacky pregnancy hormones that loosened your ligaments and joints are still to blame, along with the strained abdominal muscles that have wreaked havoc on your posture. And let's not forget all that pushing you did in the delivery room (as if you could), as well as the bending and baby lifting (and rocking) you're doing around the clock now. Later on, holding your growing baby the wrong way can lead to pain.

    What you need to know about postpartum back pain?
    It takes time for your back to return to normal (whatever that might be for you), so be patient and don't try to do too much too soon.

    What to do about postpartum back pain?
    Easy does it. You can help your back get back to normal by being extra careful about how you use it (which takes some doing, since you use your back almost all the time) and doing a few easy, sensible exercises.

    Stay conscious of how you bend and lift: start the movement from your knees, not your back, when you lift baby, laundry, stroller, etc.
    Don't hunch over when you're feeding or cooing to your baby. A straight spine is a happier spine.
    Start slowly with some gentle postpartum exercise, like pelvic tilts.
    Take a nice warm bath in a very clean, scrubbed tub. (if you're recovering from a cesarean section, ask your practitioner to tell you when it's safe to bathe.) or let a pulsating shower head work the magic.
    Use a footrest to elevate your feet slightly when sitting (and baby feeding). You deserve to put your feet up anyway!
    Try not to stand for long periods of time. Whenever possible, place one foot on a low stool when standing in order to take some pressure off your lower back.
    Get a massage! press your partner into service or, if possible, go for a pro.
    Back pain sends more patients to doctors than any condition other than the common cold. In fact, it's the fifth most common reason for hospitalizations and third most common cause of surgery. And 56% of people with lower-back aches say symptoms disrupt their daily routines, including sleep and sex (consider these 3 best sex positions for back pain). Talk about a pain in the back.

    There are many possible causes of back pain, which means there are also many non-invasive solutions, according to todd sinett, a chiropractor and coauthor of the truth about back pain. Back pain is rarely one catastrophic event, he says in the book, but several situations combining to create pain. And it turns out that some seemingly insignificant everyday habits can take a big toll on your back over time.

    Here, the top 14 mistakes that may be causing your aches and how to correct them.

    1. You're a desk jockey.

    (photograph by Willie B. Thomas/Getty images)

    Did you know that sitting puts 40% more pressure on your spine than standing? let's be honest: maintaining proper posture is probably the last thing you’re thinking about when under a major work deadline. And on a jam-packed day, regular stretching breaks may not seem like a wise way to spend your time. But skipping these habits may cause your back to suffer. That's because back muscles will weaken if you don't use them; inactive joints lose lubrication and age more quickly.

    Fix it: sitting at a 135-degree angle can reduce compression of the discs in the spine, so lean back slightly every now and then. Do it when you take a phone call or a coworker stops by to chat, sinett recommends. Make sure your office chair supports the curve of your spine, he says: your lower back should be supported, and your head should be straight not lurching forward when you look at your computer screen. Get up and walk around for a couple of minutes every half hour take trips to get water, use the bathroom, or grab papers off the printer. (or make your own standing desk with these easy tips.)

    2. You have a long commute.
    Just like at your desk, hunching over a steering wheel can tighten chest muscles and cause your shoulders to round. Slumping posture can zap energy and make you look heavier, not to mention cause back and neck problems. Back pain is the number one complaint of the patients of Darran W. Marlow, director of the chiropractic division at the texas back institute, and he advises them to first think about their driving posture.

    Fix it: Be sure you sit at a 90-degree angle, close to the wheel so you don't have to stretch, he says. Extending your leg puts your back in a compromised position, but many people don't even realize they're doing it.

    3. You skip the gym.
    Research shows that 40% of people become less active after back pain strikes a strategy that's likely to delay healing or even make their condition worse.

    Fix it: In fact, most sufferers would benefit from more exercise particularly frequent walks, which ease stiffness, says spine surgeon raj rao, md. For instant relief, he recommends stretching your hamstrings and hips. You can also try these 4 exercises to end back pain.

    4. You don't do yoga.
    By improving circulation and lowering stress, just about any kind of exercise promotes back pain recovery. But yoga may be best.
    University of washington researchers say yoga eases lower-back pain faster than conventional exercises. In a different study, 101 patients were randomly assigned to one of three groups. The first group took weekly yoga classes and practiced at home; the second group participated in weekly exercise sessions developed by a physical therapist, plus practiced at home; and the third group received a self-help back care book. After three months, the yoga group had better back-related functioning, compared with the other two groups. And after 6 months, patients who took yoga reported less back pain and better back-related functioning. Because it promotes deep breathing and relaxation, as well as stretching and strength, yoga may help with both emotional and structural triggers of back pain.

    Fix it: You can find yoga classes everywhere at gyms, YMCAS, and local studios. Make sure to tell the instructor about your pain so she can help modify certain moves for you.

    More: 5 pain-relieving yoga poses

    5. You're a crunch addict.
    Sit-ups and crunches may actually cause more back pain than they prevent, according to sinett. We hear all the time how a strong core protects your back, which is true. But crunches don't work the ab muscles that stabilize your back. In fact, they can contribute to pain by causing what sinett calls core imbalance, a condition of excessive compression, which results in the spine curving forward in a c-like shape.

    Fix it: You don't have to ditch crunches entirely, but you should do them slowly and use proper form. Include them as part of a broader core workout that also strengthens your transverse abdominus. This muscle is particularly important for a strong, steady core that supports your back, and the best way to strengthen it is with (non-crunch!) exercises like these. Added bonus: you'll whittle your middle and beat hard-to-torchbelly fat while improving posture and relieving back pain.

    6. You're not the best eater.
    Research shows that eating habits that are good for your heart, weight, and blood sugar are also good for your back. Finnish research found that people who suffered from back pain were more likely to have clogged arteries to the spine than healthy control subjects. Healthy circulation brings nutrients to the spine and removes waste, says sinett. If this doesn't happen, inflammation can result, and inflammatory chemicals in the back can trigger nerves to send pain signals to the brain.

    Fix it: a back-healthy diet is one that reduces inflammation, according to the the truth about back pain. The book's plan advises avoiding excess caffeine and processed foods (read ingredient labels for the following: hydrogenated or partially hydrogenated oils, enriched wheat flour, words ending in -iose, and additives that end in -iates or -ites), and eating more whole grains, soy, nuts and seeds, protein (chicken, fish, lean meat), vegetables, and fruit.

    More: 5 foods that help beat chronic pain

    7. Your life's in your purse.
    A stuffed-to-the-gills handbag may cause back damage that's comparable to a sports injury! when you tote a heavy bag, your shoulders become imbalanced, says sinett. Your body elevates the shoulder carrying the bag, which throws your spine off-kilter. Doing this every day can cause back muscles to ache over time.

    Fix it: first, carry the lightest bag possible. (some of today's styles with chains, studs, and other hardware are heavy even when empty.) the american chiropractic association recommends that your bag when fully loaded weighs no more than 10% of your body weight. Alternate which shoulder you carry the bag with from day to day, and consider splitting your stuff between two bags (one for each arm), which will pain proof your load by distributing it more evenly.

    8. Your mattress is really old.
    (photograph by fstop images - dejan/getty images)

    Can't remember the last time you replaced it? your back may be in trouble. A good mattress lasts 9 to 10 years, according to the national sleep foundation, but consider replacing yours every 5 to 7 years if you don't sleep well or your back throbs. A study at oklahoma state university found that most people who switched to new bedding after 5 years slept significantly better and had less back pain.

    Fix it: when you do replace your mattress, take a goldilocks approach: pick one that's not too squishy or too hard. Very firm mattresses can increase pressure on the spine and worsen pain, say spanish researchers. A study of 313 people revealed that those who caught zzzs on medium-firm mattresses were more likely to report pain improvement than those on firmer ones. To help ease nighttime discomfort even more, tuck a pillow under your knees if you sleep on your back, between your knees if you're a side sleeper, or beneath your stomach and hips if you snooze on your belly.

    9. Your bike isn't quite right.
    Do you routinely get a sore back after even a leisurely bike ride? you may need to adjust your equipment. Anywhere from 30 to 70% of bike riders experience some form of back pain, according to jennifer chu, md, an associate professor of rehabilitation medicine at the university of pennsylvania and a chronic pain expert blogger for wellsphere. You don’t need to give up on this great form of exercise, but you should make sure your bike is properly fitted for you, advises says former us olympic cycling coach ed burke, phd, of colorado springs, co.

    Fix it: try this quick test: when you straddle a road bike or hybrid, the bar should be about 1 to 2 inches from your crotch. On mountain bikes, allow 3 to 6 inches. As for your seat height, your down leg should be fully extended when the heel of that foot is on the pedal in the 6 o'clock position. Now put the ball of that foot on the pedal; there should be a slight bend in your knee in the down position. You should be able to keep a slight bend in your elbows and not feel stretched out when holding the handlebars. If your bike isn't adjusted properly, check with a local bike shop or bike club to find someone who can properly fit it for you.

    Another tweak that can help: tilt the front tip of your saddle down about 10 to 15 degrees. This simple adjustment takes pressure off your lower spine and pelvis, research shows. When researchers made this adjustment for 40 recreational cyclists who had back pain, the pain went away in 72% of the group and another 20% reported significant reduction in pain.

    10. You love high heels.
    Or flip-flops. Both lead to foot instability, which can in turn affect your back. High heels force you to arch your back, making your spinal muscles work harder. Backless shoes like sandals cause your feet to move from side to side, according to sinett, which distributes your body weight unevenly and can cause pain.

    Fix it: you don't have to forgo trendy footwear just don't walk long distances in them. Commute in comfy flats or supportive sneakers, and consider adding cushioning inserts to uncomfy shoes. When lehigh university researchers gave back-pain sufferers lightweight, flexible shoes with simple cushions, 80% reported significant relief within a year. (try these 4 exercises every high heel-wearer should do.)
    11. You ignore the pain.
    Trying to block out pain could make it worse, finds research from the rosalind franklin university of medicine and science. A better approach: let yourself consciously experience the hurt. In a standard pain test, psychologists had 68 back-pain sufferers plunge their hands or feet into ice water. When the volunteers were instructed to suppress the shock of the icy water, a key muscle in the back clenched. In contrast, the muscle didn't tense up when volunteers thought only about the shock. Over time, an increase in muscle tension intensifies pain, says lead researcher john w. Burns, phd.

    Fix it: accepting pain may be the best way to mentally cope. try thinking about the sensory details of the experience, not the negative emotions, says burns. if you have a back spasm, describe the pain to yourself if it's burning or throbbing and remind yourself that it will pass.

    12. You hold a grudge.
    To err is human. To forgive could make your aching back feel simply divine. When researchers at duke university medical center studied 58 women and men with chronic lower-back pain, they found that those who practiced forgiveness experienced less anger, resentment, depression and aches. our emotions, muscle tension, and thoughts can directly influence the strength of our pain signals, says researcher James W. Carson, PHD.

    Fix it: forgiveness isn't a once-and-done act; it involves choosing, again and again, to replace anger and resentment with understanding toward someone who has done you wrong. Try this: first imagine someone you love. Think, may this person be at ease, happy, healthy, safe, and secure. Repeat, imagining yourself, then someone you don't know personally. Finally, bring to mind someone for whom you don't have good feelings.

    13. You don't veg out.
    It's not all in your head chronic or acute stress can directly trigger backpain. When you're under the gun, your whole body clenches up, including the muscles in your neck and back. But muscles that contract need to relax eventually, says sinett. If you're stressed all the time and those muscles stay tight, it can eventually cause major pain.

    Fix it: sometimes even just realizing that stress may be at the root of your pain can help, says sinett. Then you can prioritize ways to calm down each day, be it through exercise, laughing with a friend or partner, reading a good book, etc. One particularly helpful therapy, research shows, is listening to music.

    In an older austrian study of 65 people who had herniated disks, researchers found that a combination of music and relaxation imagery significantly reduced lower-back pain. Everyone got standard medical care (painkillers, physical therapy), but half also listened to music and performed relaxation exercises every day. After 10 days, the music group reported less pain while climbing stairs, getting out of bed, and even sleeping. After 21 days, the music group's overall pain was more than 40% less than the nonmusic group. music helps reduce stress hormones and muscular tension, says researcher franz wendtner, a psychologist at the general hospital of salzburg.

    14. You watch too much TV.
    Parking yourself in front of the tube for hours and hours a day doesn't make your back very happy. For one thing, excess tv time is probably cutting into exercise time, and we've already explained how important exercise is to prevent/reduce back pain. In one norwegian study of teens, those who sat in front of tv or computer for 15 hours a week or more were three times as likely to have lower-back pain as their more active counterparts (the average american teen watches three hours of telly a day). They sit with the low back flexed really hunched over for hours, explains lead researcher astrid noreng sjolie, phd, a physiotherapist at hedmark university college in norway.

    Fix it: limit tv to shows you really want to watch, instead of idly channel surfing. And instead of fast-forwarding through commercials, do some stretches or strength moves during the breaks, which will prevent muscle strain from sitting still too long. If you have a kid complaining of back pain, make sure he walks at least one mile daily; this can cut backpain in half and give his still-developing spine a chance to stretch.
    If you have low back pain, your sex position can make or break it, so to speak. Contrary to popular belief, a side position (spooning) is not necessarily best. In fact, it could take the sizzle out of your sex life by worsening pain, according to a 2014 study in the journal spine, which focused on men. Indeed, researchers study such things.

    The study used motion capture technology to track the spinal mechanics of 10 young men while they had sex with their female partners in five common positions. Illustrations were placed on the walls for the couples to follow, though they were given no specific coaching except to move as naturally as possible and to notify the researcher when they had attained their natural coital speed and/or rhythm.

    In randomly assigned order, the couples performed two versions of missionary (front-entry, man on top), two versions of quadruped (rear-entry doggy-style), and spooning (rear-entry, lying on side). The computer then measured the lumbar spinal angles of each position, along with other kinematic data.

    For men with flexion-intolerant backs whose pain is triggered or exacerbated by bending forward the worst sex position would be spooning, the researchers concluded. The quadruped position with the woman supporting her weight on her elbows (as opposed to her hands) was deemed best. And between the two missionary positions, the one where the man supports himself with his elbows rather than hands was more spine-sparing.
    Can epidurals cause back pain?

    Studies have shown that epidural and spinal anesthesia have no effect on post-partum lower back pain.

    When your back pain doesn't go away

    At three years post-pregnancy, almost 20 percent of women with pregnancy-related back pain symptoms continue to report persistent pain. If your pain lasts for more than six months after giving birth, you should visit a chiropractor or other back specialist. For more long-lasting back pain, the cause is often situational, such as poor posture, that started during pregnancy and was never corrected.

    Why your back hurts more at night
    When we perform weight-bearing activities throughout the day, our joints become increasingly swollen and irritated. The result is more pain at the end of the day.

    If you suffer from lower back pain after giving birth, you're not alone. Almost 50 percent of women will suffer from lower back pain in the first few months after having a baby. Here's why: increased hormones can lead to lower back pain during pregnancy, the body releases relaxing, a hormone that relaxes the joints and ligaments in your pelvis to make it easier for the baby to pass through the birth canal. Unfortunately, this instability also increases the risk of inflammation and joint misalignment, which can lead to lower back pain. Relaxing levels remain elevated for three to four months after you deliver. Once they return to normal, most pregnancy-related lower back problems should subside.
    Begin exercising soon after delivery to restore abdominal and back muscle tone. Ten minutes of stretching exercises on the floor each day will restore hip and back flexibility. This can be done when the baby is taking a nap.
    Try to get back to your normal weight within six weeks after giving birth.

    Do not stretch your arms out to pick up your baby. Bring him or her close to your chest before lifting. Avoid twisting your body.

    To pick a child up from the floor, bend at your knees (not at your waist), squat down, tighten your stomach muscles, and lift with your leg muscles.

    Remove the high chair tray when you are trying to put the baby in or take the baby out of the high chair.
    When picking the child up out of the crib, put the side down and pull the child toward you rather than lifting over the top.

    Consider using a front pack to carry the baby when you are walking.
    Do not carry a child on your hip; this overloads the back muscles.
    To avoid upper back pain from breastfeeding, bring the baby to your breast rather than bending over to the baby. Use an upright chair rather than a soft couch.

    Four-door vehicles are better than two-door vehicles for ease of placing the child in the car seat. With the car seat positioned in the middle of the back seat, do not stand outside the car, reach in, and, at arm's length, try to put the baby in the seat. Instead, kneel on the back seat to place the baby into the car seat.
    Lower back pain has gradually become almost a menace for all, thanks to the sedentary lifestyle which requires a working person to sit for practically the whole day. Lack of movement makes the muscles of our low back so weak that we cannot do anything else than to suffer from lower back pain. However, there is a good news that one can easily get rid of lower back pain, with regular exercises for lower back pain relief. Yoga is one of the most effective exercising mediums for keeping one's body healthy and fit. It has innumerable yoga poses for each body part including lower back.

    Yoga poses for lower back pain relief:
    There is no doubt about the fact that there are various yoga exercises that can get one rid of low back pain but many of them are quite demanding. As most of us are not in the habit of exercising regularly, our body gets stiff and many of the yoga asanas (asana is a hindi term which means pose) want a flexible body to bend as required by the exercise posture. However, there are at least 5 yoga exercises that do not demand too much from our rigid body and we can easily do these yoga poses to get rid of low back pain. The name of these five yoga poses are salabhasana, bhujangasana, setubandhasana, supta udarakarshana and marjariasana.

    Ardha salabhasana- locust yoga pose for lower back pain relief

    Lie down on floor on stomach keeping your with chin touched on the ground
    Place both your hands below the thighs. Keep the palms facing up
    While inhaling, lift up your right leg as high as possible. Do not bend the knee.
    Hold the leg in air while counting till five.
    Now while exhaling, bring your leg down.
    Again while inhale inhaling, lift up your left leg up, hold till you count five and while exhaling, bring the leg down.
    Repeat the process for five times with each leg alternatively.
    When you are comfortable with doing ardha salabhasana, you can start doing salabhasana where you must lift both your legs at the same time.

    Salabhasana yoga pose make muscles at the back strong along with those of hips, legs and the thighs. This is one of the best yoga exercises for low back pain relief and also increases your stamina.

    Bhujangasana- cobra yoga pose for lower back pain relief

    Lie down on stomach with stretched feet, heels, toes and knees kept together
    Let your chin touch the ground.
    Keep your palms by the side of your chest. Fingers will remain below the shoulder line.
    While slowly inhaling, lift your head, neck and chest off the ground. Don't take them too high. Your elbows will remain bent and closer to body. Keep looking up
    Hold the position for a count of 5 (about 30 seconds)
    While exhaling, bring the upper part down.
    Repeat the exercise for three times.

    Bhujangasan or the cobra pose strengthens your back, especially the lower back by releasing all tension along the back.

    Sethubandhasana- pelvic tilt yoga pose for lower back pain relief

    Lie down on your back with legs folded at the knees, keeping feet flat and as close to the hips as possible. Keep the feet a little apart from each other.
    If possible, hold your heels with both the hands otherwise let your hands lie down at the sides with palms down.
    While inhaling, lift your waist as high as you can. Hold for about 20-30 seconds.
    While exhaling, bring down the waist.
    Repeat for five times.

    Setubandhasana or the bridge yoga pose is good for over all pelvic muscle strengthening and give relief from low back pain in the process.

    Supta udarakarshan- spinal twist yoga pose for lower back pain relief

    Lie down on your back, keep the feet together and arms perpendicular to shoulders with palms facing and touching the ground.
    While inhaling, lift your right leg up at 90 degrees or as high as possible. Keep the leg straight.
    Now take the leg twisting on to left while exhaling. Simultaneously turn your head to right.
    Hold for a 30 seconds and bring back the leg and head to earlier position.
    Now repeat the process with left leg, lifting the left leg up, twisting towards right while keeping the head on left.
    Repeat for six times.

    Spinal twisting with alternate leg raising will strengthen your lower back muscles giving you relief from low back pain.

    Marjariasana- cat stretch yoga pose for lower back pain relief

    Kneel down on your hands and knees, keep your hands directly beneath the shoulder and knees beneath the hips. Knees can be kept a foot apart from each other.
    Now inhale while curving your spine downwards and then exhale while making an arch like pose with your spine.
    While doing the exercise, gaze towards your navel area. Don't bend your arms, keep them straight.
    Hold this yoga pose for a few seconds.
    While inhaling return to the first position of curved spine.
    Repeat this for at least ten times.

    Marjariasana yoga pose or the cat pose is a good stretching exercise for your back, torso, and neck and improves spinal flexibility thus giving relief from low back pain.

    If you make the habit of doing these yoga asanas everyday, preferably twice (morning and evening), you can hope to get rid of lower back-pain in considerable period of time. Also when you continue doing these yoga exercises after your back pain is gone, there is no chance of your lower back pain returning to you!
    Dyspareunia is a term used for pain felt in the pelvis during or after sexual intercourse. Nobody really knows exactly how common it is, as many women never seek medical help. However, questionnaires asking women if they have symptoms suggest that somewhere between 1 and 4 out of 10 women experience it. Most commonly, this is early in their sexual lives and around the menopause.

    There are many causes of dyspareunia, most of which are not serious or damaging in nature, but all can be detrimental to your sex life and ultimately may lead to relationship difficulties. It can be a vicious cycle, with pain leading to nervousness about sex (intercourse), and nervousness leading to dryness and further pain.

    It's also not uncommon for dyspareunia to remain after the cause has been treated, particularly if things have been left untreated for a while. For this reason, it is important to seek help early, so that treatable causes can be discovered and managed. This leaflet discusses the types and possible causes of dyspareunia.

    What is dyspareunia?
    Dyspareunia (pain felt in the pelvis during or after having sex (intercourse)) may be thought of as either superficial dyspareunia or deep dyspareunia. They have different causes and treatments, and although it's possible to experience both at the same time, most women find that their dyspareunia is predominantly one or the other type.

    Superficial dyspareunia:
    This is pain felt in the vulva, at the vaginal entrance (introitus) and the lower part of the vagina. It typically begins with penetration or very early on after intercourse has begun, and is sore and instant. It is usually quickly relieved by stopping penetration, although you may be sore to the touch afterwards for a little while. The causes of superficial dyspareunia are usually local problems of the vaginal and perineal skin (the perineum is the area of skin between the vaginal opening and the back passage).

    Deep dyspareunia:
    This is the term for pain felt deeper in the pelvis during or after intercourse. It can also spread to involve the fronts of the thighs. It may be sharp or dull, may stop when penetration stops or can continue for minutes or even hours. The causes of this type of pain usually lie rather deeper in the pelvis.
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Dr. Paolo Ortelli
Dr. S K Sinha
/ Ortho Neuro Physiotherapy Clinic
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