Back pain is something that affects many people all over the world. Persistent and chronic pain seems to be one of the most common complaints. Middle back pain is back pain that is felt in the thoracic vertebrae region, which is located between the base of the neck and top of the lumbar spine. The ribs attach to a long, flat bone in the middle of the chest called the sternum and wrap around the back. In case, there is a nerve around there is squeezed, disturbed, or injured, you are likely to feel pain in different spots where the nerve goes through, for example, your arms, legs, chest and the stomach.

Some of the most common causes of middle back pain are as follows:

Middle back pain can happen as a consequence of injury or sudden damage or it can happen through strain or poor stance after some time.
The most widely recognized reason for middle back pain seems to begin from soft tissue problems or muscular irritation. These can emerge from poor stance, lack of strength, prolonged sitting in front of a computer, utilizing a heavy backpack, overuse injuries, (for example, repetitive movement), or injury, (like a whiplash damage brought about by an auto crash or as a consequence of a sports injuries).
The middle back is a moderately normal site for inflammatory, degenerative, metabolic, infective and neoplastic conditions.
Middle back pain and its dysfunctions are connected with various conditions, for example, essential and optional osteoporosis (particularly vertebral cracks and hyperkyphosis emerging from vertebral bone loss), ankylosing spondylitis, osteoarthritis and Scheuermann's infection.
Muscle strain, overuse or damage to the muscles, tendons, and discs that are backing your spine can also cause middle back pain.
Weight on the spinal nerves from specific issues, for example, a herniated disc.
A fracture in one of the vertebrae can also cause pain in this region.
Osteoarthritis created by the breakdown of ligament or cartilage that cushions the little joints in the spine.
Myofascial pain that influences the connective tissue of a muscle or gathering of muscles.
In uncommon cases, pain might be brought about by different issues, for example, gall bladder disease, cancer or an infection.
Getting hit hard in the back can also cause chronic pain.
Lift something too heavy may cause pain and a sudden pressure in this area.
A compression fracture of the vertebra can also bring about intense or chronic pain in the middle back. The injury may bring about a fracture, however in ladies over age 50 without critical injury or somebody known to have osteoporosis, an unconstrained vertebral fracture is possible.
Other contributing factors to injury include lack of strength which can be treated by a Pain Management Specialist using non-surgical methods.

Common Causes of Middle Back Pain

What is paralysis?
Paralysis is a loss of muscle power and function of any part of the body. It is seen in the form of weakness of body parts, loss of sensation, and loss of movement of that part.

What is physiotherapy and why it is used?
Physiotherapy includes massage, therapeutic physical activities, scientific procedures, and education. Physiotherapy should be started as soon as possible, and it needs to be regularly followed, on a daily basis to see its best results. If it is not done under the proper guidance, it may worsen the condition of the patients. It is helpful in the following ways:

Helps to improve blood circulation and relax muscles
Slows down the progress of paralysis
Improves muscle tone
Maintains the respiratory function
Prevents pressure sores and contracture in the bedridden patients
Helps to build up strength in the affected muscles which helps to prevent the limbs from becoming deformed
Helps in building up the motivation and morale of the patient
Helps improve balance and coordination of the muscles
What therapies are included in it?
It includes the following therapies:

Aerobic exercises: It encourages a rapid exchange of oxygen to muscle tissues which increases sensory and motor function.
Method of physical conditioning: It is conducted via active or passive ranges of motion which help improve the muscle strength and also help the patient to adapt or learn how to use the paralyzed limb.
Exercises: Exercises, such as hip rotation exercise and its variation, ankle rotation exercises, and toe rotation exercises are advised in lower limb paralysis.
Electric stimulation therapy: It helps restore the motor function in paralyzed patients where electrical stimulation is done via a low-frequency device.
Mobility aids: Mobility aids, such as a wheelchair, help to move from one place to another place.
Hydrotherapy pool: It helps assist patients to overcome conditions where movement is limited because of paralysis and where muscles are weakened.
Massage therapy: Massage therapy helps regain control of muscles and boost the range of motion by improving blood circulation to the affected part.
Hand muscle exercises: It includes exercise with the balls or any other toy to improve hand grip and muscle power.
Speech therapy: In patients with aphasia, speech therapy is given to improve the speech.
Parallel bars: It helps practice walking and balancing when there is impairment.
Physical training: In physical training, various exercises are taught to improve the muscle strength of the affected part.
Use of teaching transformers (wheelchairs, bed, car, or toilet): It helps improve safety and also promotes independence.

Role Of Physiotherapy In Patients With Paralysis!

Arthritis is a disease usually associated with elderly people, but it can also affect children. When arthritis affects children, it is known as juvenile rheumatoid arthritis. This disorder affects the musculoskeletal structure of a child and can cause pain, stiffness and swelling in the muscles, joints, ligaments and bones. In some cases, it can also affect the internal organs. With medication and therapy, the symptoms of this disorder can be managed and the quality of the child s life can be improved.

Hence, it is important to recognise the signs and symptoms of this disease. Some of the symptoms to look out for are:

Pain: Complaints of pain in the joints or muscles on waking up from bed can be a sign of juvenile arthritis. This may affect a child s jaw, neck, hands, knees and feet. For most children, moving around helps relieve some of the pain. Unlike the pain triggered by an injury, this kind of pain develops slowly and affects both symmetrical joints.

Joint stiffness: Children affected by this disorder may complain of stiff joints which hamper normal movement and activities. As with pain, this stiffness is usually worst in the morning and improves with movement.

Swelling: Redness and inflammation of painful joints is another symptom of this disorder. The joint may also feel warm to touch. This swelling may come and go or persist for several days. The joints of the hands, feet and knees are most susceptible to swelling.

 Fever: Frequent fever accompanied by fatigue can indicate juvenile arthritis. These fevers usually come on suddenly and are relieved after a short time. Also, they do not exhibit any signs of respiratory or stomach infections.

Rashes: Rashes that are symptomatic of this disorder appear commonly over the knuckles, nose bridge or on the trunk, arms and legs. This often takes the form of a faint, pink rash that persists for weeks but unlike other rashes, it does not itch or ooze.

Weight loss: Drastic weight loss and an unexplained loss of appetite can also signal this disorder. In such cases, the child may also appear fatigued and showcase symptoms of associated malnutrition disorders.

 Eye problems: Persistent troubles with eyesight such as pain, blurred vision and redness of the eye can be a sign of juvenile arthritis. In some cases, this disorder also causes the iris and uveitis as well as the middle layer of the eye to appear inflamed. If you wish to discuss about any specific problem, you can consult a rheumatologist.

Juvenile Rheumatoid Arthritis - 7 Signs Your Child Is Suffering from It!

The problem of morning back and neck pain may be due to the position of sleeping or it may be related to inflammatory arthritis which can be familial. Morning back pain is largely related to wrong sleeping posture and less commonly due to arthritic conditions like Ankylosing Spondylitis or Rheumatoid Arthritis. Whatever be the cause- this condition requires attention by an Orthopedic doctor as it may worsen in due course of time and should not be taken lightly. 

Some common factors causing this are: 

Mattress: Too soft or too hard a mattress might induce back ache after sleep. For people with waist and hips of equal proportion, a firmer mattress would do well. For those with narrower waist than their hips, a flexible and softer mattress that can move with the pelvic weight would be a perfect choice. Refrain from using old hardened mattresses. 
Pillow: The pillow you use must be able to render support to your neck naturally. Instead of using excessively firm or soft pillow, try substituting it with memory foam pillows, refillable water pillows or cervical support pillows. 
Posture: Not changing your position while sleeping or sleeping on the belly exerts strain on the back muscles, causing pain. On the other hand, sleeping on the back or on the sides causes comparatively less strain on the spine. 
Other causes such as strenuous workouts or physical activities or sitting at a stretch during the day might cause pain while sleeping or after getting up from bed. 
Remedies for Morning Back Pain: 

Fortunately, there are some home remedies to cure the morning back pain. 

Switching your mattress is a more expensive remedy for back pain, but may often be the ultimate cure. Most people sleep the best on medium-firm mattresses. Be sure to try out the mattress before you buy it. 
For occasional back pain after sleeping, apply heat to your back to relax your muscles before you go to bed and when you get up in the morning. 
Massage your back with pain relieving creams and apply heat on it with a heating pad for quick relief. 
Specific spinal stretching exercises and Planks (a type of exercise) can greatly help in easing back pain, if done on a regular basis. 
It is always recommended to CONSULT an Orthopaedic doctor if you suffer from morning back pain.

Morning Back Pain And Neck Pain

Most of us suffer from lower back pain at some point in our lives; be it from a sedentary lifestyle, spending hours at the office desk or from strenuous physical exercises. In most cases, a little bit of rest does the trick. However, if the lower back pain persists for 3-6 weeks, physiotherapy is recommended.

How does physiotherapy help?

The main purpose behind physiotherapy is reducing lower back pain and increasing muscle and bone function, so that such instances are avoided in the future. Physiotherapy is the first line of defence against lower back pain. More drastic measures such as surgery are undertaken once physiotherapy fails to do is job.

Physiotherapy is often recommended when the back pain is caused due to lifestyle factors, a minor injury like a fall or other moderate factors. For more severe back injuries, doctors recommend surgery straight away when there is no scope of performing physiotherapy.

Low-intensity back pain can be cured using a combination of heat packs, ultrasound wave therapy and Iontophoresis (using a localized current source to introduce medical ionic compounds to the body).

A physical therapy program for back pain usually has two components:

Passive physical therapy to help reduce the patient's pain to a more manageable level

Active exercises

Passive Physical Therapy - Modalities

The physical therapist may focus on decreasing pain with passive physical therapy (modalities). These therapies are considered passive because they are done to the patient. Examples include:

Heat/ice packs

TENS units

Iontophoresis

Ultrasound

Active Physical Therapy - Back Pain Exercises

In addition to passive therapies, active physical therapy (exercise) is also necessary to rehabilitate the spine. Here are some of the common exercises for back pain:

Back Stretch: Put your hands underneath your head while lying back. Bend your knees but put your feet on the ground. Roll your legs to one side and hold them there for 10 seconds. Repeat three times for each side.

Deep Lunge: For this, you need to kneel on one knee with the other foot pointed towards the front. Lift the back knee up and hold it there for five seconds and then bring it down. Repeat this exercise three times for each side.

One Leg Stand: This is the simplest of exercises. Hold on to a wall for support while standing and face towards it. Then slowly hold one leg and bend it behind you. Hold in the same position for five seconds before bringing it down. Repeat the process three times for each leg in five second gaps.

Physiotherapy for Back Pain

Fibromyalgia is a musculoskeletal disorder that is more prevalent among women (in the age group between 25 - 60 years) than men. The condition often results in muscular and joint pain along with extreme tiredness. Further, there may be severe headaches, body stiffness, insomnia or sleeping disorders, high sensitivity to extreme temperatures, abdominal pain, Irritable bowel syndrome and also Fibro Fog ( a condition triggered by Fibromyalgia, whereby an individual is unable to concentrate on anything). In some, the condition can trigger severe anxiety, stress, and depression.

While discussing Fibromyalgia, it is important to mention about the Tender Points or Trigger Points. These are delicate points and areas located throughout the body where even a gentle tap or pressure is enough to cause pain. Some of these trigger points in Fibromyalgia include:

upper chest.
back of the head.
knees.
top of shoulders.
outer elbows.
hips
Some of the common factors that play a significant role in triggering Fibromyalgia are

Stress and Trauma: Fibromyalgia may be an outcome of extreme physical, mental and emotional turmoil (which often creates a hormonal imbalance) or Post-Traumatic Stress Disorder.
Fibromyalgia may be linked to genetics and hereditary. People with a family history of Fibromyalgia are more susceptible to the painful condition.
In some individuals, an autoimmune disorder such as Lupus or Rheumatoid Arthritis can also be a contributing factor resulting in Fibromyalgia.
Acupressure to treat Fibromyalgia

People often opt for Alternative Therapy to treat Fibromyalgia. Individuals with Fibromyalgia benefit immensely from Acupressure. Acupressure is a popular alternative therapy that finds its origin in China. It channelizes upon the use of pressure at certain points in the body to ease the pain. Some of the acupressure points that are often used to relieve the pain, especially related to the Post-Traumatic Stress Disorder, in Fibromyalgia include:

Stomach 36 (ST 36): ST 36 holds great significance in providing a soothing and calming effect in people with extreme stress and anxiety (one of the critical symptoms associated with Fibromyalgia). ST 36 is located in the depression of the tibia (lateral side), at a distance of about four fingers downwards from the patella or the knee. Gently and slowly massaging the point for 3-4 minutes is said to provide great relief.
Ren 17: Another acupressure point that goes a long way to lower the anxiety and physical stress is Ren 17 or the chest center. This acupressure point is the middle of the chest (anterior midline), at the fourth intercostal space from the second rib downwards.
Ear Shen Men: The Ear Shen Men is an important acupressure point in the triangular fossa, at the upper region of the ear. People with physical and emotional stress benefit from this acupressure point.
Pericardium 6: The Pericardium 6 is in the mid arm region (lower and inner part of the arm) between the two tendons at a distance of four fingers from the wrist crease. In addition to a great soothing effect, Pericardium 6 is beneficial for people with nausea.
Yintang: Nothing works more like the Yintang to relieve stress and anxiety. The acupressure point in between the eyes at the eyebrow level.

Role Of Acupressure In Treating Fibromyalgia

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