Back pain is one of the most common debilitating disorder in the world today. The pain affects 90% of people at some point of their lives. Human back comprises of various structures (see figure) which are nerves, bones, muscles, ligaments, and tendons, any or all of which can be a source of pain. Once back pain occurs, it may become chronic (more than 4 weeks) and you shall need to consult a pain physician for relief and accurate diagnosis.
Since prevention is always better than cure,  you can save yourself from having back pain if you follow these basic tips.
Regular Exercise in Correct Form: Regular exercise is important to maintain proper muscular strength of the back. Human back is supported by several big muscle groups (see figure). They serve two functions - one is to facilitate the posture and movements of the back itself and the other is to help movements of the rest of the body appendages (arms, head, pelvis and legs).The health of these muscle group is important to take stress off the spinal bones and maintain proper function. Most of these muscles are red muscle fibers as they need to maintain their activity for prolonged periods of time. Just to give you an idea - your biceps (arm muscles) have to work only when you bend your arm. But your back muscles have to function all the time - whether you sit, walk, stand or even sleep. But the point is what kind of exercises are good for your back? The best exercises for back include body weight low impact aerobics like brisk walking, swimming, stationary bicycling, extension exercises and yoga. What is important to remember while doing these exercises if that you need to be gentle in your movements and achieve correct "form" - this is possible if you can ask someone (preferably a trainer) to observe and point out whether the back stays straight during the exercise. It has been seen that arching and excessive bending is associated with injury to the back while exercising.
Stay Hydrated and Eat Natural Nutritious diet:The inter vertebral discs contain 70 - 80% water. The muscles and tissues have 60% water content. Therefore, it is important to stay hydrated. In addition, you must eat a nutritious diet consisting of green leafy vegetables, good protein source and just enough carbohydrates. Deficiencies of essential nutrients like Vitamin D can result in diseases like osteoporosis. Another important aspect is to maintain body weight within healthy limits. This is very important as increased belly fat is linked to increased back pain due to mechanical factors.
Lift objects correctly and maintain proper posture:While lifting objects, keep them as close to body as possible. Do not slouch or bend excessively while lifting. Just keep your back straight at all times. You may bend your knees a little if required (see figure). Think before you lift and get help if needed.
While working, you must not sit for more than 45 minutes at a stretch. Walk for two minutes, go to a colleague's desk and say hi or even just drink some water or visit the washroom. Humans evolved as hunter - gatherers and our bodies are more adapted to walking / standing than to sitting for prolonged periods. Those of you who travel more and have to sit for long periods of time also need to follow above tips - avoid prolonged sitting in same posture.While exercising, improper position can do more harm than good. Therefore, proper form and posture is a must.
Bonus tip: Avoid cigarette smoking and those who smoke cigarettes to decrease your chances of having degenerative disc diseases leading to chronic back pain early in life.
Word of caution to prevent permanent damage: In case of back pain, which is not responding to home remedies or over the counter painkillers, please contact a Pain Physician to pinpoint the diagnosis and appropriate management.

3 Essential Tips to Prevent Back Pain

Knee pain is one of the most common and painful ailments that can limit mobility. Injuries can result in cartilage or meniscal tears or sprains too. Obesity is another reason because of which knee pain is on the rise. Also, regular wear and tear of ligaments and tendons around the knees due to old age is another cause. These days, with reduced physical activities and sedentary lifestyles, the rate at which knees are wearing out has also become accelerated. Whatever the reason, a correct diagnosis followed by prompt treatment can help. Over the years, physiotherapy has been playing an important role in treating knee injuries. Whether to supplement the various drugs to reduce pain and inflammation or to avoid surgery, physiotherapy has helped many and its popularity is growing every day. Here are some ways that physiotherapy can help reduce pain.

Improve flexibility of tendons: The knee cap is an area where there are lot of tendons and ligaments, coordinating to enable movement. Careful exercising can ensure that the flexibility of tendons and ligaments is improved, thereby making your knee movement easier and less painful.
Improves blood supply: As we all know, proper movement requires good blood supply. Exercising with special focus on the knee ensures that blood supply is improved, and thereby the supporting ligaments and tendons function optimally.
Enhances the knee cap function: The knee cap is that portion which joins your thigh bone to your calf bones. This is prone to slip out of place, especially with arthritis and injuries. This can be painful and limit movement to a great degree. Focused exercises aimed at improving knee cap function will ensure that the knee cap has a wider range of function, and does not slip out of its socket easily.
Reduce rigidity: Once you start physiotherapy, you will feel your knees getting more flexible. The rigidity that had set in as a result of injuries and/or old age will also reduce over a period of time.
Slow down the wear and tear: When you start physiotherapy after knee damage, continuing the exercise routine, of course with expert guidance, can reduce the pace at which further damage might happen. A word of caution though. Be sure to consult an experienced physiotherapist before you begin. Exercising in a bad manner can do equal or more harm than the original injury or old age itself.

Knee Pain and Physiotherapy

It is normal and alright to feel pain in the knees occasionally after a physical activity or prolonged walking. However, it is a serious cause of concern if the pain is experienced every now and then. Not responding to your knee pain for long can lead to the extreme disability. Knee pain does not crop up in a day and it may surprise you when it first appears. 

Initially, you may notice slight pain and discomfort. If you have identified knee pain at this level, managing it is easy. You can perform different exercises to prevent pain from occurring. If the pain severe, you need to go consult a doctor, who will then help identify the real cause of pain. The following exercises, along with medications, can help you overcome knee pain and restore the mobility of the joint.

Stair Step ups: Choose a comfortable stairway. Place your hand on the wall or banister. This is to ensure that you are balanced. Your left foot should be on the taller step. Your right foot should be on the ground. Stay in this posture for a second. Now, step back, and bring left foot to the right foot. Repeat this 6 times. Reverse the legs and continue doing for 6 times. If you want to take rest between the steps, feel free to do so.
Ups and Downs: You need an armless chair that is strong. Sit on the edge but comfortably. Your arms should be at your side, relaxed and loose. Sit erect and your feet should be flat. If you feel you need balance, and then cross your arms. Start standing up. This should not be instant but deliberate, controlled, and gradual movement. Stand slowly up to the full height, and hold on for 2 seconds. Again sit down. Repeat this 5 times.
Straight Leg Raise: This can be a part of your everyday exercise regime. This is a strengthening workout that does not put too much effort on the knees. Lie down on your back. One leg should be straight on the ground and the other one should be bent. Now, slowly lift the leg that is straight, and the toes should point upward. Raise your leg up to 30 degrees, but you can start with 15 to 20 degrees in the initial stage. Repeat 15 times and perform at least 3 sets of this exercise. Keep alternating legs. This workout strengthens the knees, thigh muscles, and the ankle joints, thus offering multifold benefits.
Wall Hamstring Stretch: Hamstring muscles too can be the cause of knee pain and discomfort. To strengthen the hamstring muscles and alleviate knee pain, this exercise helps a lot. Lie down on the floor flat. Your feet should be flexed. Choose a space that is close to a wall, or a sturdy table. Your right leg should be propped on the wall or table. If you don t prefer any, a resistance band is a good alternative. When stretching, you can find your flexibility level and when you feel that you have reached the deepest point, start relaxing. Keep alternating contracting and relaxing every 5 seconds. After 10 to 15 sets, you can try the same with the left leg.
Knee Rolls: Use an exercise mat or a carpet that is cozy. Lie on your back. Bend the knees, and ensure your feet are flat. Your arms should be stretched on the sides. Look at the ceiling, and hold the knees together. In the same posture, slowly roll the knees towards the right. When you feel a gentle twitch or after 5 seconds, move to original position. Then lower the knees to the left. Hold and release. For each side, repeat 10 times.
These exercises strengthen the knees and improve the quality of life by bidding bye to the pain. Understanding that these are magic remedies that work overnight is the key to stay focused and keep going without quitting.

Exercises That Can Help Relieve Knee Pain!

People who suffer from arthritis are more likely to experience osteoarthritis symptoms. The intensity of the feeling of knee pain in winter is often linked to barometric pressure. In winter, there is a reduction in the pressure exerted by the air around us. This drop in pressure can cause the tissues around the joints to swell resulting in increased pain. The other possible cause of knee pain in winter can be explained from the influence of heat. Fluid in tissues becomes more viscous during winter. As a result of this increased viscosity, the elasticity of the muscles decreases, resulting in winter aches and pains. 
Some scientists believe that the higher pain intensity in winter is to be more of a psychological thing. Seasonal affective disorder is more during winter, and people suffering from mental depression seem to sense more pain during winter as the weather restricts outdoor activities. Improper intake of food also causes knee pain in winter due to undigested material. Even though winter arthritis is uncomfortable, the following tips help to make the joints work better and make you withstand the season easier.

Tips to Manage Joint Pain in Winters

Physical activity in winter can reduce winter aches and pains and enhance overall health benefits. Low impact activities like aerobics, swimming in a heated pool, weight training, and riding a stationary bicycle can reduce stiffness, increase the blood flow, and support the knees. Thus, winter arthritis can be well managed by doing exercises.
Diet also plays a vital role. Eating a balanced diet that comprised of low saturated fat, lean proteins, more fiber, and refined carbs helps to improve body functions during the winter. Drinking water throughout the day helps to reduce winter aches and pains. It is essential to consume easily digestible foods like vegetables. Consuming vegetables like carrots and cucumbers that have diuretic properties can help to eliminate waste products from the body.
Vitamin D deficiency may worsen osteoarthritis. It is necessary to take a supplement vitamin D or ensure to make your diet is vitamin-D rich. Fish oil is a potent source of omega 3 fatty acids. Increase your intake of milk, a rich source of protein and calcium that help to strengthen the bones. Exposing the body to sunlight help to obtain vitamin D.
Non-steroidal anti-inflammatory drugs such as aspirin and ibuprofen can be used to reduce inflammation and pain. Injecting a viscous substance can decrease the friction of the bones and ease the condition.
Home Remedies for Knee Pain in Winters

Wrap the inflamed knees with blanched cabbage leaves. This can cool down inflamed knees.  Aloe vera also helps to reduce inflammation.
Comfrey (symphytum officinale) can act as an anti-inflammatory agent. Create a compress using mashed root or comfrey tea soaked bandages can also be used to reduce inflammation.
Applying an ice-pack can help to reduce swelling and alleviate winter aches and pains. While applying ice-pack, ensure to cover the entire knee. Applying a bag of frozen peas to the area also works well. While using ice or heat therapy, make sure to do them carefully as over agressive and over doing it, can cause problems. 
Steam therapy also helps to reduce pain in your knees. Soak your knee in a steaming hot water for 15 minutes. Applying hot water bag also can relieve knee pain in winter effectively.
Winter aches and pains all over the body can be relieved by administrating massage therapy by a professional.
Avoid applying strain or pressure on your knees. Take adequate amount of rest to reduce pain and swelling.
These are basic guidelines to help you. Contact your doctor for further management.

Tips For Managing Joint Pain in Winter

Neck pain is fairly common among adults. It results from the soft tissues such as ligaments, muscles and tendons. It can result from spasms and muscle strain from neck problems such as disc degeneration and spinal stenosis. Be it a chronic pain or a sudden one, addressing it is important to get on with the daily office life. 

Here is a list of some quick solutions, which when followed can give considerable relief from the pain:

Computer should be at eye level: While sitting at it you must ensure that the middle of the computer screen is parallel to the eye. If it is required that you bend your neck to view the screen, then you should adjust the screen, without bending your neck. This happens most often while working with a laptop. The chair length can be adjusted to fix this problem.
Refrain from neck straining while typing: If typing requires straining the neck, it should be ensured that the same doesn t happen. This is the case while texting in a mobile. A better solution is to fix this is to take the mobile at a level which does not require the neck bend down. It will ensure that the joints and discs of the neck are not stressed.
Use headset: If the work demands longer time on the phone, instead of bending the neck it makes sense to use a headset. Practicing the chin tuck exercise can help in this case. This exercise can strengthen the soft muscles of the neck. It also maintains the alignment of the head and the shoulder.
Stay hydrated: Enough hydration is necessary to ensure spinal alignment and disc height. Hydration also takes a eases the spine and relaxes the soft muscles. A practice of adequate hydration throughout the day can help stop the degeneration of the cervical disc. While drinking water is a matter of practice, keeping a water bottle serves as a constant reminder to drink it throughout the day. Keeping an alarm after 2 hours also serves as a constant reminder to drink water.
Carrying weight: One common mistake committed by most people is to carry weight with one hand. Since the load doesn t distribute evenly, it strains the neck muscles causing pain. It should be ensured that the office briefcase or the heavy purse is carried with equal stress on both the shoulders. This will ensure a painless day at the office.
Maintaining a good posture: Poor sitting or walking posture is often the cause of neck pain. While sitting it should be ensured that the back is straight and rests in the chair once in awhile. The neck and head should fall in a line while working.

Neck Pain at Work - 6 Tips to Help You Prevent it

Exercises to cure long hours of sitting
Most of us are used to sitting throughout the day, willingly or unwillingly due to work or otherwise. We spend more hours sitting, and most of our work is done in this position. The downsides of this are many, one of them being a stiff back which not only causes a lot of pain but also initiates many other health problems.
Train yourselves on these highly effective exercises which minimise the pain and keep your muscles active.

1. Back press: put towel on your back and press the towel with the back. Hold that position for 10 sec. Repeat 10 times. Do not hold your breath while applying pressure at the back.
2. Bridges: lie on the floor, bend your knees and secure your feet on the ground. Raise your hips upwards so that your body forms a straight line from your shoulders to your knees. Release and go back to previous position.
3. Knee to chest exercise: just lie down on an exercise mat, bend your one knee while lying and try to touch that knee to the stomach. Hold it for 10 seconds. Repeat this with the other leg. Alternate the legs each time.
4. Bilateral knee to chest: bend both the knees while lying on bed. With support of your hands try bringing both bent knees to touch the stomach. Hold that position for 10 seconds. Repeat 5 times.
5. Static abdominal exercise: lying on your back, try to contract your stomach without holding your breath. Hold it for 10 seconds. Repeat the exercise for 7 or 10 times.
6. Knee to opposite chest: lying on your back, bend your knees. Try bringing one knee to opposite side of the chest and hold that position for 7 sec. Do this for 7 times and repeat the same for the other leg too.
7: leg swings: these are easy and fun. Stand by the wall, hold on to a rod or something similar to keep balance. Now with the leg that is not towards the wall, swing. Swing your leg from front to back, left to right. Do not be too quick, do this at a mediocre pace. Repeat with the other leg.
8: static glutei: lying on the stomach, squeeze your buttock and hold it for 10 seconds. Repeat 10 times.

General precautions:
1. Avoid bending instantly after or during the exercises. Incase you have to bend, first bend your knee then bend your back to pick up anything from ground.
2. While getting up from bed first turn to one side while lying, sideways then get up from bed slowly.
3. Apply hot pack in back whenever there is pain.
4. Try to sleep in hard part of mattress not in soft mattress.



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