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

Pain related sleep disruption has affected a large number of people around the globe. Statistics has it that, in India, about 25% of the population suffers from pain-related sleep deprivation. Studies call it  the vicious cycle of pain and sleep  as pain affects your ability to sleep and lack of sleep makes the pain even worse.

Back pain and arthritis are examples of some common pain-related medical disorders. People with these types of chronic pains have reported persistent sleeplessness or have had immense trouble falling asleep.

The following are the primary sleep disorders associated with chronic pain:

Insomnia: It is a medical condition that is characterized by an inability to fall asleep no matter how physically exhausted you are. Insomnia can be acute (lasting for one night to a week) or chronic (that lasts for more than 3 weeks).
Hypersomnia: It is a condition wherein you tend to sleep excessively; in this condition, you will have trouble being awake throughout the day or can fall asleep at any point of time.
Sleep Apnoea: This is a sleep disorder wherein breathing pauses and resumes repeatedly. Risk factors include obesity, age and gender; it is more commonly observed in men. This condition can be chronic with symptoms such as snoring loudly or feeling very tired even after one has had a night s sleep.
Restless leg syndrome: It is a sleep disorder wherein you continuously move your legs while sleeping. However, this condition can also cause you to move your legs even if you aren t sleeping.
Some of the causes of sleep disorders due to chronic pain are:

Pain
Worry and anxiety
Sweating at night
Depression and other mental disorders
Treatment

A pain and sleep disorder should be simultaneous as both the components of it, pain and sleep, are interrelated. Some of the ways people with chronic pain can still have a good night s sleep are:

Limiting caffeine intake
Abstaining from alcohol and smoking, as these disrupt the sleep cycles, thus aggravating the existing pain.
Practicing meditation and other relaxation techniques
Pain killers or sleeping pills can be administered, but only with the doctor s advice.
Hot water fomentation over painful area during night, for better sleep.

Back Pain and Bad Sleep

Today  working  usually implies sitting at a desk from morning to evening. While this may seem more comfortable than working in the fields, sitting at a desk can trigger a host of back problems. This is because sitting in the same position all day makes the spine bend forward and lowers the efficiency of the back muscles. Working at a desk not only strains your back, but also restricts your movements to typing on a keyboard and moving a mouse. 

Once a back problem begins, it usually lasts a lifetime hence; here are a few tips to save your back.

Get yourself a good chair: Your chair is crucial to your back s health. Avoid the hard backed plastic chairs and pick a more flexible mesh backed office chair if you sit at the table for a long span of time. Ergonomic chairs may seem expensive, but are worth the expense in the long run.
Stretch your muscles: Sitting in the same position all day, puts the muscles under stress and with time can constrict the muscles. Make it appoint to stand up every 30 minutes and stretch your back and sides. Also try rotating your hips and shoulders form time to time.
Take a break: No matter how much work you have in front of you, take a break at the end of each hour. Taking even 2 minutes off out of 60 every hour can have a huge impact on your health. If you still feel guilty skip using the phone to connect with your colleague and walk over to their desks instead.
Get a pedometer: Keeping a pedometer will help you track the number of steps taken in a day. Ideally, a person should take 10,000 steps a day to stay healthy. If you sit at a desk for majority of the day, take every opportunity you can to up the count on your pedometer. Go for a walk around your office after lunch or park your car a little way off from the office to create opportunities to walk.
Take the stairs: As far as possible avoid escalators and elevators. Instead climb stairs for a quick workout. If your office is on the 20th floor, walking up may not be feasible, but you could get off the elevator on the 18th floor and walk up the remaining two floors.
Eat healthy: Lastly, pay attention to what you eat. Avoid eating at the office canteen or picking up a bite at the coffee shop and carry lunch from home. This ensures that you eat a balanced meal.

World Spine Day-6 Back Saving Tips for People Who Sit at a Desk All Day

Why does PAIN occur? Understand the Mechanism of Pain

Pain is an unpleasant and distressing physical sensation caused by disease or injury, which induces hurt and anxiety in those suffering from it.
There are many different manifestations of pain, ranging from short term (acute pain) to long term (chronic pain). Other classifications include pain in the internal organs (visceral pain), injured tissue (inflammatory pain), nerves (neuropathic pain), etc.

The reason for the occurrence of pain depends on the cause and kind of pain being experienced. In most cases, pain acts as a warning sign that the body has been afflicted by a disorder of some sort, which may have arisen due to internal sickness or external wounding. Acute pains are generally cured on their own through rest or simple medication. Chronic pains, on the other hand, are more complicated in nature and the treatment requires more elaborate diagnosis.

The mechanism of pain

Pain is an extremely personal and subjective experience and affects each individual to varying degrees. The pain signals, which can arise in any part of the body, travel through the spinal cord to the brain along thousands of specialized nerves and nerve fibres. In the brain, it is processed in the centres associated with anxiety, emotions, memory, appetite, etc. Signals and pain inputs are then returned from the brain to the spinal cord, which may heighten or diminish pain.

In some cases, pain may also be induced by damage to the brain and spinal cord, which happens after a stroke.
A constant barrage of pain signals may cause the cells at the end of nerve fibres to become over-sensitized. This is known as 'wind-up' and is one of the most common causes of chronic pain that occurs even though the root of the problem has been identified and treated.

The causes and effects of pain differ from case to case depending on the signals received by the brain and its interpretation. It affects the individual's day to day activities and if persistent, can also have a harmful impact on mental health and psychosis. Pain is always handled, diagnosed and treated differently in all patients by drawing out the best possible solution to the problem.





Why does PAIN occur? Understand the Mechanism of Pain

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

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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