About 80 percent of people all across the globe experience lower back pain at some stage in their lives. It is one of the most common reasons why people miss their work and appoint a physiotherapist. But lower back pain is an ailment that can be avoided with proper knowledge and some back exercises. In case your lower back pain is not under control and you have been neglecting it, you are susceptible to acute pain, sciatica, nerve pain and pain in other regions caused from a pinched nerve. Long-term pain in the back portion can lead to permanent ailments like degenerative disc disease or spinal stenosis.

Probable causes of lower back pain
Severe pain in the lower back region can be caused due to a herniated disc, back muscle pain, ligament strain or any other non-specific pain. An individual may also suffer from lower back pain due to systemic conditions like rheumatoid arthritis, fibromyalgia or ankylosing spondylitis. Though these causes are very common in most people suffering from lower-back pain, the diagnosis varies from person to person and to ensure the best care to alleviate the pain, you must consult a responsive musculoskeletal physiotherapist.

Stages for assessing and treating lower back pain
Managing the back pain is the primary objective of physiotherapy. In reality, back pain is the final symptom that is developed and the first thing that must be addressed.

Stage I
Back pain relief: The physiotherapist is going to use different types of tools and items to help the pain subside along with the inflammation. These include electrotherapy, acupuncture, ice application, soft-tissue massage and deloading taping techniques. Sometimes the physiotherapist may also recommend an anti-inflammatory drug if the pain is intolerable.

Stage II
Restoring normal strength: With the settling of pain and inflammation, you are more susceptible to injury because though your pain has subsided, your ligaments and muscles are weak. Your doctor will aim at restoring normal motion of lumbar spine, muscle endurance and strength, proprioception, balance and walking abilities.

Stage III
Restoring full body function: Depending on your daily chores and activity, your physiotherapist will aim at restoring the function of your back portion to keep you safe while performing the chosen activities. For some, it may be taking a slow walk around the park while for others it may mean taking part in some sports activity.

Stage IV
Preventing recurrence: Your physiotherapist will rehabilitate you to prevent further occurrence of this excruciating pain by suggesting proper postures, exercise and core muscle workout.

Each of these stages are important to help you get rid of severe back pain and with daily exercise, you can regulate your body and spare yourself from recurrence of this lower back pain.

Treating Chronic Lower Back Pain

The human body allows for movement through the complex system of bones, muscles and joints. A break in the bone is medically known as a fracture and can be caused by constant stress, pressure or impact. It is common knowledge that with age, the bone strength decreases and incidence of fractures (osteoporotic fracture) increases. Based on the affected bone and impact, different types of fractures are commonly identified as:

Complete: When the breakage of the bone is complete, producing two or more pieces, it is referred to as a complete fracture.
Incomplete: When the breakage is incomplete, where the bone has cracked, but does not break into pieces, it is known as an incomplete fracture.
Another type would be the open or closed fracture:
Open fracture: When the skin is exposed and the bone breaks through this exposed skin, it is known as compound or open fracture.
Simple or closed fracture: The bone breaks, but the skin continuity is maintained. Again, here are different types including hairline, greenstick, oblique, etc.
What is the reason behind a fracture?
A bone will fracture when force is applied to it that is stronger than the bone itself. A key factor in a bone s susceptibility to fracturing is age. Both children and older people are prone to bone fractures. Children s bones are constantly growing and have not reached their full strength. Elderly people have brittle bones with old age and are prone to develop bone diseases, making them susceptible to fractures.

How they are treated?
Splint and pain medications are commonly used. Closed reduction where the fracture is reduced without opening up the tissues and open reduction, where the tissues are opened up are common approaches to managing fractures.

Can they be prevented?
Especially with children and in the elderly, extra precaution should be taken to avoid any kind of injury and fracture.

Develop an exercise routine to strengthen the muscles
Manage weight
Use the right footwear and exercise gear
Watch your medications (avoid sleep inducing ones)
Increase lighting in the room/home to improve clarity of vision for elderly
Make the home/living area fall-proof by reducing clutter, using railing in the bathroom and bedroom, using rubber mat, etc.
While a fall may seem inevitable, taking the above steps can help reduce the incidence and severity of a fall, thereby minimizing damage.

Bone Fracture - Common Types and How They Can be Prevented?

Physiotherapy plays a pivotal role in helping a person recover after a hip replacement surgery. It brings back the old flexibility and prevents blood clots in the area where the procedure has taken place. After the surgery team gives its green signal, a physiotherapist starts working with a patient for a full recovery. 

Here is a list of some common exercises that a physiotherapist suggests after a hip replacement surgery:

Walking: It is important to use the crutches for a time period of 4-5 weeks post the procedure. Until the surgeon or the physiotherapist advises against using the crutches, it makes sense to use it while walking. It makes sense to retain the normal walking posture by using the crutches rather than limping without it. A physiotherapist reviews the pressure exerted by the arm while holding a crutch, before advising the patient to get rid of the crutches.
Increasing hip flexibility: This is a basic form of exercise where an individual lies on one side of the body with knees and hips bent. A pillow is placed in between the knees. While doing this, it should be ensured that both the feet is kept together and the back muscle is not twisted. The top knee should be slowly raised like an opening of the calm shell. This position should be maintained for 4-5 seconds.
Strengthening the hips: The body should rest on the stomach. The buttocks should be tightened and one leg should be slowly lifted. This position should be maintained for a stretch of 3-5 seconds. The same should be repeated for both the legs.
Strengthening the hip and the stomach muscle: The body should rest on the back with a leg bent. The stomach muscle should be tightened and the bent leg should be lifted carefully while ensuring that the bend does not supersede more than 90 degrees. While keeping the stomach muscle tight, the lifted leg should slowly come down to touch the surface. This act should be repeated for 5-6 times.
Strengthening the thigh muscle: While sitting in a steady chair, an elastic loop should be wrapped around the ankles. The elastic loop should be stretched with one leg while keeping the other foot firmly rooted to the ground. The lifted foot should slowly come down to the normal position. The same act should be repeated for 4-5 times.
Improving balance: An elastic loop should be tied to one leg of a table and the other end of the loop should be tied to one ankle. The table should be held on for maintaining balance. Maintaining an erect position, the tied up ankle should be stretched sideways. The position should be maintained for 3-5 seconds to return back to normal standing position.

How Physiotherapy Can Improve Recovery After Hip Replacement Surgery?

The causes and symptoms of chronic lower back pain

Lower back pain is characterized by a feeling of pain around the lumbar region (curve of the back connecting the upper back and glutes- muscles in the buttock that are responsible for thigh movement) caused by muscle or ligament injury. The spinal area is most likely to be affected by lower pain as it may impair routine activities like walking and standing. Any lower back pain that lasts for more than ninety days can be considered as chronic.

Causes of lower back pain

There are plenty of causes for lower back pain. Anything that exposes the lumbar area of the spine to a level of stress beyond its capacity can cause lower back pain. These causes are-

1. Disorders of the discs

The spinal area in the lower back comprises of small bones called the vertebra, which are connected to each other by pieces of cartilage known as discs. These discs act as shock absorbers, and when exposed to excessive shock can cause the disc to bulge, resulting in herniated discs. Wear and tear of the discs can also occur.

2. Spinal stenosis

Spinal stenosis occurs when the area around the spine becomes narrow. It may affect the nerves surrounding the lower back, resulting in pain.

3. Wear and tear of the joints and ligaments

Normal wear and tear of the joints and ligaments cause difficulties in holding the spine in its proper position and this progresses with age. This may cause a vertebra to slide over another and affect the nerve endings, giving rise to pain.

Symptoms of lower back pain

The symptoms of lower back pain are usually a dull or excruciating pain in the lower back. It can also affect other parts of the body such as the hips and the legs. In case of severe pain, simple activities like walking, bending and sitting will be impaired.



The Causes and Symptoms of Chronic Lower Back Pain

If you suffer from persistent backaches and neck pain, you may be diagnosed with spondylitis. Spondylitis refers to degenerative changes of the spine, such as the formation of bone spurs and degeneration of spinal discs. This condition can affect the neck, upper or mid back and lower back. Of these, spondylitis of the neck- cervical spondylitis and lower back- lumbar spondylitis are most common.

Spondylitis is considered to be triggered by age. As a person grows older, the wear and tear of the bones and ligaments of the spinal column can lead to the development of bone spurs and osteoarthritis. Age can also cause the discs between vertebrae to weaken and degenerate leading to bulging discs and herniating spinal discs. Most people experience the first symptoms of spondylitis between the age of 20 and 50. A family history of spondylitis and being prone to injuries also increases a person s risk of suffering from spondylitis.

Since spondylitis is a degenerative disease, there is no cure for this condition. However, the pain associated with it can be managed. Thus, treatment for spondylitis is very similar to treatment for neck or back pain. This treatment can be in the form of pain medication, exercise, physical therapy and minimally invasive surgery. Depending on the extent of spinal damage the doctor may prescribe steroids that need to be injected directly into the intervertebral spaces. This is also known as epidural injections.

Spondylitis patients are often advised to follow their normal schedule and refrain from bed rest as this can prolong recovery. However, at the same time, you should not undertake any activity that puts additional pressure or stress on the spinal column. Alternating between warm and cold compresses can help relieve the pain associated with spondylitis. Additionally, try sleeping with a pillow between your legs to relieve low back pain. 

Special pillows that offer cervical support can help relieve spondylitis of the neck.

Surgery may be considered in cases where this condition causes or worsens nerve damage. Spinal decompression surgery involves relieving pressure on the nerves in the spinal column that may be caused by a herniated disc, spinal stenosis or foraminal stenosis. This surgery can be performed through a laminectomy, discectomy or foraminotomy. Bone spurs in the spinal column or a vertebral disc can also be removed surgically. However, these surgeries are rarely performed as most patients respond well to non-surgical treatments.

Causes of Spondylitis - How Can it Be Treated?

If you are an avid runner, then you might also be well aware of the type of running injuries one is prone to. It might be foolish to say that running injuries can be prevented. It is because these injuries do happen quite often. Though these cannot be prevented, these can definitely be treated. Furthermore, precautions from your side can always be taken to make sure that these injuries do not cause a major impact on your health and can be cured without much of a hassle. Here are some important points that you need to remember to avoid running injuries or to lessen their adverse impact on your body.


Flexible Body: Flexibility is an important part of a runner s body. You not only need to have the stamina to run, but also must possess flexible features to get you out swiftly from any serious damage. Flexibility is attained when you do regular exercises and stretching in particular. It makes your muscles resilient towards many injuries and provides your body a better shape and long lasting stamina as well.
Strengthen Your Body: Body strength is required if you want to avoid any sports injuries. Special strength training sessions are organised with the coaches of sportspersons. These sessions help in building up muscle strength. This would, in turn, lessen muscle fatigue and make you able enough to perform better.
Balanced Diet: It does not matter whether you are an athletic or not, a balanced diet is needed for everyone. Balanced diet does not mean picking and choosing of food. It means a proper diet chart, mapping everything that your body needs to stay fit. Furthermore, it should contain ample amount of water to keep you hydrated.
Take Rest When Required: It is often said by the elders that too much of work would ruin your health and body. Thus, even for the athletes, it is important to take rest in between periods of heavy training sessions. This would give you a chance to relax your body and relieve you of all the stress. Furthermore, if you are injured or hurt, it would give you ample time to recover from your injuries.
Wear Proper Shoes: As a runner, you need to take care of all parts of your body. This would also include your legs. To prevent any sprains or muscle injury in the leg and to practice for long hours, proper running shoes are needed.  


How To Avoid Running Injuries?

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