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

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

Back pain is a common source of pain and can be acute, sub-acute or chronic in nature. Back pain is classified along the segments of the spine and can be divided into neck pain, middle back pain, lower back pain and coccydynia or tail bone pain. Back pain can be quite troublesome as it disables a person to move about freely due to constant ache.

Here are some procedures for the treatment of back pain.

    Give your back some rest: Most people who get back pain become obsessed with it and end up getting MRI scans and x-rays done. Some even take injections and other such measures without recognizing the intensity of the pain. It is advised not to rush into the matter immediately and the simplest way to cure the pain is by resting. 90% of pains in the back resolve by themselves in 6 weeks and so you must give your back a break instead of taking medical actions and let time do the healing.
    Pills: While you let time treat your back pain, sometimes the pain increases and gives you a bad time. In this case, you can take anti-inflammatory medicinal pills such as ibuprofen or naproxen. These pills will help you ease the pain. However, using such pills for a continued period of time causes side effects such as gastrointestinal disorders. Hence, you should not take them for more than ten days at a stretch.
    Hot and cold compress: Apply a bag of frozen peas or an ice pack to the affected area for 48 hours after the pain appears. Every session should be about 20 minutes, and you should take more than two sessions each day. After two days, repeat the same procedure using a heat pad instead of ice. The cooling procedure shuts down your blood capillaries and reduces the flow of blood to that area. The swelling is eased as a result. The heating, on the other hand, loosens tight muscles and increases the blood circulation, providing extra oxygen.
    Change your mattress: People who sleep on firm mattresses and cushions on their beds are at a higher risk of having a back pain. According to studies, it has been observed that people sleeping on medium-firm mattresses have healthier backs. In case your mattress in sagging or is over 8 years old, you should replace it.
    Acupuncture: When your back pain is very severe, you can resort to acupuncture, which provides efficient pain relief. The procedure changes the way your nerves react and reduces inflammation.

Back pain arises from various reasons and should always be taken care of. Unattended back pain worsens and makes the affected person suffer.

Suffering From Lower Back Pain - 5 Ways You Can Treat it

Does you back hurt only when you wake up in the morning or is it a chronic problem? If yes, then you need to take immediate steps to treat it. Back pain, being the common physical anomaly for people primarily in the age range of 35-50, is one of the top causes for office absenteeism and mid-life lethargy and fatigue. Usually back pain indicates an underlying problem that involves the nerves, bones and muscles.

Here are some risk factors for back pain:

Pregnancy
Stress related to work
Leading a sedentary lifestyle
Anxiety and depression
Being overweight
Over exercising
Strenuous physical work outs
Smoking
There are varied reasons as to why back pain may occur. Discussing the causes of back pain is beyond the purview of this article; the focus is now going to be on some of the stretches one can practice to get relief from back pain: 

Downward dog: A classic yoga pose, the downward dog stretches the entire back, hamstrings and the whole of the leg. Begin the process in a classic push up pose with the palms and toes on the floor. Keeping your back straight, lift your tailbone up and straighten your legs. Push the heels to the floor and breathe to get the most out of this stretch.
Child s pose: A simple stretch, it begins with you sitting back on your buttocks and then stretching the arms in front of you. Keep your forehead on the floor and breathe slowly.
Cat cow pose: If your common complaint is that of a sore and painful back, then this is one of the best stretches for you. A very simple pose, you begin by sitting on all fours, then transitioning into the cat pose by pushing your spine upwards. Hold the pose for one breath and then go to the cow pose wherein you lift your buttocks and the head while scooping your spine.

Back Pain - 3 Stretch Exercises You Must Follow!

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

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