Dr. K J Choudhury

Lower back pain is fast becoming an epidemic not just among elderly, but across all age groups. Primary causes of back pain are quite a few including lumbar hernia, disc degenerative disease (DDD), spondylosis etc., but the symptoms are usually the same excruciating pain in the lower region of the spine, followed by stiffness. Since back pain is caused due to a number of spinal problems, it manifests differently in different patients. The pain may be dull, burning or sharp. It could also be felt at a single point or over a broad area and could be accompanied by muscle spasms or stiffness or even shooting pain in one or both legs.

Back pain can also be differentiated according to time period:

1. Acute: Pain lasts for less than three months.
2. Recurrent: Acute symptoms reoccur over time.
3. Chronic: Pain lasts longer than three months.

Sometimes symptoms resolve on their own, but in many cases conservative treatment, such as physiotherapy, which often work better than surgery, becomes essential. Alternate therapies like surgery, acupressure, acupuncture as well as yoga and Ayurveda also help.

Physiotherapy - Exercises that work
Since the reason for low back pain is not always same, a patient’s treatment too should be tailored for his specific symptoms and condition. This is what the physiotherapist will do design an exercise plan based on the patient’s specific problem and its cause.

Physiotherapy treatments may include:

1. Manual therapy, which includes direct spinal manipulation aimed at improving the mobility of joints and soft tissues
2. Strengthening and flexibility exercises
3. Education about what do and what not to do
4. Training for proper sleeping positions, lifting, bending, and sitting as well as for working at home and at work
5. Use of heat/cold treatments or electrical stimulation to help relieve pain

Physiotherapy exercises help support the back and strengthen muscles so that the spine is cushioned properly. This is why physiotherapy is relevant as a treatment for backache. Treatments like traction help in lengthening the spine and relieving compression of nerves that cause sciatica, radiating pain into legs largely due to lumbar herniation. If back pain is extreme, a patient will require physical therapy along with medication, which will help in managing pain and bringing inflammation down. But in the long term, being physically active, going for walks, sitting properly and maintaining a good posture will help the most. In case you have a concern or query you can always consult an expert & get answers to your questions!

While we may not think twice about taking over the counter painkillers coz of body ache or such symptoms, there are some risks associated with pain relievers you may not be aware of. There are some situations where you can put yourself at risk by using these pain drugs improperly.

Movement of the head and neck is enabled by the various joints in this region, the main role being played by the cervical spine. This is a part of the vertebra or the spine and supports the head and neck in all movements. There are cervical vertebrae, ligaments, muscles, and nerves which ensure this movement happens smoothly. However, given the complexity of the whole structure, head and neck pain are also two of the most common joint pains.

The Neck Bone’s Connected to the Head Bone…

The vertebrae of your neck (cervical spine) support the weight of your head and all its motions, which may not seem like much – until you realize your head weighs as much as a bowling ball. When your neck bones are not positioned properly, the result is tightening of the muscles and irritation of the nerves that connect with your head. Your head and neck symptoms may include some or all of the following:

1. Sharp or dull pain or discomfort in your neck
2. Stiffness in your neck
3. Inability to turn your head to one side
4. Headache
5. Shoulder pain
6. Jaw pain

Fortunately, you don’t have to live with head and neck pain – and you don’t have to take drugs to eliminate the pain. 

Causes:

The causes for head and neck pain can range from muscle strain to arthritis to pinched nerve to cancer.

1. Posture problems: Not providing adequate support when being seated grows to be a menace. With the changing lifestyle where people end up staring at a monitor, there is tremendous stress on the neck muscles, leading to pain and stiffness. There is also loss of flexibility, leading to a stiff neck and headaches.
2. Muscle strain: This can occur due to a sudden movement, either when doing something or as a result of accident (like a whiplash injury). The muscle can be torn or injured and this can result in pain, swelling, and inflammation of the affected area.
3. Stress: One of the most common identifier of stress is the constant ache/nagging pain in the back of the neck.
4. Disk herniation: When the disk is moved out of its space due to excessive movement and rotation, the disk gets herniated and the nerve gets ‘pinched.’ This can cause a sharp, shooting pain to the area where the nerve emerges out of that disk.

Spondylitis, arthritis, etc., are other chronic inflammatory conditions which can affect the neck and head areas.

Side effects:

When there is pain in the head and neck area, the whole body function is affected. The movement is limited and therefore vision, neck movements, and other functions are affected. This, in turn, affects the overall quality of life.

Management:

1. Identify the problem with a thorough examination, X-ray, and if required soft tissue examination.
2. Ice the area for relief of pain temporarily.
3. Improve ergonomics in terms of height of the monitor, seat/chair, etc., so the strain is minimized.
4. Develop an exercise regimen, which gives adequate exercise to the head and neck muscles.
5. Manage stress. Be it physical, chemical, or emotional stress, it takes a toll on the head and neck area. Managing the stress (there is no escape from it!) will definitely see the pains and stiff neck go away.
6. Engage in pain management, which is holistic (as above) and does not always resort to medications.

If you are suffering from a constant back or neck pain that never seems to go away and disrupts your routine considerably, then you can consider chiropractic treatment option. Chiropractic care is a natural treatment of musculoskeletal disorders without any drugs or surgery. Chiropractors specialize in reshaping the spine, which changed from its original shape due to many reasons causing pain and inflammation. It is widely accepted a form of treatment in all developed countries like the USA, UK, etc. and gaining popularity in India especially in cases of back pain.

How do they treat?
After carefully listening to the patient, Chiropractors initiates the treatment on the specially designed table. Their palm and finger play a vital role in chiropractic treatment. They apply a light thrust on the affected area on the spine and gradually glide down until the end of the spine in the sacral region. This process actually helps to realign the spine by straightening it.

Chiropractors may massage on the soft tissue as well to ease out the pain. A chiropractor glides the pressure through the muscles of their patients, which gives a tremendous value-added benefit with a little time or effort on the chiropractor's part. The massaging action relaxes strained muscle surrounding the spine, which enhances patient satisfaction.

What is the duration?
Treatments generally take weeks for a permanent solution to the back pain. Initially the skilled professional may suggest you to for 2-3 visits within a week. Depending on the response, it may come down to once a week. Each session varies between 20 - 30 minutes under the expert's fingers. They keep on tracking the improvement level by comparing to the first visit. They are effective in Subacute back pain, Chronic Back Pain, and Neck Pain.

• Heat and cold therapies
• Relaxing methods
• Electrical stimulus
• Promo block
• Stretching Exercises
• Educating the Patient

Chances of further aggravation in chiropractic treatment are low if performed by a trained practitioner. Further, if you have been under a chiropractor for long and your back pain isn’t improving its time to visit your family physician to find out if any other treatment option should be pursued, but in most cases, this procedure can provide relief on a long-term basis. In case you have a concern or query you can always consult an expert & get answers to your questions!