Feeling Movement In Lower Abdomen

Dr. Julie Mercy J DavidErasmus Mundus Master in Adapted Physical Activity, MPT, BPTh/BPTPhysiotherapist

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If you are suffering from burning pain or tingling sensation in hands or feet; sharp shooting pain in legs; numbness in hands or feet, then you might be suffering from neuropathic pain. What is a neuropathic pain? Neuropathic pain is a special type of pain which occurs when there is damage to nerve fibres, which produces tingling or burning type of pain. It is of two types: 1. Peripheral neuropathic pain: it occurs when there is an injury to peripheral nerve fibres (a-delta or c-fibers) which carries pain sensation to the brain (thalamus) for interpretation. 2. Central neuropathic pain: it occurs due to sensitization of central pain interpreting mechanisms (thalamus) to falsely feel pain when peripheral nerve fibres are no longer sending pain impulses to them. Worldwide-estimates of the prevalence of neuropathic pain is 7% i.e. 7 persons out of 100 people are suffering from different types of neuropathic pain. Symptoms: •tingling sensation or feeling of ants crawling under skin •burning sensation •sharp shooting pain or electric current-like sensation •stabbing pain •dull pain with numbness or heaviness reasons for neuropathic pain: •diabetes mellitus: most common cause worldwide due to uncontrolled blood sugar levels, causing damage to nerve fibres. •alcohol consumption/cigarette smoking: damage to nerve fibres or damage to blood vessels supplying nerve fibres. Burning pain in feet •neck pain/low back pain/glutei pain •vit. B12 deficiency •chemotherapy for cancer patients •post-herpes virus infection •post-spine surgery •post-amputation •diseases like spinal cord injury, multiple sclerosis, hiv, lead toxicity, etc. Special neuropathies: 1. Carpal tunnel syndrome: tingling, burning sensation in hand which occurs due to compression of median nerve in the wrist area. It occurs in women especially due to pregnancy, hypothyroidism, diabetes, etc. And in men due to improper position of the wrist during working on computers. 2. Cervical radiculopathy: pain in neck and shoulder region (which increases with neck movements), along with sharpshooting pain radiating from neck to hand occurs in cases of cervical radiculopathy. This is due to compression of the cervical nerve root by disc prolapse, facet subluxation, muscle spasm, trauma, etc. 3. Lumbar radiculopathy: pain in lower back or glutei region with sharp shooting pain radiating from hip to leg/foot region, occurs in cases of lumbar radiculopathy or sciatica. This is due to compression of lumbar nerve root or sciatic nerve by disc prolapse, facet joint, trauma, hypertrophied ligamentumflavum, piriformis syndrome, etc. 4. Meralgiaparesthetica: tingling or burning sensation in front of the thigh, occurs due to compression of lateral cutaneous nerve of thigh, near waist region. Usual causes are tight or constrictive clothing at waist region, prolonged sitting, protuberant abdomen, etc. Prevention of neuropathy: 1. Avoid alcohol consumption and cigarette smoking. 2. Maintain ideal body weight/bmi (body mass index) 3. Lifestyle changes: daily exercises (>30 minutes per day) or brisk walking or swimming; avoid prolonged sitting or standing (>30 minutes). 4. Food/diet should have following components: •green vegetables e.g. Spinach, fenugreek leaves (methi), radish, etc •coloured vegetables e.g. Tomato, carrot, capsicum (green/red), ladies-finger (bhindi) •milk products e.g. Milk, buttermilk, curd, cheese (paneer) •protein-rich foods e.g. Fish, egg, chicken, pulses (daal) •fibre-rich foods e.g. Bran, oats, brown-rice •fruits e.g. Apple, orange, guava, papaya, pomegranate, berries 5. Blood sugar control (in diabetics) 6. Care of feet: •regular inspection of feet (with mirror) •comfortable, well-fitted shoes •regular consultation with a podiatrist •treatment of wounds, foot deformities 7. Adequate sleep 8. Warm water bath (increases blood flow to the affected area) treatment: •consult pain medicine specialist. •neuropathic painkillers e.g. Amitriptyline, pregabalin, gabapentin, capsaicin, duloxetine, etc. •vit. B12 supplements, anti-oxidants, multi-vitamins. •transcutaneous electrical nerve stimulation (tens) •acupuncture •relaxation and yoga •neural prolotherapy. 

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Dr. Julie Mercy J DavidErasmus Mundus Master in Adapted Physical Activity, MPT, BPTh/BPTPhysiotherapist

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You need to diagnose whether the back pain is originally due to back issues or it is due to kidney issues. Kidney pain vs. Back pain because your kidneys are located toward your back and= underneath your ribcage, it may be hard to tell if the pain you’re experiencing in that area is coming from your back or your kidney. The symptoms you’re having can help you figure out which is the source of the pain. The location, type, and severity of the pain are some of the things that will be different depending on whether the pain is from a problem in your kidneys or your back. How to identify kidney painkidney pain is most often caused by a kidney infection or a stone in the tubes coming out of your kidney. If the pain is coming from your kidney, it will have these features: where the pain is located kidney pain is felt in your flank, which is the area on either side of your spine between the bottom of your ribcage and your hips. It usually occurs in one side of your body, but it can occur in both sides. Type of pain kidney pain is usually sharp if you have a kidney stone and a dull ache if you have an infection. Most often it will be constant. It won’t get worse with movement or go away by itself without treatment. If you’re passing a kidney stone, the pain may fluctuate as the stone moves. Radiation of the pain sometimes the pain spreads (radiates) to your inner thigh or lower abdomen. Severity of the pain kidney pain is classified according to how bad it is — severe or mild. A kidney stone usually causes severe pain, and the pain from an infection is usually mild. Things that make it better or worse typically, nothing makes the pain better until the problem is corrected, such as by passing the stone. Unlike back pain, it usually won’t change with movement. Accompanying symptoms if you have a kidney infection or a kidney stone, you may also experience: •fever and chills •nausea and vomiting •cloudy or dark urine •an urgent need to urinate •pain when you urinate •a recent infection in your bladder •blood in your urine (this can happen with an infection or kidney stones) •small kidney stones that look like gravel in your urine how to identify back pain back pain is more common than kidney pain and is usually caused by a problem in the muscles, bones, or nerves in your back. Has the following features: where the pain is located back pain can occur anywhere on your back, but it’s most commonly located in your lower back or one of your buttocks. Type of pain muscle pain feels like a dull ache. If a nerve has been injured or irritated, the pain is a sharp burning sensation that may travel down your buttock to your lower leg or even your foot. Muscle pain may affect one or both sides, but nerve pain usually only affects one side. Radiation of the pain nerve pain may spread to your lower leg. Pain from a muscle usually stays in the back. Severity of the pain back pain is described as acute or chronic based on how long you’ve had it. Acute pain lasts days to weeks, subacute pain lasts six weeks to three months, and chronic pain lasts longer than three months. Things that make it better or worse back pain may get worse with movement or if you sit or stand for a long time. It may get better if you switch positions or walk around. Accompanying symptoms other symptoms you may experience with back pain include: •the painful spot looking swollen and feeling tender to the touch •a muscle spasm in the painful area •numbness or weakness in one or both of your legs (if the pain is due to a nerve issue) if you find you have back pain and can’t hold your urine or bowel movements, something is pressing on your spinal nerves, and you should be evaluated immediately. This condition, called caudaequina syndrome, can cause severe long-term damage to your spinal nerves if not treated right away. 6 imbalances that cause pain—and how to fix them "pain is a medical condition and a medical issue, says brett jones, owner of applied strength in pittsburgh who is certified for the functional movement screen, a system of tests and cor rective exercise strategies. "it's a warning sign. The pain is there to tell you something's wrong. 

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Dr. Julie Mercy J DavidErasmus Mundus Master in Adapted Physical Activity, MPT, BPTh/BPTPhysiotherapist

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Back pain back pain exercises; kindly do these exercises. Back pain is described as acute or chronic based on how long you’ve had it. Acute pain lasts days to weeks, subacute pain lasts six weeks to three months, and chronic pain lasts longer than three months. Things that make it better or worse back pain may get worse with movement or if you sit or stand for a long time. It may get better if you switch positions or walk around. Other symptoms you may experience with back pain include: •the painful spot looking swollen and feeling tender to the touch •a muscle spasm in the painful area •numbness or weakness in one or both of your legs (if the pain is due to a nerve issue) if you find you have back pain and can’t hold your urine or bowel movements, something is pressing on your spinal nerves, and you should be evaluated immediately. This condition, called cauda equina syndrome, can cause severe long-term damage to your spinal nerves if not treated right away. 6 imbalances that cause pain—and how to fix them "pain is a medical condition and a medical issue, says brett jones, owner of applied strength in pittsburgh who is certified for the functional movement screen, a system of tests and cor rective exercise strategies. "it's a warning sign. The pain is there to tell you something's wrong. And that warning sign could be more serious than "you're going too hard. Jones and the other coaches consulted for this piece all had a horror story to tell-when pain in a client meant a more serious condition such as a nerve issue, thyroid issue, or even cancer. The point: if you experience regular pain while exercising-or when you're not-go to the doctor. If you've been cleared by a doc and you're still feeling discomfort, try these simple tests to see what's truly causing the pain-it could be related to an imbalance in a completely different part of your body. The good news: with these drills, stretches, and corrective exercises, you may be able to fix them-no doctors necessary. 1. Standing extension how it helps – this standing extension helps reverse what you do on a daily basis (hunching)… since most bulging discs and herniated discs are caused by poor posture and repeated flexion of the spine (esp bending fwd in bad posture), this stretch helps push the disc back to neutral position. How to do it – begin this exercise by standing up with good posture. Now take both hands and place them on both sides of your lower back. Now with the help of your hands push your pelvis forward and extend your spine back. Follow the extension with your neck so that you end up facing the ceiling. – start with 10 repetitions and do 2-3 sets. – this one is particularly great to do when you need a break from sitting at your desk. ** this should not cause any pain. If you feel pain during it is not a good one for you. In that case, stop and try some of the other exercises below instead. 2. Half cobra pose (prone lumbar extension) how it helps – the half cobra stretch helps to push the disc material back towards the center of the inter-vertebral disc to allow for improved healing. The goal of repeated lower back extension is the “centralization of symptoms”, which basically means pain that travels down the affected leg to the foot should come back up closer to the low back – which will in turn alleviate the pain. How to do it – begin this exercise by lying on your stomach (prone position) and slowly prop yourself up on your elbows while keeping your hips in contact with the floor. – hold the prop-up position for 10-15 seconds before returning to the prone position (lying face down). – gradually increase to holding the end position for 30 seconds. Aim for 10 repetitions of this stretch. ** initially, you may not be able to tolerate this position very well, so make sure you start slowly and carefully. If there’s any pain, try a different exercise instead. 3. Full cobra pose (advanced extension) how it helps – this stretch is based on the same principle as the half cobra pose above. This advanced extension helps to push disc material back towards the center of the intervertebral disc, with the goal of alleviating pain symptoms. How to do it – once you’ve mastered the half cobra pose, you can increase the difficulty by moving to the advanced version of this stretch. Begin this exercise by lying on your stomach in the prone position (lying facing down) and slowly press up on your hands while keeping your pelvis in contact with the floor and lower back relaxed. – hold the prop-up position for 10 seconds. Aim for 10 repetitions of this stretch. – eventually try to hold this pose for longer if it feels good (20-30 seconds). ** if you feel pain during this exercise, it is not a good one for you. In that case, stop and try some of the other exercises instead. 4. Cat-cow how it helps – this is one of the most popular herniated disc exercises. By combining two yoga poses, the cat-cow stretch can help to relieve pressure on the herniated disc by opening the intervertebral disc space. It also improves mobility of the spine, which may help to relieve disc herniation pain and speed recovery. How to do it – begin this stretch on your hands and knees. Inhale and let your stomach “drop” towards the floor as you look up towards the ceiling. – follow this by exhaling and slowly rounding your spine while pressing into the floor with your hands and slightly curving your neck to look at your feet. – aim for 10 repetitions of this stretch and do 2-3 sets. How it helps – this exercise will help strengthen and stabilize your lower back and deep spine muscles. This will help you to maintain a good posture and avoid future episodes of herniated discs. How to do it: – begin on your hands and knees with your hands positioned under your shoulders and knees positioned under your hips. – raise your left arm and reach it forwards until it is aligned with your torso; at the same time, kick your right leg backwards until is it aligned with your torso. – hold this position for 2-3 seconds before slowly returning to the starting position. – repeat with your right arm and left leg. – alternate sides for 10 repetitions and do 2-3 sets. ** ensure that your head, neck, and back maintain a neutral alignment to minimize stress on your neck. 5.plank: how it helps – just like the bird dog, this “core” exercise will help bring your pelvis into right position by strengthening the deep spinal muscles and glutes (butt muscles). How to do it – begin lying on your stomach with your forearms against the mat. – engage your core and lift your body so that you are resting on your forearms and toes. – start with 10 second holds and work up to 30 second holds, do 2-3 sets. ** ensure to keep your back straight throughout the entire exercise – spine in neutral position. Thoracic expansion if you’re using a chair, sit facing forward and allow your upper body to fall over the back of the chair. Extend your arms above your head for a deeper stretch. Hold either position for 10 seconds. 1. Plank the world record for the longest plank is 8 hours. Luckily, you don’t need to hold it that long for the exercise to have an effect! in fact. You can hold it for 10-15 seconds. • the plank is similar to a push-up position, but instead of resting on your hands, you rest on your elbows and bring them directly underneath your chest. • after kneeling, lean forward and place your elbows on the ground directly below your shoulders. • lift your knees off of the floor and push your feet back. Ensure your back is straight and keep your neck aligned with the rest of your spine. • hold the position and tighten your core muscles for the desired time. 2. Side plank just like the original plank, but only balancing on one side. • lie on the floor on your side, facing sideways with your feet together. • lift up your body until you are supporting yourself with your elbow, directly below your shoulder. • raise your hips until your body is in a straight line and tighten your core muscles; your body should create a slant from your shoulders to your feet. • hold this position without dropping your hips. • repeat on the opposite side. 3. Pelvic tilt with exercise ball sit on a ball that allows your legs to be at a 90-degree angle with your feet flat on the floor. • keep your shoulders back and spine straight. • tilt your hips forward and flex your abdominals tight. • tilt your hips backward as you stick your tailbone out. • move back and forth slowly, keeping your shoulders back. • repeat 10 times for 3 sets. 4. Superman lie on your stomach, face down, with your arms out in front of you. • lift arms, legs, and chest off the floor simultaneously while keeping your hips grounded. • hold for a minimum of two seconds. • lower back down slowly. • repeat 10 times for 3 sets. 6. Crunches lie flat on your back, placing your feet flat on the floor with your legs bent. • fold your arms across your chest and lift your torso up until your head, neck, and torso are off the ground. • hold for a moment before lowering back down. • repeat. 6. Quadruped arm opposite leg raises • kneel on the floor, lean forward, and place your hands palm-down on the floor. • make sure your back is straight, your knees are below your hips, and that your palms are directly below your shoulders. • raise one arm as you raise the opposite leg until both are aligned straight out from your body, parallel to your spine. 

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Dr. Julie Mercy J DavidErasmus Mundus Master in Adapted Physical Activity, MPT, BPTh/BPTPhysiotherapist

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Back pain back pain exercises; kindly do these exercises. Back pain is described as acute or chronic based on how long you’ve had it. Acute pain lasts days to weeks, subacute pain lasts six weeks to three months, and chronic pain lasts longer than three months. Things that make it better or worse back pain may get worse with movement or if you sit or stand for a long time. It may get better if you switch positions or walk around. Other symptoms you may experience with back pain include: •the painful spot looking swollen and feeling tender to the touch •a muscle spasm in the painful area •numbness or weakness in one or both of your legs (if the pain is due to a nerve issue) if you find you have back pain and can’t hold your urine or bowel movements, something is pressing on your spinal nerves, and you should be evaluated immediately. This condition, called cauda equina syndrome, can cause severe long-term damage to your spinal nerves if not treated right away. 6 imbalances that cause pain—and how to fix them "pain is a medical condition and a medical issue, says brett jones, owner of applied strength in pittsburgh who is certified for the functional movement screen, a system of tests and cor rective exercise strategies. "it's a warning sign. The pain is there to tell you something's wrong. And that warning sign could be more serious than "you're going too hard. Jones and the other coaches consulted for this piece all had a horror story to tell-when pain in a client meant a more serious condition such as a nerve issue, thyroid issue, or even cancer. The point: if you experience regular pain while exercising-or when you're not-go to the doctor. If you've been cleared by a doc and you're still feeling discomfort, try these simple tests to see what's truly causing the pain-it could be related to an imbalance in a completely different part of your body. The good news: with these drills, stretches, and corrective exercises, you may be able to fix them-no doctors necessary. 1. Standing extension how it helps – this standing extension helps reverse what you do on a daily basis (hunching)… since most bulging discs and herniated discs are caused by poor posture and repeated flexion of the spine (esp bending fwd in bad posture), this stretch helps push the disc back to neutral position. How to do it – begin this exercise by standing up with good posture. Now take both hands and place them on both sides of your lower back. Now with the help of your hands push your pelvis forward and extend your spine back. Follow the extension with your neck so that you end up facing the ceiling. – start with 10 repetitions and do 2-3 sets. – this one is particularly great to do when you need a break from sitting at your desk. ** this should not cause any pain. If you feel pain during it is not a good one for you. In that case, stop and try some of the other exercises below instead. 2. Half cobra pose (prone lumbar extension) how it helps – the half cobra stretch helps to push the disc material back towards the center of the inter-vertebral disc to allow for improved healing. The goal of repeated lower back extension is the “centralization of symptoms”, which basically means pain that travels down the affected leg to the foot should come back up closer to the low back – which will in turn alleviate the pain. How to do it – begin this exercise by lying on your stomach (prone position) and slowly prop yourself up on your elbows while keeping your hips in contact with the floor. – hold the prop-up position for 10-15 seconds before returning to the prone position (lying face down). – gradually increase to holding the end position for 30 seconds. Aim for 10 repetitions of this stretch. ** initially, you may not be able to tolerate this position very well, so make sure you start slowly and carefully. If there’s any pain, try a different exercise instead. 3. Full cobra pose (advanced extension) how it helps – this stretch is based on the same principle as the half cobra pose above. This advanced extension helps to push disc material back towards the center of the intervertebral disc, with the goal of alleviating pain symptoms. How to do it – once you’ve mastered the half cobra pose, you can increase the difficulty by moving to the advanced version of this stretch. Begin this exercise by lying on your stomach in the prone position (lying facing down) and slowly press up on your hands while keeping your pelvis in contact with the floor and lower back relaxed. – hold the prop-up position for 10 seconds. Aim for 10 repetitions of this stretch. – eventually try to hold this pose for longer if it feels good (20-30 seconds). ** if you feel pain during this exercise, it is not a good one for you. In that case, stop and try some of the other exercises instead. 4. Cat-cow how it helps – this is one of the most popular herniated disc exercises. By combining two yoga poses, the cat-cow stretch can help to relieve pressure on the herniated disc by opening the intervertebral disc space. It also improves mobility of the spine, which may help to relieve disc herniation pain and speed recovery. How to do it – begin this stretch on your hands and knees. Inhale and let your stomach “drop” towards the floor as you look up towards the ceiling. – follow this by exhaling and slowly rounding your spine while pressing into the floor with your hands and slightly curving your neck to look at your feet. – aim for 10 repetitions of this stretch and do 2-3 sets. How it helps – this exercise will help strengthen and stabilize your lower back and deep spine muscles. This will help you to maintain a good posture and avoid future episodes of herniated discs. How to do it: – begin on your hands and knees with your hands positioned under your shoulders and knees positioned under your hips. – raise your left arm and reach it forwards until it is aligned with your torso; at the same time, kick your right leg backwards until is it aligned with your torso. – hold this position for 2-3 seconds before slowly returning to the starting position. – repeat with your right arm and left leg. – alternate sides for 10 repetitions and do 2-3 sets. ** ensure that your head, neck, and back maintain a neutral alignment to minimize stress on your neck. 5.plank: how it helps – just like the bird dog, this “core” exercise will help bring your pelvis into right position by strengthening the deep spinal muscles and glutes (butt muscles). How to do it – begin lying on your stomach with your forearms against the mat. – engage your core and lift your body so that you are resting on your forearms and toes. – start with 10 second holds and work up to 30 second holds, do 2-3 sets. ** ensure to keep your back straight throughout the entire exercise – spine in neutral position. Thoracic expansion if you’re using a chair, sit facing forward and allow your upper body to fall over the back of the chair. Extend your arms above your head for a deeper stretch. Hold either position for 10 seconds. 1. Plank the world record for the longest plank is 8 hours. Luckily, you don’t need to hold it that long for the exercise to have an effect! in fact. You can hold it for 10-15 seconds. • the plank is similar to a push-up position, but instead of resting on your hands, you rest on your elbows and bring them directly underneath your chest. • after kneeling, lean forward and place your elbows on the ground directly below your shoulders. • lift your knees off of the floor and push your feet back. Ensure your back is straight and keep your neck aligned with the rest of your spine. • hold the position and tighten your core muscles for the desired time. 2. Side plank just like the original plank, but only balancing on one side. • lie on the floor on your side, facing sideways with your feet together. • lift up your body until you are supporting yourself with your elbow, directly below your shoulder. • raise your hips until your body is in a straight line and tighten your core muscles; your body should create a slant from your shoulders to your feet. • hold this position without dropping your hips. • repeat on the opposite side. 3. Pelvic tilt with exercise ball sit on a ball that allows your legs to be at a 90-degree angle with your feet flat on the floor. • keep your shoulders back and spine straight. • tilt your hips forward and flex your abdominals tight. • tilt your hips backward as you stick your tailbone out. • move back and forth slowly, keeping your shoulders back. • repeat 10 times for 3 sets. 4. Superman lie on your stomach, face down, with your arms out in front of you. • lift arms, legs, and chest off the floor simultaneously while keeping your hips grounded. • hold for a minimum of two seconds. • lower back down slowly. • repeat 10 times for 3 sets. 6. Crunches lie flat on your back, placing your feet flat on the floor with your legs bent. • fold your arms across your chest and lift your torso up until your head, neck, and torso are off the ground. • hold for a moment before lowering back down. • repeat. 6. Quadruped arm opposite leg raises • kneel on the floor, lean forward, and place your hands palm-down on the floor. • make sure your back is straight, your knees are below your hips, and that your palms are directly below your shoulders. • raise one arm as you raise the opposite leg until both are aligned straight out from your body, parallel to your spine. • slowly lower both your arm and leg until you are back in the starting position. • switch arm and leg, and repeat. 7. Dead bug lie flat on the floor on your back. • lift your arms straight up from your body, reaching through the air. • raise one leg until it is at a 90-degree angle from your body. • slowly lower until it is in the starting position. • switch legs and repeat. 8. Hip bridge lie on your back with your knees bent and raised, your feet flat on the floor, and your arms at your sides. • keep your feet hip-distance apart and try to keep your leg in vertical alignment with your knee. • flex your glutes and push through your heels to raise your hips upward. Try to make a diagonal line from your shoulders to your knees. • hold for a short moment before lowering back down. • repeat 10 times for 3 sets. 

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Dr. Julie Mercy J DavidErasmus Mundus Master in Adapted Physical Activity, MPT, BPTh/BPTPhysiotherapist

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Back pain back pain exercises; kindly do these exercises. Back pain is described as acute or chronic based on how long you’ve had it. Acute pain lasts days to weeks, subacute pain lasts six weeks to three months, and chronic pain lasts longer than three months. Things that make it better or worse back pain may get worse with movement or if you sit or stand for a long time. It may get better if you switch positions or walk around. Other symptoms you may experience with back pain include: •the painful spot looking swollen and feeling tender to the touch •a muscle spasm in the painful area •numbness or weakness in one or both of your legs (if the pain is due to a nerve issue) if you find you have back pain and can’t hold your urine or bowel movements, something is pressing on your spinal nerves, and you should be evaluated immediately. This condition, called cauda equina syndrome, can cause severe long-term damage to your spinal nerves if not treated right away. 6 imbalances that cause pain—and how to fix them "pain is a medical condition and a medical issue, says brett jones, owner of applied strength in pittsburgh who is certified for the functional movement screen, a system of tests and cor rective exercise strategies. "it's a warning sign. The pain is there to tell you something's wrong. And that warning sign could be more serious than "you're going too hard. Jones and the other coaches consulted for this piece all had a horror story to tell-when pain in a client meant a more serious condition such as a nerve issue, thyroid issue, or even cancer. The point: if you experience regular pain while exercising-or when you're not-go to the doctor. If you've been cleared by a doc and you're still feeling discomfort, try these simple tests to see what's truly causing the pain-it could be related to an imbalance in a completely different part of your body. The good news: with these drills, stretches, and corrective exercises, you may be able to fix them-no doctors necessary. 1. Standing extension how it helps – this standing extension helps reverse what you do on a daily basis (hunching)… since most bulging discs and herniated discs are caused by poor posture and repeated flexion of the spine (esp bending fwd in bad posture), this stretch helps push the disc back to neutral position. How to do it – begin this exercise by standing up with good posture. Now take both hands and place them on both sides of your lower back. Now with the help of your hands push your pelvis forward and extend your spine back. Follow the extension with your neck so that you end up facing the ceiling. – start with 10 repetitions and do 2-3 sets. – this one is particularly great to do when you need a break from sitting at your desk. ** this should not cause any pain. If you feel pain during it is not a good one for you. In that case, stop and try some of the other exercises below instead. 2. Half cobra pose (prone lumbar extension) how it helps – the half cobra stretch helps to push the disc material back towards the center of the inter-vertebral disc to allow for improved healing. The goal of repeated lower back extension is the “centralization of symptoms”, which basically means pain that travels down the affected leg to the foot should come back up closer to the low back – which will in turn alleviate the pain. How to do it – begin this exercise by lying on your stomach (prone position) and slowly prop yourself up on your elbows while keeping your hips in contact with the floor. – hold the prop-up position for 10-15 seconds before returning to the prone position (lying face down). – gradually increase to holding the end position for 30 seconds. Aim for 10 repetitions of this stretch. ** initially, you may not be able to tolerate this position very well, so make sure you start slowly and carefully. If there’s any pain, try a different exercise instead. 3. Full cobra pose (advanced extension) how it helps – this stretch is based on the same principle as the half cobra pose above. This advanced extension helps to push disc material back towards the center of the intervertebral disc, with the goal of alleviating pain symptoms. How to do it – once you’ve mastered the half cobra pose, you can increase the difficulty by moving to the advanced version of this stretch. Begin this exercise by lying on your stomach in the prone position (lying facing down) and slowly press up on your hands while keeping your pelvis in contact with the floor and lower back relaxed. – hold the prop-up position for 10 seconds. Aim for 10 repetitions of this stretch. – eventually try to hold this pose for longer if it feels good (20-30 seconds). ** if you feel pain during this exercise, it is not a good one for you. In that case, stop and try some of the other exercises instead. 4. Cat-cow how it helps – this is one of the most popular herniated disc exercises. By combining two yoga poses, the cat-cow stretch can help to relieve pressure on the herniated disc by opening the intervertebral disc space. It also improves mobility of the spine, which may help to relieve disc herniation pain and speed recovery. How to do it – begin this stretch on your hands and knees. Inhale and let your stomach “drop” towards the floor as you look up towards the ceiling. – follow this by exhaling and slowly rounding your spine while pressing into the floor with your hands and slightly curving your neck to look at your feet. – aim for 10 repetitions of this stretch and do 2-3 sets. How it helps – this exercise will help strengthen and stabilize your lower back and deep spine muscles. This will help you to maintain a good posture and avoid future episodes of herniated discs. How to do it: – begin on your hands and knees with your hands positioned under your shoulders and knees positioned under your hips. – raise your left arm and reach it forwards until it is aligned with your torso; at the same time, kick your right leg backwards until is it aligned with your torso. – hold this position for 2-3 seconds before slowly returning to the starting position. – repeat with your right arm and left leg. – alternate sides for 10 repetitions and do 2-3 sets. ** ensure that your head, neck, and back maintain a neutral alignment to minimize stress on your neck. 5.plank: how it helps – just like the bird dog, this “core” exercise will help bring your pelvis into right position by strengthening the deep spinal muscles and glutes (butt muscles). How to do it – begin lying on your stomach with your forearms against the mat. – engage your core and lift your body so that you are resting on your forearms and toes. – start with 10 second holds and work up to 30 second holds, do 2-3 sets. ** ensure to keep your back straight throughout the entire exercise – spine in neutral position. Thoracic expansion if you’re using a chair, sit facing forward and allow your upper body to fall over the back of the chair. Extend your arms above your head for a deeper stretch. Hold either position for 10 seconds. 1. Plank the world record for the longest plank is 8 hours. Luckily, you don’t need to hold it that long for the exercise to have an effect! in fact. You can hold it for 10-15 seconds. • the plank is similar to a push-up position, but instead of resting on your hands, you rest on your elbows and bring them directly underneath your chest. • after kneeling, lean forward and place your elbows on the ground directly below your shoulders. • lift your knees off of the floor and push your feet back. Ensure your back is straight and keep your neck aligned with the rest of your spine. • hold the position and tighten your core muscles for the desired time. 2. Side plank just like the original plank, but only balancing on one side. • lie on the floor on your side, facing sideways with your feet together. • lift up your body until you are supporting yourself with your elbow, directly below your shoulder. • raise your hips until your body is in a straight line and tighten your core muscles; your body should create a slant from your shoulders to your feet. • hold this position without dropping your hips. • repeat on the opposite side. 3. Pelvic tilt with exercise ball sit on a ball that allows your legs to be at a 90-degree angle with your feet flat on the floor. • keep your shoulders back and spine straight. • tilt your hips forward and flex your abdominals tight. • tilt your hips backward as you stick your tailbone out. • move back and forth slowly, keeping your shoulders back. • repeat 10 times for 3 sets. 4. Superman lie on your stomach, face down, with your arms out in front of you. • lift arms, legs, and chest off the floor simultaneously while keeping your hips grounded. • hold for a minimum of two seconds. • lower back down slowly. • repeat 10 times for 3 sets. 6. Crunches lie flat on your back, placing your feet flat on the floor with your legs bent. • fold your arms across your chest and lift your torso up until your head, neck, and torso are off the ground. • hold for a moment before lowering back down. • repeat. 6. Quadruped arm opposite leg raises • kneel on the floor, lean forward, and place your hands palm-down on the floor. • make sure your back is straight, your knees are below your hips, and that your palms are directly below your shoulders. • raise one arm as you raise the opposite leg until both are aligned straight out from your body, parallel to your spine. • slowly lower both your arm and leg until you are back in the starting position. • switch arm and leg, and repeat. 7. Dead bug lie flat on the floor on your back. • lift your arms straight up from your body, reaching through the air. • raise one leg until it is at a 90-degree angle from your body. • slowly lower until it is in the starting position. • switch legs and repeat. 8. Hip bridge lie on your back with your knees bent and raised, your feet flat on the floor, and your arms at your sides. • keep your feet hip-distance apart and try to keep your leg in vertical alignment with your knee. • flex your glutes and push through your heels to raise your hips upward. Try to make a diagonal line from your shoulders to your knees. • hold for a short moment before lowering back down. • repeat 10 times for 3 sets. 

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Dr. Julie Mercy J DavidErasmus Mundus Master in Adapted Physical Activity, MPT, BPTh/BPTPhysiotherapist

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Back pain exercises; kindly do these exercises. Back pain is described as acute or chronic based on how long you’ve had it. Acute pain lasts days to weeks, subacute pain lasts six weeks to three months, and chronic pain lasts longer than three months. Things that make it better or worse back pain may get worse with movement or if you sit or stand for a long time. It may get better if you switch positions or walk around. Other symptoms you may experience with back pain include: •the painful spot looking swollen and feeling tender to the touch •a muscle spasm in the painful area •numbness or weakness in one or both of your legs (if the pain is due to a nerve issue) if you find you have back pain and can’t hold your urine or bowel movements, something is pressing on your spinal nerves, and you should be evaluated immediately. This condition, called cauda equina syndrome, can cause severe long-term damage to your spinal nerves if not treated right away. 6 imbalances that cause pain—and how to fix them "pain is a medical condition and a medical issue, says brett jones, owner of applied strength in pittsburgh who is certified for the functional movement screen, a system of tests and cor rective exercise strategies. "it's a warning sign. The pain is there to tell you something's wrong. And that warning sign could be more serious than "you're going too hard. Jones and the other coaches consulted for this piece all had a horror story to tell-when pain in a client meant a more serious condition such as a nerve issue, thyroid issue, or even cancer. The point: if you experience regular pain while exercising-or when you're not-go to the doctor. If you've been cleared by a doc and you're still feeling discomfort, try these simple tests to see what's truly causing the pain-it could be related to an imbalance in a completely different part of your body. The good news: with these drills, stretches, and corrective exercises, you may be able to fix them-no doctors necessary. 1. Standing extension how it helps – this standing extension helps reverse what you do on a daily basis (hunching)… since most bulging discs and herniated discs are caused by poor posture and repeated flexion of the spine (esp bending fwd in bad posture), this stretch helps push the disc back to neutral position. How to do it – begin this exercise by standing up with good posture. Now take both hands and place them on both sides of your lower back. Now with the help of your hands push your pelvis forward and extend your spine back. Follow the extension with your neck so that you end up facing the ceiling. – start with 10 repetitions and do 2-3 sets. – this one is particularly great to do when you need a break from sitting at your desk. ** this should not cause any pain. If you feel pain during it is not a good one for you. In that case, stop and try some of the other exercises below instead. 2. Half cobra pose (prone lumbar extension) how it helps – the half cobra stretch helps to push the disc material back towards the center of the inter-vertebral disc to allow for improved healing. The goal of repeated lower back extension is the “centralization of symptoms”, which basically means pain that travels down the affected leg to the foot should come back up closer to the low back – which will in turn alleviate the pain. How to do it – begin this exercise by lying on your stomach (prone position) and slowly prop yourself up on your elbows while keeping your hips in contact with the floor. – hold the prop-up position for 10-15 seconds before returning to the prone position (lying face down). – gradually increase to holding the end position for 30 seconds. Aim for 10 repetitions of this stretch. ** initially, you may not be able to tolerate this position very well, so make sure you start slowly and carefully. If there’s any pain, try a different exercise instead. 3. Full cobra pose (advanced extension) how it helps – this stretch is based on the same principle as the half cobra pose above. This advanced extension helps to push disc material back towards the center of the intervertebral disc, with the goal of alleviating pain symptoms. How to do it – once you’ve mastered the half cobra pose, you can increase the difficulty by moving to the advanced version of this stretch. Begin this exercise by lying on your stomach in the prone position (lying facing down) and slowly press up on your hands while keeping your pelvis in contact with the floor and lower back relaxed. – hold the prop-up position for 10 seconds. Aim for 10 repetitions of this stretch. – eventually try to hold this pose for longer if it feels good (20-30 seconds). ** if you feel pain during this exercise, it is not a good one for you. In that case, stop and try some of the other exercises instead. 4. Cat-cow how it helps – this is one of the most popular herniated disc exercises. By combining two yoga poses, the cat-cow stretch can help to relieve pressure on the herniated disc by opening the intervertebral disc space. It also improves mobility of the spine, which may help to relieve disc herniation pain and speed recovery. How to do it – begin this stretch on your hands and knees. Inhale and let your stomach “drop” towards the floor as you look up towards the ceiling. – follow this by exhaling and slowly rounding your spine while pressing into the floor with your hands and slightly curving your neck to look at your feet. – aim for 10 repetitions of this stretch and do 2-3 sets. How it helps – this exercise will help strengthen and stabilize your lower back and deep spine muscles. This will help you to maintain a good posture and avoid future episodes of herniated discs. How to do it: – begin on your hands and knees with your hands positioned under your shoulders and knees positioned under your hips. – raise your left arm and reach it forwards until it is aligned with your torso; at the same time, kick your right leg backwards until is it aligned with your torso. – hold this position for 2-3 seconds before slowly returning to the starting position. – repeat with your right arm and left leg. – alternate sides for 10 repetitions and do 2-3 sets. ** ensure that your head, neck, and back maintain a neutral alignment to minimize stress on your neck. 5.plank: how it helps – just like the bird dog, this “core” exercise will help bring your pelvis into right position by strengthening the deep spinal muscles and glutes (butt muscles). How to do it – begin lying on your stomach with your forearms against the mat. – engage your core and lift your body so that you are resting on your forearms and toes. – start with 10 second holds and work up to 30 second holds, do 2-3 sets. ** ensure to keep your back straight throughout the entire exercise – spine in neutral position. Thoracic expansion if you’re using a chair, sit facing forward and allow your upper body to fall over the back of the chair. Extend your arms above your head for a deeper stretch. Hold either position for 10 seconds. 1. Plank the world record for the longest plank is 8 hours. Luckily, you don’t need to hold it that long for the exercise to have an effect! in fact. You can hold it for 10-15 seconds. • the plank is similar to a push-up position, but instead of resting on your hands, you rest on your elbows and bring them directly underneath your chest. • after kneeling, lean forward and place your elbows on the ground directly below your shoulders. • lift your knees off of the floor and push your feet back. Ensure your back is straight and keep your neck aligned with the rest of your spine. • hold the position and tighten your core muscles for the desired time. 2. Side plank just like the original plank, but only balancing on one side. • lie on the floor on your side, facing sideways with your feet together. • lift up your body until you are supporting yourself with your elbow, directly below your shoulder. • raise your hips until your body is in a straight line and tighten your core muscles; your body should create a slant from your shoulders to your feet. • hold this position without dropping your hips. • repeat on the opposite side. 3. Pelvic tilt with exercise ball sit on a ball that allows your legs to be at a 90-degree angle with your feet flat on the floor. • keep your shoulders back and spine straight. • tilt your hips forward and flex your abdominals tight. • tilt your hips backward as you stick your tailbone out. • move back and forth slowly, keeping your shoulders back. • repeat 10 times for 3 sets. 4. Superman lie on your stomach, face down, with your arms out in front of you. • lift arms, legs, and chest off the floor simultaneously while keeping your hips grounded. • hold for a minimum of two seconds. • lower back down slowly. • repeat 10 times for 3 sets. 6. Crunches lie flat on your back, placing your feet flat on the floor with your legs bent. • fold your arms across your chest and lift your torso up until your head, neck, and torso are off the ground. • hold for a moment before lowering back down. • repeat. 6. Quadruped arm opposite leg raises • kneel on the floor, lean forward, and place your hands palm-down on the floor. • make sure your back is straight, your knees are below your hips, and that your palms are directly below your shoulders. • raise one arm as you raise the opposite leg until both are aligned straight out from your body, parallel to your spine. 

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Dr. Julie Mercy J DavidErasmus Mundus Master in Adapted Physical Activity, MPT, BPTh/BPTPhysiotherapist

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6 imbalances that cause pain—and how to fix them "pain is a medical condition and a medical issue, says brett jones, owner of applied strength in pittsburgh who is certified for the functional movement screen, a system of tests and cor rective exercise strategies. "it's a warning sign. The pain is there to tell you something's wrong. And that warning sign could be more serious than "you're going too hard. Jones and the other coaches consulted for this piece all had a horror story to tell-when pain in a client meant a more serious condition such as a nerve issue, thyroid issue, or even cancer. The point: if you experience regular pain while exercising-or when you're not-go to the doctor. If you've been cleared by a doc and you're still feeling discomfort, try these simple tests to see what's truly causing the pain-it could be related to an imbalance in a completely different part of your body. The good news: with these drills, stretches, and corrective exercises, you may be able to fix them-no doctors necessary. 1. Standing extension how it helps – this standing extension helps reverse what you do on a daily basis (hunching)… since most bulging discs and herniated discs are caused by poor posture and repeated flexion of the spine (esp bending fwd in bad posture), this stretch helps push the disc back to neutral position. How to do it – begin this exercise by standing up with good posture. Now take both hands and place them on both sides of your lower back. Now with the help of your hands push your pelvis forward and extend your spine back. Follow the extension with your neck so that you end up facing the ceiling. – start with 10 repetitions and do 2-3 sets. – this one is particularly great to do when you need a break from sitting at your desk. ** this should not cause any pain. If you feel pain during it is not a good one for you. In that case, stop and try some of the other exercises below instead. 2. Half cobra pose (prone lumbar extension) how it helps – the half cobra stretch helps to push the disc material back towards the center of the inter-vertebral disc to allow for improved healing. The goal of repeated lower back extension is the “centralization of symptoms”, which basically means pain that travels down the affected leg to the foot should come back up closer to the low back – which will in turn alleviate the pain. How to do it – begin this exercise by lying on your stomach (prone position) and slowly prop yourself up on your elbows while keeping your hips in contact with the floor. – hold the prop-up position for 10-15 seconds before returning to the prone position (lying face down). – gradually increase to holding the end position for 30 seconds. Aim for 10 repetitions of this stretch. ** initially, you may not be able to tolerate this position very well, so make sure you start slowly and carefully. If there’s any pain, try a different exercise instead. 3. Full cobra pose (advanced extension) how it helps – this stretch is based on the same principle as the half cobra pose above. This advanced extension helps to push disc material back towards the center of the intervertebral disc, with the goal of alleviating pain symptoms. How to do it – once you’ve mastered the half cobra pose, you can increase the difficulty by moving to the advanced version of this stretch. Begin this exercise by lying on your stomach in the prone position (lying facing down) and slowly press up on your hands while keeping your pelvis in contact with the floor and lower back relaxed. – hold the prop-up position for 10 seconds. Aim for 10 repetitions of this stretch. – eventually try to hold this pose for longer if it feels good (20-30 seconds). ** if you feel pain during this exercise, it is not a good one for you. In that case, stop and try some of the other exercises instead. 4. Cat-cow how it helps – this is one of the most popular herniated disc exercises. By combining two yoga poses, the cat-cow stretch can help to relieve pressure on the herniated disc by opening the intervertebral disc space. It also improves mobility of the spine, which may help to relieve disc herniation pain and speed recovery. How to do it – begin this stretch on your hands and knees. Inhale and let your stomach “drop” towards the floor as you look up towards the ceiling. – follow this by exhaling and slowly rounding your spine while pressing into the floor with your hands and slightly curving your neck to look at your feet. – aim for 10 repetitions of this stretch and do 2-3 sets. How it helps – this exercise will help strengthen and stabilize your lower back and deep spine muscles. This will help you to maintain a good posture and avoid future episodes of herniated discs. How to do it: – begin on your hands and knees with your hands positioned under your shoulders and knees positioned under your hips. – raise your left arm and reach it forwards until it is aligned with your torso; at the same time, kick your right leg backwards until is it aligned with your torso. – hold this position for 2-3 seconds before slowly returning to the starting position. – repeat with your right arm and left leg. – alternate sides for 10 repetitions and do 2-3 sets. ** ensure that your head, neck, and back maintain a neutral alignment to minimize stress on your neck. 5.plank: how it helps – just like the bird dog, this “core” exercise will help bring your pelvis into right position by strengthening the deep spinal muscles and glutes (butt muscles). How to do it – begin lying on your stomach with your forearms against the mat. – engage your core and lift your body so that you are resting on your forearms and toes. – start with 10 second holds and work up to 30 second holds, do 2-3 sets. ** ensure to keep your back straight throughout the entire exercise – spine in neutral position. Thoracic expansion if you’re using a chair, sit facing forward and allow your upper body to fall over the back of the chair. Extend your arms above your head for a deeper stretch. Hold either position for 10 seconds. 1. Plank the world record for the longest plank is 8 hours. Luckily, you don’t need to hold it that long for the exercise to have an effect! in fact. You can hold it for 10-15 seconds. • the plank is similar to a push-up position, but instead of resting on your hands, you rest on your elbows and bring them directly underneath your chest. • after kneeling, lean forward and place your elbows on the ground directly below your shoulders. • lift your knees off of the floor and push your feet back. Ensure your back is straight and keep your neck aligned with the rest of your spine. • hold the position and tighten your core muscles for the desired time. 2. Side plank just like the original plank, but only balancing on one side. • lie on the floor on your side, facing sideways with your feet together. • lift up your body until you are supporting yourself with your elbow, directly below your shoulder. • raise your hips until your body is in a straight line and tighten your core muscles; your body should create a slant from your shoulders to your feet. • hold this position without dropping your hips. • repeat on the opposite side. 3. Pelvic tilt with exercise ball sit on a ball that allows your legs to be at a 90-degree angle with your feet flat on the floor. • keep your shoulders back and spine straight. • tilt your hips forward and flex your abdominals tight. • tilt your hips backward as you stick your tailbone out. • move back and forth slowly, keeping your shoulders back. • repeat 10 times for 3 sets. 4. Superman lie on your stomach, face down, with your arms out in front of you. • lift arms, legs, and chest off the floor simultaneously while keeping your hips grounded. • hold for a minimum of two seconds. • lower back down slowly. • repeat 10 times for 3 sets. 6. Crunches lie flat on your back, placing your feet flat on the floor with your legs bent. • fold your arms across your chest and lift your torso up until your head, neck, and torso are off the ground. • hold for a moment before lowering back down. • repeat. 6. Quadruped arm opposite leg raises • kneel on the floor, lean forward, and place your hands palm-down on the floor. • make sure your back is straight, your knees are below your hips, and that your palms are directly below your shoulders. • raise one arm as you raise the opposite leg until both are aligned straight out from your body, parallel to your spine. • slowly lower both your arm and leg until you are back in the starting position. • switch arm and leg, and repeat. 7. Dead bug lie flat on the floor on your back. • lift your arms straight up from your body, reaching through the air. • raise one leg until it is at a 90-degree angle from your body. • slowly lower until it is in the starting position. • switch legs and repeat. 8. Hip bridge lie on your back with your knees bent and raised, your feet flat on the floor, and your arms at your sides. • keep your feet hip-distance apart and try to keep your leg in vertical alignment with your knee. • flex your glutes and push through your heels to raise your hips upward. Try to make a diagonal line from your shoulders to your knees. • hold for a short moment before lowering back down. • repeat 10 times for 3 sets. 

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Dr. Julie Mercy J DavidErasmus Mundus Master in Adapted Physical Activity, MPT, BPTh/BPTPhysiotherapist

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Burning pain or tingling sensation in hands or feet if you are suffering from burning pain or tingling sensation in hands or feet; sharp shooting pain in legs; numbness in hands or feet, then you might be suffering from neuropathic pain what is a neuropathic pain? Neuropathic pain is a special type of pain which occurs when there is damage to nerve fibres, which produces tingling or burning type of pain. It is of two types: 1. Peripheral neuropathic pain: it occurs when there is an injury to peripheral nerve fibres (a-delta or c-fibers) which carries pain sensation to the brain (thalamus) for interpretation. 2. Central neuropathic pain: it occurs due to sensitization of central pain interpreting mechanisms (thalamus) to falsely feel pain when peripheral nerve fibres are no longer sending pain impulses to them. Worldwide-estimates of the prevalence of neuropathic pain is 7% i.e. 7 persons out of 100 people are suffering from different types of neuropathic pain. Symptoms: •tingling sensation or feeling of ants crawling under skin •burning sensation •sharp shooting pain or electric current-like sensation •stabbing pain •dull pain with numbness or heaviness reasons for neuropathic pain: •diabetes mellitus: most common cause worldwide due to uncontrolled blood sugar levels, causing damage to nerve fibres. •alcohol consumption/cigarette smoking: damage to nerve fibres or damage to blood vessels supplying nerve fibres. Burning pain in feet •neck pain/low back pain/glutei pain •vit. B12 deficiency •chemotherapy for cancer patients •post-herpes virus infection •post-spine surgery •post-amputation •diseases like spinal cord injury, multiple sclerosis, hiv, lead toxicity, etc. Special neuropathies: 1. Carpal tunnel syndrome: tingling, burning sensation in hand which occurs due to compression of median nerve in the wrist area. It occurs in women especially due to pregnancy, hypothyroidism, diabetes, etc. And in men due to improper position of the wrist during working on computers. 2. Cervical radiculopathy: pain in neck and shoulder region (which increases with neck movements), along with sharpshooting pain radiating from neck to hand occurs in cases of cervical radiculopathy. This is due to compression of the cervical nerve root by disc prolapse, facet subluxation, muscle spasm, trauma, etc. 3. Lumbar radiculopathy: pain in lower back or glutei region with sharp shooting pain radiating from hip to leg/foot region, occurs in cases of lumbar radiculopathy or sciatica. This is due to compression of lumbar nerve root or sciatic nerve by disc prolapse, facet joint, trauma, hypertrophied ligamentumflavum, piriformis syndrome, etc. 4. Meralgiaparesthetica: tingling or burning sensation in front of the thigh, occurs due to compression of lateral cutaneous nerve of thigh, near waist region. Usual causes are tight or constrictive clothing at waist region, prolonged sitting, protuberant abdomen, etc. Prevention of neuropathy: 1. Avoid alcohol consumption and cigarette smoking. 2. Maintain ideal body weight/bmi (body mass index) 3. Lifestyle changes: daily exercises (>30 minutes per day) or brisk walking or swimming; avoid prolonged sitting or standing (>30 minutes). 4. Food/diet should have following components: •green vegetables e.g. Spinach, fenugreek leaves (methi), radish, etc •coloured vegetables e.g. Tomato, carrot, capsicum (green/red), ladies-finger (bhindi) •milk products e.g. Milk, buttermilk, curd, cheese (paneer) •protein-rich foods e.g. Fish, egg, chicken, pulses (daal) •fibre-rich foods e.g. Bran, oats, brown-rice •fruits e.g. Apple, orange, guava, papaya, pomegranate, berries 5. Blood sugar control (in diabetics) 6. Care of feet: •regular inspection of feet (with mirror) •comfortable, well-fitted shoes •regular consultation with a podiatrist •treatment of wounds, foot deformities 7. Adequate sleep 8. Warm water bath (increases blood flow to the affected area) treatment: •consult pain medicine specialist. •neuropathic painkillers e.g. Amitriptyline, pregabalin, gabapentin, capsaicin, duloxetine, etc. •vit. B12 supplements, anti-oxidants, multi-vitamins. •transcutaneous electrical nerve stimulation (tens) •acupuncture •relaxation and yoga •neural prolotherapy. 

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Dr. Julie Mercy J DavidErasmus Mundus Master in Adapted Physical Activity, MPT, BPTh/BPTPhysiotherapist

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Burning pain or tingling sensation in hands or feet if you are suffering from burning pain or tingling sensation in hands or feet; sharp shooting pain in legs; numbness in hands or feet, then you might be suffering from neuropathic pain what is a neuropathic pain? Neuropathic pain is a special type of pain which occurs when there is damage to nerve fibres, which produces tingling or burning type of pain. It is of two types: 1. Peripheral neuropathic pain: it occurs when there is an injury to peripheral nerve fibres (a-delta or c-fibers) which carries pain sensation to the brain (thalamus) for interpretation. 2. Central neuropathic pain: it occurs due to sensitization of central pain interpreting mechanisms (thalamus) to falsely feel pain when peripheral nerve fibres are no longer sending pain impulses to them. Worldwide-estimates of the prevalence of neuropathic pain is 7% i.e. 7 persons out of 100 people are suffering from different types of neuropathic pain. Symptoms: •tingling sensation or feeling of ants crawling under skin •burning sensation •sharp shooting pain or electric current-like sensation •stabbing pain •dull pain with numbness or heaviness reasons for neuropathic pain: •diabetes mellitus: most common cause worldwide due to uncontrolled blood sugar levels, causing damage to nerve fibres. •alcohol consumption/cigarette smoking: damage to nerve fibres or damage to blood vessels supplying nerve fibres. Burning pain in feet •neck pain/low back pain/glutei pain •vit. B12 deficiency •chemotherapy for cancer patients •post-herpes virus infection •post-spine surgery •post-amputation •diseases like spinal cord injury, multiple sclerosis, hiv, lead toxicity, etc. Special neuropathies: 1. Carpal tunnel syndrome: tingling, burning sensation in hand which occurs due to compression of median nerve in the wrist area. It occurs in women especially due to pregnancy, hypothyroidism, diabetes, etc. And in men due to improper position of the wrist during working on computers. 2. Cervical radiculopathy: pain in neck and shoulder region (which increases with neck movements), along with sharpshooting pain radiating from neck to hand occurs in cases of cervical radiculopathy. This is due to compression of the cervical nerve root by disc prolapse, facet subluxation, muscle spasm, trauma, etc. 3. Lumbar radiculopathy: pain in lower back or glutei region with sharp shooting pain radiating from hip to leg/foot region, occurs in cases of lumbar radiculopathy or sciatica. This is due to compression of lumbar nerve root or sciatic nerve by disc prolapse, facet joint, trauma, hypertrophied ligamentumflavum, piriformis syndrome, etc. 4. Meralgiaparesthetica: tingling or burning sensation in front of the thigh, occurs due to compression of lateral cutaneous nerve of thigh, near waist region. Usual causes are tight or constrictive clothing at waist region, prolonged sitting, protuberant abdomen, etc. Prevention of neuropathy: 1. Avoid alcohol consumption and cigarette smoking. 2. Maintain ideal body weight/bmi (body mass index) 3. Lifestyle changes: daily exercises (>30 minutes per day) or brisk walking or swimming; avoid prolonged sitting or standing (>30 minutes). 4. Food/diet should have following components: •green vegetables e.g. Spinach, fenugreek leaves (methi), radish, etc •coloured vegetables e.g. Tomato, carrot, capsicum (green/red), ladies-finger (bhindi) •milk products e.g. Milk, buttermilk, curd, cheese (paneer) •protein-rich foods e.g. Fish, egg, chicken, pulses (daal) •fibre-rich foods e.g. Bran, oats, brown-rice •fruits e.g. Apple, orange, guava, papaya, pomegranate, berries 5. Blood sugar control (in diabetics) 6. Care of feet: •regular inspection of feet (with mirror) •comfortable, well-fitted shoes •regular consultation with a podiatrist •treatment of wounds, foot deformities 7. Adequate sleep 8. Warm water bath (increases blood flow to the affected area) treatment: •consult pain medicine specialist. •neuropathic painkillers e.g. Amitriptyline, pregabalin, gabapentin, capsaicin, duloxetine, etc. •vit. B12 supplements, anti-oxidants, multi-vitamins. •transcutaneous electrical nerve stimulation (tens) •acupuncture •relaxation and yoga •neural prolotherapy. 

0 person found this helpful

Dr. Julie Mercy J DavidErasmus Mundus Master in Adapted Physical Activity, MPT, BPTh/BPTPhysiotherapist

91% (41326 ratings)

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Back pain back pain exercises; kindly do these exercises. Back pain is described as acute or chronic based on how long you’ve had it. Acute pain lasts days to weeks, subacute pain lasts six weeks to three months, and chronic pain lasts longer than three months. Things that make it better or worse back pain may get worse with movement or if you sit or stand for a long time. It may get better if you switch positions or walk around. Other symptoms you may experience with back pain include: •the painful spot looking swollen and feeling tender to the touch •a muscle spasm in the painful area •numbness or weakness in one or both of your legs (if the pain is due to a nerve issue) if you find you have back pain and can’t hold your urine or bowel movements, something is pressing on your spinal nerves, and you should be evaluated immediately. This condition, called cauda equina syndrome, can cause severe long-term damage to your spinal nerves if not treated right away. 6 imbalances that cause pain—and how to fix them "pain is a medical condition and a medical issue, says brett jones, owner of applied strength in pittsburgh who is certified for the functional movement screen, a system of tests and cor rective exercise strategies. "it's a warning sign. The pain is there to tell you something's wrong. And that warning sign could be more serious than "you're going too hard. Jones and the other coaches consulted for this piece all had a horror story to tell-when pain in a client meant a more serious condition such as a nerve issue, thyroid issue, or even cancer. The point: if you experience regular pain while exercising-or when you're not-go to the doctor. If you've been cleared by a doc and you're still feeling discomfort, try these simple tests to see what's truly causing the pain-it could be related to an imbalance in a completely different part of your body. The good news: with these drills, stretches, and corrective exercises, you may be able to fix them-no doctors necessary. 1. Standing extension how it helps – this standing extension helps reverse what you do on a daily basis (hunching)… since most bulging discs and herniated discs are caused by poor posture and repeated flexion of the spine (esp bending fwd in bad posture), this stretch helps push the disc back to neutral position. How to do it – begin this exercise by standing up with good posture. Now take both hands and place them on both sides of your lower back. Now with the help of your hands push your pelvis forward and extend your spine back. Follow the extension with your neck so that you end up facing the ceiling. – start with 10 repetitions and do 2-3 sets. – this one is particularly great to do when you need a break from sitting at your desk. ** this should not cause any pain. If you feel pain during it is not a good one for you. In that case, stop and try some of the other exercises below instead. 2. Half cobra pose (prone lumbar extension) how it helps – the half cobra stretch helps to push the disc material back towards the center of the inter-vertebral disc to allow for improved healing. The goal of repeated lower back extension is the “centralization of symptoms”, which basically means pain that travels down the affected leg to the foot should come back up closer to the low back – which will in turn alleviate the pain. How to do it – begin this exercise by lying on your stomach (prone position) and slowly prop yourself up on your elbows while keeping your hips in contact with the floor. – hold the prop-up position for 10-15 seconds before returning to the prone position (lying face down). – gradually increase to holding the end position for 30 seconds. Aim for 10 repetitions of this stretch. ** initially, you may not be able to tolerate this position very well, so make sure you start slowly and carefully. If there’s any pain, try a different exercise instead. 3. Full cobra pose (advanced extension) how it helps – this stretch is based on the same principle as the half cobra pose above. This advanced extension helps to push disc material back towards the center of the intervertebral disc, with the goal of alleviating pain symptoms. How to do it – once you’ve mastered the half cobra pose, you can increase the difficulty by moving to the advanced version of this stretch. Begin this exercise by lying on your stomach in the prone position (lying facing down) and slowly press up on your hands while keeping your pelvis in contact with the floor and lower back relaxed. – hold the prop-up position for 10 seconds. Aim for 10 repetitions of this stretch. – eventually try to hold this pose for longer if it feels good (20-30 seconds). ** if you feel pain during this exercise, it is not a good one for you. In that case, stop and try some of the other exercises instead. 4. Cat-cow how it helps – this is one of the most popular herniated disc exercises. By combining two yoga poses, the cat-cow stretch can help to relieve pressure on the herniated disc by opening the intervertebral disc space. It also improves mobility of the spine, which may help to relieve disc herniation pain and speed recovery. How to do it – begin this stretch on your hands and knees. Inhale and let your stomach “drop” towards the floor as you look up towards the ceiling. – follow this by exhaling and slowly rounding your spine while pressing into the floor with your hands and slightly curving your neck to look at your feet. – aim for 10 repetitions of this stretch and do 2-3 sets. How it helps – this exercise will help strengthen and stabilize your lower back and deep spine muscles. This will help you to maintain a good posture and avoid future episodes of herniated discs. How to do it: – begin on your hands and knees with your hands positioned under your shoulders and knees positioned under your hips. – raise your left arm and reach it forwards until it is aligned with your torso; at the same time, kick your right leg backwards until is it aligned with your torso. – hold this position for 2-3 seconds before slowly returning to the starting position. – repeat with your right arm and left leg. – alternate sides for 10 repetitions and do 2-3 sets. ** ensure that your head, neck, and back maintain a neutral alignment to minimize stress on your neck. 5.plank: how it helps – just like the bird dog, this “core” exercise will help bring your pelvis into right position by strengthening the deep spinal muscles and glutes (butt muscles). How to do it – begin lying on your stomach with your forearms against the mat. – engage your core and lift your body so that you are resting on your forearms and toes. – start with 10 second holds and work up to 30 second holds, do 2-3 sets. ** ensure to keep your back straight throughout the entire exercise – spine in neutral position. Thoracic expansion if you’re using a chair, sit facing forward and allow your upper body to fall over the back of the chair. Extend your arms above your head for a deeper stretch. Hold either position for 10 seconds. 

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