Low Back Pain

Everybody has suffered a back pain at least once in their life and most are believed to resolve spontaneously. At least half of the patients become perfectly alright within a period of 2 weeks and 90% recover in a span of 3 months. Only about a mere 2% adults remain with persistent back pain at the end of a year. In almost 90% cases no pathological cause can be identified. Epidemiologic studies have determined that risk factors related to the development of back pain include dissatisfaction with job, repetitive lifting of heavy weight, low-frequency vibrations, low educational level, smoking, and social problems.

Causes of low back pain can be faulty posture, overexertion, lifting heavy weight, muscle spasm, prolapsed Intervertebral disc, Ankylosing spondylosis, spondylolisthesis and tumor. Fracture of vertebrae, trauma, infection i.e.osteomyelitis, spinal canal stenosis and fibromyalgia are some other causes. Beyond this many intra-abdominal causes can also bring about a referred back pain. Appendicitis, Gall-stone colic, Renal colic are some examples. A thorough consideration of patient history, astute physical examination and few simple investigations can identify the exact cause.

Pathological causes need drug therapy or surgery as indicated but non-pathological pain has multiple treatment modalities. Counter-irritants help give temporary relief like sleeping with a pillow between your knees while lying on the side is supposed to be the ideal position to sleep in as it relieves the pressure off the back muscles. Another equally effective way is to sleep on the back with a pillow or towel below the bend of knees. Hot water fomentations provide relief in many cases.

Certain theories and belief groups that trace down physical symptoms to psychological or more specifically emotional causes, maintain that the back is the symbol of support, which is true. The spine is the most important structure in the human ability to maintain an erect posture. They attribute various emotions to the different regions of the back and the pain to the lack of fulfillment of those emotions. Upper Back Pain is said to be due to lack of emotional support like feeling unloved, Middle Back Pain is associated with a feeling of Guilt such as living in the past and Lower Back Pain is apparently linked to fear of monetary loss and may include lack of financial support. Probably, resolving these issues might also put ones back on the road to good health and you can anticipate a pain-free self.

The following exercises we think should help you to stretch and thereby strengthen your back, thigh and hip muscles:

Trunk Flexion Stretch – Sit on bended knees and hands. Tuck in chin and arch back backwards. Slowly sit back on heels, letting shoulders drop toward floor. Hold for 45-60 seconds. Repeat 10 times.

Standing Hamstring Stretch – Stand on right leg with left leg on table/chair. Stretch hamstring by slowly bending right knee. Hold for 35-40 seconds. Repeat with the other leg.

Curl-up exercise – Lie on back on the floor. Keeping arms folded across chest, tilt pelvis to flatten back. Tuck chin in towards the chest. Tighten abdominal muscles while raising head and shoulders from floor. Hold for 10 seconds and release. Repeat 15 times. Gradually increase number of repetitions. You can do as many as 100 with pauses after each set of 25 curl-ups.

Double knee-to-chest Stretch – Lie down on back. Pull both knees into chest until you feel a comfortable stretch in lower back. Keep the back relaxed. Hold for 45-60 seconds.

Lower trunk Rotation Stretch – Lie on back. Keeping back flat and feet together, rotate knees to one side. Hold for 45-60 seconds.

Pelvic Tilt Exercise – Lie on the back on the floor with feet flat, knees bent and arms on the sides. Flatten the small of the back against floor. This will make the hip tilt upwards. Hold for 15 seconds and release. Gradually increase holding time till 60 seconds.

Prone Lumbar Extension – The purpose of this exercise is to extend your lower back. Lie on your stomach and place your hands on the floor near the sides of your head. Slowly push your upper body off the floor by straightening your arms, but keep your hips on the floor. Hold for 10 seconds, and then relax your arms, moving back to the floor.

Alternate Arm-leg Extension Exercise – Face floor on hands and knees. Raise left arm and right leg. Do not arch neck. Hold for 10 seconds and release. Raise right arm and left leg. Do not arch neck. Hold for 10 seconds and release.

Alternate Leg Extension Exercise – Lie on your stomach with arms folded under your chin. Slowly lift one leg, not too high, without bending it, while keeping your pelvis flat on the floor. Slowly lower your leg and repeat with the other leg.

A regular regime including each of the above mentioned exercises is a sure shot way to not only prevent back pain but also get rid of any non-pathological current pain.

– Dr. Rachita Narsaria