Articles on back injury

5 Best Exercises to Reduce Back Pain

Dr. Vishwas Virmani, Physiotherapist
Lower back pain is a very common problem among adults and most people will suffer from back pain sometime throughout their life. Research has shown that problems related to the back are the most common reason people take time off work in the U.K. Back related problems are also the most common reason people seek treatment with an osteopath.Lower back pain is often caused by overuse and muscle strains or injury. Other factors that increase your risk for low back pain include getting older, having a family history of lower back pain, sitting for long periods, and lifting or pulling heavy objects.Regular exercise is one of the best ways of keeping back pain at bay. Even a gentle home exercise program can help decrease low back pain. It may also help prevent re-injury to your back and reduce the risk and severity of disability if you get a back injury.Below are five simple exercises anyone can do at home without any special equipment to help you look after your back properly and keep you as active as possible.1. Straight Leg Raises– Lie on your back with one leg straight and one knee bent– Tighten your abdominal muscles slightly to stabilize the lower back– Slowly lift the straight leg up to just above the height of the opposite bent knee and hold 1-5 seconds– Lower the leg slowly– Repeat 10 times– Repeat on the other side with the opposite leg straight and opposite knee bent2. Knee To Chest Stretch– Lie on your back with your knees bent– Raise one leg and pull it up towards your chest as far as possible– Hold your knee in this position for 1-5 seconds– Lower the leg back to the starting position– Repeat 5 times with each knee3. Pelvic Lift– Lie on your back with your knees bent– Slowly raise your buttocks and pelvis off the floor as high as possible– Hold this position for 1-5 seconds– Lower your buttocks and pelvis back down to the floor– Repeat this 10 times4. Knee Rolls/Swings– Lie on your back with your knees bent and the two knees/legs touching– Turn your head to the right– Turn or roll both of your knees, keeping your feet on the floor, over to the left as far as possible– Hold for 1-5 seconds– Return the knees and head to the centre– Repeat to the opposite side(s)– Repeat 5 times in direction5. Back Extension Stretch– Lie on your front on a firm surface– Place your hands palm down and the elbows bent under your shoulders– Now straighten your arms raising your upper trunk off the floor so your elbows are straight– Keep your pelvis and legs on the floor allowing your back to arch as much possible– Hold for 1-5 seconds– Relax your body and return to the starting position– Repeat 5-10 timesThese 5 simple exercises if done regularly will help keep your back and whole spine more supple and less prone to injury. Remember though don’t continue any of the exercises if they cause discomfort or irritate any recovering injury or ache. If ever in any doubt or if your lower back pain is not easing seek professional advice as soon as possible.

Beware of Lower Back Pain

Dr. Vishwas Virmani, Physiotherapist
Lower Back Pain: Risks and PreventionIs tying your shoe laces a painful task every morning? Do you think twice before you bend over to sweep the floor? If your answer is YES, then here is what you need to know about lower back pain.Risks factorsAgeing: The chances of back pain increases with your age. It generally starts from 30 plus with wear and tear of the spine. People between 30-60 years have disc related disorders while people over 60 have back related issues because of osteoarthritis.Genetics: Certain types of spinal disorders like degenerative disc disease have genetic components.Occupational risks: If you have a job that required you to stand for long hours, sit for long hours without proper back rest or do a lot of bending and lifting weights like construction workers do then you are at a higher risk.Lack of exercise: If you are someone who does not exercise at all you may be at a risk of back pain. Weak and unused muscles often lead to back pain.Being overweight: Being overweight puts extra stress on your back.Diseases: Diseases such as cancer or arthritis also cause back pain.Prevention is better than cureThere are other factors such as smoking, improper lifting, and psychological issues that may contribute to your back pain. Try following these simple preventive measures to keep your back pain at bay.●     Exercising helps prevent lower back pain and increases core stability●     Be cautious of hurting yourself when you lift weight●     Try different sleeping postures●     Wear low-heeled shoes and footwear that is comfortable●     Pick the right backpack or briefcase with wide adjustable straps.●     Change your lifestyle: stop smoking; improve your diet; and take up meditation or see a counselor to help manage your stress levels.Take good care of your back, and it will always ‘have your back’!

What a Pain in the (Lower) Back! Symptoms

Dr. Vishwas Virmani, Physiotherapist
Lower Back Pain: Causes and SymptomsAnyone who has ever suffered from lower back pain will know that it is a living nightmare, which can confine you to your bedroom for days. People over 60 are more likely to suffer from lower back pain due to the degeneration of their spinal joints. If you are experiencing any discomfort in your back, you must get yourself checked,to ascertain the reasons behind your back pain. Here are some common causes of back pain:1. Spinal Stenosis: A common cause of back pain in the elderly is spinal stenosis. This is a condition when there is an abnormal narrowing of the spine, and any small injury can trigger severe pain in the back and legs.2. Spondylosis: This affects older women more than it does older men. Spondylosis is a condition when the lumbar vertebrae degenerate or develop small fractures causing lower back pain.3. Facet joint osteoarthritis: This is a kind of arthritis that affects the spine in the later part of life. This degenerative condition might lead to stiffness, discomfort, pain and other problems.Since lower back pain is a very common complaint among older folk, people find it difficult to differentiate between routine discomfort and a serious condition. So, here is a list of symptoms of lower back pain.1. Severe leg pain while walking2. Relief from lower back pain only while sitting down or an increase in pain due to being seated3. Pain fluctuates between mild to severe4. Gradual increase inlower back pain5. Numbness, weakness, tingling sensation and discomfort in back and legs6. Problems in bowel movement7.  Prolonged back pain accompanied by weight lossIf you are experiencing one or more of these symptoms, visit your doctor for a thorough check up. After all, your spine is the backbone of your well-being!

Is Lower Back Pain a Pain in Your Butt?

Dr. Vishwas Virmani, Physiotherapist
How to Treat Lower Back PainRemember those Ooh, aah, ouch! Iodex! ads from the 1980s, when the actors would grimace their way through aches and pains, only to suddenly discover Iodex, and be magically cured?While balms work wonders in ads, seniors dealing with lower back pain need solutions that can help them in the long run. There are a number of different reasons for lower back pain in the elderly, from serious conditions includingbone diseases like Osteoarthritis or systemic diseases like fibromyalgia, to more benig ones like inflammation of the joints.There are a number of treatment options available to seniors struggling with lower back pain. Depending on what's causing the pain, whether it's a disease or just the aging process doctors could suggest invasive and/or non-invasive treatment options.InvasiveFor example, if a growing tumour is what's causing the pain (by pinching certain nerves), doctors might suggest invasive treatments like surgery to remove the growth. They could also suggest 'Interventional Pain Therapy', which includes steroid injections to combat the inflammation that occurs in conditions like facet joint arthritis. Non-invasiveNon-invasive treatments include massage therapy, analgesic medication,and non-opioid drugs called NSAIDS. Low impact exercises like yoga can help stretch, massage, and condition your lower and mid-back muscles.A strong and supple back is essential to your overall health, especially since that's where some of our key core muscles are located.

Spinal Cord Injury

Dr. Apoorva Kumar, Spine Surgeon
What is Spinal Cord Injury?A spinal cord injury usually begins with a sudden, traumatic blow to the spine that fractures or dislocates vertebrae. The damage begins at the moment of injury when displaced bone fragments, disc material, or ligaments bruise or tear into spinal cord tissue. Most injuries to the spinal cord don't completely sever it. Instead, an injury is more likely to cause fractures and compression of the vertebrae, which then crush and destroy axons -- extensions of nerve cells that carry signals up and down the spinal cord between the brain and the rest of the body. An injury to the spinal cord can damage a few, many, or almost all of these axons. Some injuries will allow almost complete recovery. Others will result in complete paralysis.Is there any treatment?Improved emergency care for people with spinal cord injuries and aggressive treatment and rehabilitation can minimize damage to the nervous system and even restore limited abilities.  Respiratory complications are often an indication of the severity of spinal cord injury   About one-third of those with injury to the neck area will need help with breathing and require respiratory support. The steroid drug methylprednisolone appears to reduce the damage to nerve cells if it is given within the first 8 hours after injury.  Rehabilitation programs combine physical therapies with skill-building activities and counseling to provide social and emotional support. Electrical simulation of nerves by neural prosthetic devices may restore specific functions, including bladder, breathing, cough, and arm or leg movements, though eligibility for use of these devices depends on the level and type of the spinal cord injury.What is the prognosis?Spinal cord injuries are classified as either complete or incomplete.  An incomplete injury means that the ability of the spinal cord to convey messages to or from the brain is not completely lost. People with incomplete injuries retain some motor or sensory function below the injury.  A complete injury is indicated by a total lack of sensory and motor function below the level of injury.  People who survive a spinal cord injury will most likely have medical complications such as chronic pain and bladder and bowel dysfunction, along with an increased susceptibility to respiratory and heart problems. Successful recovery depends upon how well these chronic conditions are handled day to day.Surgery to relieve compression of the spinal tissue by surrounding bones broken or dislocated by the injury is often necessary, through timing of such surgery may vary widely.  A recent prospective multicenter trial called STASCIS is exploring whether performing decompression surgery early (less than 24 hours following injury) can improve outcomes for patients with bone fragments or other tissues pressing on the spinal cord.What research is being done?The National Institute of Neurological Disorders and Stroke (NINDS) conducts spinal cord research in its laboratories at the National Institutes of Health (NIH) and also supports additional research through grants to major research institutions across the country.  Advances in research are giving doctors and patients hope that repairing injured spinal cords is a reachable goal.  Advances in basic research are also being matched by progress in clinical research, especially in understanding the kinds of physical rehabilitation that work best to restore function. Some of the more promising rehabilitation techniques are helping spinal cord injury patients become more mobile.neurosurgery

Myths and Facts About Low Back Pain

Dr. (Maj) Pankaj N Surange, Spine and Pain Specialist
· Low back pain is the most common musculoskeletal complaint, with potentially devastating consequences.· 90%of patients with acute low back pain do not require surgery. Most specialists agree that non-surgical treatment should be tried first.· Surgery as first line treatment is indicated only in few selected cases. These are medical emergencies such as a broken neck or if you have symptoms such as weakness in the legs that gets progressively worse and/or bladder and/or bowel incontinence caused by the back problem.· The incidence of back pain is highest between the ages of 35 and 55.· Disc is not always the culprit. Small joints of spine are the source of pain in majority of patients.· The pain combined with depression and anxiety in long-term cases places sufferers at risk for suicide.· People who work at sedentary occupations are at a higher risk of disk injury than those who do moderate amounts of physical work.· Up to 85 per cent of persons with back pain can’t recall a specific incident that brought on their pain.· Early interventional treatments in Back pain management have been found to return patients to work and regular activities more rapidly than past conservative therapies.· Early intervention decreases unnecessary chronic pain, long-term treatments and disabilities.· Heat and massage therapy cannot cure the disease. These do not provide long term solutions to the problems of back. These are mainly used for managing pain during the recovery period.NewerDevelopments and Better Understanding in Management of Back painA wide range of treatment is available for low back pain, depending on what is causing the pain and how long it lasts. Most people find that their low back pain improves within a few weeks. Chances are good that your pain will go away soon with some basic self-care.· If you have recently developed low back pain, stay active and consider taking over-the-counter pain medicines .· Staying active is better for you than bed rest. In fact, staying in bed more than 1 or 2 days can actually make your pain worse and lead to other problems such as stiff joints and muscle weakness.· If your low back pain has lasted longer than 3 months, you will probably benefit from more intensive treatment.· Must visit Interventional pain and spine specialist :-· if you have moderate to severe low back pain that lasts more than a couple of days;· if you have back or leg symptoms that have gotten worse;· if your symptoms have not gone away after 2 weeks of home treatment;· or if improved symptoms flare up again.·  A physical examination by pain specialist and possibly an imaging(x-ray/MRI) test may produce new information about your condition and help direct your treatment decisions.· Physical Therapy: TENS, Ultrasound, Heat and Cryotherapy:o These modalities should always be considered an adjunct to an active treatment program in the management of acute low back pain.o They should never be used as the sole method of treatment.Interventions: Minimally invasive non surgical procedures for management of Back PainFor back pain sufferers, interventional pain management techniques can be particularly useful. In addition to a thorough medical history and physical examination, interventional pain management physicians have a wide array of treatments that can be used including the following: Epidural injections (in all areas of the spine):The use of anesthetic and anti-inflammatory medications injected into the epidural space to relieve pain or diagnose a specific condition. Nerve, root, and median branch blocks:Injections done to determine if a specific spinal nerve root is the source of pain. Blocks also can be used to reduce inflammation and pain.Facet joint injections:An injection used to determine if the facet joints are the source of pain.These injections can also provide pain relief. Discography:An "inside" look into the discs to determine if they are the source of a patient's pain. This procedure involves the use of a dye that is injected into a disc and then examined using x-ray or CT Scan.Pulsed Radio frequency Neurotomy (PRFN): A minimally invasive procedure that disables spinal nerves and prevents them from transmitting pain signals to the brain. Rhizotomy:A procedure in which pain signals are "turned off" through the use of heated electrodes that are applied to specific nerves that carry pain signals to the brain. Spinal cord stimulation:The use of electrical impulses that are used to block pain from being perceived in the brain. Intrathecal pumps: A surgically implanted pump that delivers pain medications to the precise location in the spine where the pain is located. Percutaneous Discectomy / Nucleoplasty:A minimally invasive day care procedure in which tissue is removed from the disc with the help of decompressor through a very minute hole ,in order to decompress and relieve pressure on the spinal nerves. Ozoneucleolysis or Ozone discectomy: Has emerged as an affordable, least invasive approach and costs 2/3 of the price of conventional surgery. Ozone injected inside the affected intervertebral disc under c- arm guidance, causes shrinkage of disc and thus reducing the volume and lessening the pressure on nerves.These techniques are exciting. They offer the possibility of treating low back pain and sciatica with much less trauma and risk than surgery.Following any period of prolonged inactivity, begin a program of regular low-impact exercises:· Speed walking, swimming, or stationary bike riding 30 minutes a day can increase muscle strength and flexibility.· Yoga can also help stretch and strengthen muscles and improve posture· Always stretch before exercise or other strenuous physical activity.· Don’t slouch when standing or sitting.When standing, keep your weight balanced on your feet. Your back supports weight most easily when curvature is reduced.· At home or work, make sure your work surface is at a comfortable height for you.· Sit in a chair with good lumbar support and proper position and height for the task. Keep your shoulders back. Switch sitting positions often and periodically walk around the office or gently stretch muscles to relieve tension. A pillow or rolled-up towel placed behind the small of your back can provide some lumbar support. If you must sit for along period of time, rest your feet on a low stool or a stack of books.· Wear comfortable, low-heeled shoes.· Sleep on your side to reduce any curve in your spine. Always sleep on a firm surface.· Ask for help when transferring an ill or injured family member from a reclining to a sitting position or when moving the patient from a chair to a bed.· Don’t try to lift objects too heavy for you. Lift with your knees, pull in your stomach muscles, and keep your head down and in line with your straight back. Keep the object close to your body.Do not twist when lifting.· Maintain proper nutrition and diet to reduce and prevent excessive weight, especially weight around the waistline that taxes lower back muscles.· If you smoke, quit. Smoking reduces blood flow to the lower spine and causes the spinal discs to degenerate.

Low Back Pain: What All You Must Know

Dr. (Maj) Pankaj N Surange, Spine and Pain Specialist
Back pain is a problem which is very often faced by all the human beings at least once in their lifetime. This pain, if not taken seriously can turn into a deadly disease which can put your life at stake.Some important facts about back painLow back pain is the most common musculoskeletal complaint, with potentially devastating consequences.90% of patients with acute low back pain do not require surgery. Most specialists agree that non-surgical treatment should be tried first. Surgery as first line treatment is indicated only in few selected cases. These are medical emergencies such as a broken neck or if you have symptoms such as weakness in the legs that gets progressively worse and/or bladder and/or bowel incontinence caused by the back problem.The incidence of back pain is highest between the ages of 35 and 55.Disc is not always the culprit. Small joints of spine are the source of pain in majority of patients.The pain combined with depression and anxiety in long-term cases places sufferers at risk for suicide.People who work at sedentary occupations are at a higher risk of disk injury than those who do moderate amounts of physical work.Up to 85 per cent of persons with back pain can’t recall a specific incident that brought on their pain.Early interventional treatments in back pain management have been found to return patients to work and regular activities more rapidly than past conservative therapies.Early intervention decreases unnecessary chronic pain, long-term treatments and disabilities.Heat and massage therapy cannot cure the disease. These do not provide long term solutions to the problems of back. These are mainly used for managing pain during the recovery period.Newer Developments and Better Understanding in Management of Back painA wide range of treatment is available for low back pain, depending on what is causing the pain and how long it lasts.Most people find that their low back pain improves within a few weeks. Chances are good that your pain will go away soon with some basic self-care.If you have recently developed low back pain, stay active and consider taking over-the-counter pain medicines .Staying active is better for you than bed rest. In fact, staying in bed more than 1 or 2 days can actually make your pain worse and lead to other problems such as stiff joints and muscle weakness.If your low back pain has lasted longer than 3 months, you will probably benefit from more intensive treatment.Must visit Interventional pain and spine specialist :-If you have moderate to severe low back pain that lasts more than a couple of Days;If you have back or leg symptoms that have gotten worse; If your symptoms have not gone away after 2 weeks of home treatment; Or, if improved symptoms flare up again.A physical examination by pain specialist and possibly an imaging (x-ray/MRI) test may produce new information about your condition and help direct your treatment decisions.Physical Therapy: TENS, UltrasoundHeat and Cryotherapy:These Modalities should always be considered an adjunct to an active treatment program in the management of acute low back pain. They should never be used as the sole method of treatment.Interventions: Minimally invasive non surgical procedures for management of Back PainFor back pain sufferers, interventional pain management techniques can be particularly useful. In addition to a thorough medical history and physical examination, interventional pain management physicians have a wide array of treatments that can be used including the following: Epidural injections (in all areas of the spine):The use of anesthetic and anti-inflammatory medications injected into the epidural space to relieve pain or diagnose a specific condition.Nerve, root, and median branch blocks:Injections done to determine if a specific spinal nerve root is the source of pain. Blocks also can be used to reduce inflammation and pain. Facet joint injections: An injection used to determine if the facet joints are the source of pain. These injections can also provide pain relief. Discography:An "inside" look into the discs to determine if they are the source of a patient's pain. This procedure involves the use of a dye that is injected into a disc and then examined using x-ray or CT Scan.Pulsed Radiofrequency otomy (PRFN): A minimally invasive procedure that disables spinal nerves and prevents them from transmitting pain signals to the brain. Rhizotomy:A procedure in which pain signals are "turned off" through the use of heated electrodes that are applied to specific nerves that carry pain signals to the brain. Spinal cord stimulation:The use of electrical impulses that are used to block pain from being perceived in the brain. Intrathecal pumps: A surgically implanted pump that delivers pain medications to the precise location in the spine where the pain is located. Percutaneous Discectomy / Nucleoplasty:A minimally invasive day care procedure in which tissue is removed from the disc with the help of decompressor through a very minute hole ,in order to decompress and relieve pressure on the spinal nerves. Ozoneucleolysis or Ozone discectomy: Has emerged as an affordable, least invasive approach and costs 2/3rd of the price of conventional surgery. Ozone injected inside the affected intervertebral disc under c- arm guidance, causes shrinkage of disc and thus, reducing the volume and lessening the pressure on nerves.Intradiscal Electrothermoplasty (IDET) This procedure involves the insertion of a needle into the affected disc with the guidance of an x-ray machine. A wire is then threaded down through the needle and into the disc until it lies along the inner wall of the annulus. The wire is then heated which destroys the small nerve fibers that have grown into the cracks and have invaded the degenerating disc. These techniques are exciting. They offer the possibility of treating low back pain and sciatica with much less trauma and risk than surgery.Quick tips to a healthier backFollowing any period of prolonged inactivity, begin a program of regular low-impact exercises. Speed walking, swimming, or stationary bike riding 30 minutes a day can increase muscle strength and flexibility.Yoga can also help stretch and strengthen muscles and improve postureAlways stretch before exercise or other strenuous physical activity. Don’t slouch when standing or sitting. When standing, keep your weight balanced on your feet. Your back supports weight most easily when curvature is reduced. At home or work, make sure your work surface is at a comfortable height for you. Sit in a chair with good lumbar support and proper position and height for the task.Keep your shoulders back. Switch sitting positions often and periodically walk around the office or gently stretch muscles to relieve tension. A pillow or rolled-up towel placed behind the small of your back can provide some lumbar support. If you must sit for a long period of time, rest your feet on a low stool or a stack of books. Wear comfortable, low-heeled shoes. Sleep on your side to reduce any curve in your spine. Always sleep on a firm surface.Ask for help when transferring an ill or injured family member from a reclining to a sitting position or when moving the patient from a chair to a bed. Don’t try to lift objects too heavy for you. Lift with your knees, pull in your stomach muscles, and keep your head down and in line with your straight back. Keep the object close to your body. Do not twist when lifting. Maintain proper nutrition and diet to reduce and prevent excessive weight, especially weight around the waistline that taxes lower back muscles. If you smoke, quit. Smoking reduces blood flow to the lower spine and causes the spinal discs to degenerate.

Sports Injuries In Young Athletes - An Overview

Dr. Senthilvelan.R, Orthopedist
The prevalence of injuries in young athletes is on the rise as more and more young children take upon more intense sports training. There are multi factorial reasons which contribute to overuse injuries in young athletes. Targeted interventions are necessary in prevention of these injuries.Children have numerous benefits when they stay active and physically fit by participating in sports, however there is concern regarding safety of intense sports participation of young athletes. Almost 1/3rd to 50 percent of injuries in this age group is as a result of overuse.Chronic overuse injuries are generally defined as injuries that occur because of increased levels of physiological stress without sufficient recovery time. A number of prevention strategies are available to prevent which target the athlete's neuro-muscular control mechanisms to reduce the likelihood of injury.Numbers of extrinsic risk factors are often implicated in over use injuries. These can occur in a number of scenarios. In the first scenario the athlete may attempt to rapidly increase training load after period of inactivity and this could result in stress fractures. In this situation the body does not have enough time to adapt to higher level of stress and is not adequately prepared to dissipate repetitive forces.A second scenario is when an athlete attempts to participate at a level that exceeds individual’s skill level. There could be potential mismatch between skill and fitness level to that of imposed physical demand and can potentially lead to injury.Coaches or PT masters at school should understand the physical fitness levels of children at school and design training in a  way to provide appropriate progression of training.Ways to prevent Overuse injuries:1. A young athlete needs to be assessed in regards to readiness of running and his/hers relative risk of running related injury. Determining the fitness level before running, length of running and prior running injuries and previous sports needs to be documented.2. Modifying training volumes for athletes who have recently undergone growth spurts are recommended to reduce stress on growing bones.3. Provision of individualized training programs taking into account their fitness level, and injuries._______________________________________________________________________________________

Three Tips to Reduce Back Pain as You Grow Older

Dr. Jyotsna Gupta, Gynecologist/Obstetrician
As you get older, your back needs attention. Here are some tips to help you reduce back pain.TIP 1 - RIGHT NUTRITION Right nutrition is most essential requirement for back pain. nutrition is provide by sufficient nutrient which gives strengthen to our musculoskeletal system of body. Nutrient which provide sufficient nutrition are:-TIP 2 - REGULAR EXERCISE  FOR BACK Extra weight means extra stress on your body , which lead to back pain .for those that carry weight in the belly region, the strain on the back  only increases. Find an eating plan that works for you, and get your  BMI under control. As we can see today,most of our activities are sedentary which does not strengthen up our back muscles rather they weaken them. It is even more necessary to exercise regularly. But make sure to try it with the guidance of an expert. (Either a PT or Yoga therapist.Regular exercise builds up the strength of our musculature, mobilises & lubricates our joints and improves the flexibility the most required.Not just that even the nourishment to our musculoskeletal system improves with an improved blood circulation.The different activities which help our spine and back to strengthen can be - yogic asanas, sun-salutations(for those who can), swimming, cycling and walking.TIP 3 - RIGHT POSTUREAs all of us know that we spend lots of time through the day sitting for most of the activities.so it is apparent that your back takes the burden of sitting most of time. If a right posture is maintained, it can prevent of our back problems.Make sure to let your spine take its natural curvature while sitting. you need to keep in mind proper spine alignment not just when watching TV or sitting at your desk at work. The position you sleep in can go in wrong way keeping back pain occur. the best position is on your side in a relaxed fetal position with your knee bent .place a pillow between your legs, so that as you sleep, the top leg does not slide forward, causing a twist in your lower back .consider also using a small pillow under your neck, so that your spine stay in alignment as much as possible. Remember to focus on your small daily movements, such as how you pick up objects (always bend at the knees)how you carry your purse or backpack(make sure it’s not too heavy and wear your backpack on both shoulder), invest in a new mattress or/and pillow that are firm and prevent your spine to curve, and add some gentle stretching to your morning routineDr. Jyotsna Guptahttps://www.facebook.com/gynecologistindelhi/http://gynecologist-delhi.webs.com/