Articles on 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.

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.

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.

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/

Ways to Avoid Neck and Back Pain While Doing Household Activities!

Dr. Vishwas Virmani, Physiotherapist
WORK VACUUMING THE LUNGE:Adopt a step position and posture as in the sport of fencing, with one leg stepping out in front .this way you can easily shift forward and back in various directions. As you step forward, you can reach forward with your vacuuming hand. Keep your pelvic “bowl” level. Put your other hand on your hip or thigh to take weight off the low back and help you stay up. Attempt to change vacuuming hands every once in a while. KNEELING AND HALF KNEELING These methods lower your center of gravity and automatically take some of the bend out of activity. Try the as alternative positions for a few minutes. They are really comfortable.DUSTING AND POLISHING Attempt kneeling or half kneeling when working on low surfaces. Prop your inactive arm on yourself or on the furniture to take more weight through your arms and less through your spine.  DOING THE LAUNDRYAvoid overloading the basket. Avoid slumped or overarched alignment when lifting, loading, and carrying. Load with one hand while taking weight through the other. Use exaggerated good alignment when lifting and carrying.DOING THE DISHES, IRONING, CLEANING WINDOWSThese tasks are similar to each other in that they involve sustained standing in a slightly forward- bend position. Place one foot up on a box or chair or inside the cabinet under the sink to help level your pelvic bowl ; and/or tense the muscles of your buttocks and lower abdomen to maintain your pelvis stable, level, and firmly up against the counter. For one-handed tasks, prop through your “resting” arm to take weight off the spine.

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’!

Understanding Your Back

Dr. Alagappan Thiyagarajan, Physiotherapist
The spine is made up of many bones called vertebrae. These are roughly circular and between each vertebra is a disc. The discs are made of strong rubber-like tissue which allows the spine to be fairly flexible. A disc has a stronger fibrous outer part and a softer jelly-like middle part called the nucleus pulposus.The spinal cord, which contains the nerves that come from the brain, is protected by the spine. Nerves from the spinal cord come out from between the vertebrae to relay messages to and from various parts of the body.Strong ligaments attach to the vertebrae. These give extra support and strength to the spine. Various muscles also surround, and are attached to, various parts of the spine. Symptoms of lumbar back painLower Back Pain: Initially occurs only during certain activities but as the conditions gets worse it back pain may persists for longer periods of time.Muscle Spasm: Feeling of muscle spasm while sitting down or standing up.Radiating Pain: If the condition has led to compression of the spinal nerve, causing radiating pain from the spine and down to the leg (Sciatica).Numbness in legSwelling of para spinal musclesTender spots What Is Back Pain?Back pain can range from a dull, constant ache to a sudden, sharp pain that makes it hard to move. It can start quickly if you fall or lift something too heavy, or it can get worse slowly.Who Gets Back Pain?Anyone can have back pain, but some things that increase your risk are:Getting older. Back pain is more common the older you get. You may first have back pain when you are 30 to 40 years old.Poor physical fitness. Back pain is more common in people who are not fit.Being overweight. A diet high in calories and fat can make you gain weight. Too much weight can stress the back and cause pain.Heredity. Some causes of back pain, such as ankylosing spondylitis, a form of arthritis that affects the spine, can have a genetic component.Other diseases. Some types of arthritis and cancer can cause back pain.Your job. If you have to lift, push, or pull while twisting your spine, you may get back pain. If you work at a desk all day and do not sit up straight, you may also get back pain.Smoking. Your body may not be able to get enough nutrients to the disks in your back if you smoke. Smoker’s cough may also cause back pain. People who smoke are slow to heal, so back pain may last longer.Another factor is race. For example, black women are two to three times more likely than white women to have part of the lower spine slip out of place.Can Back Pain Be Prevented?The best things you can do to prevent back pain are:Exercise often and keep your back muscles strong.Maintain a healthy weight or lose weight if you weigh too much. To have strong bones, you need to get enough calcium and vitamin D every day.Try to stand up straight and avoid heavy lifting when you can. If you do lift something heavy, bend your legs and keep your back straight.When Should I See a Doctor/therapist for Pain?You should see a doctor if you have:Numbness or tinglingSevere pain that does not improve with restPain after a fall or an injuryPain plus any of these problems:Trouble urinatingWeaknessNumbness in your legsFeverWeight loss when not on a diet.How Is Back Pain Diagnosed?To diagnose back pain, your doctor will take your medical history and do a physical exam. Your doctor may order other tests, such as:X raysMagnetic resonance imaging (MRI)Computed tomography (CT) scanBlood tests.Medical tests may not show the cause of your back pain. Many times, the cause of back pain is never known. Back pain can get better even if you do not know the cause.What Is the Difference Between Acute and Chronic Pain?Acute pain starts quickly and lasts less than 6 weeks. It is the most common type of back pain. Acute pain may be caused by things like falling, being tackled in football, or lifting something heavy. Chronic pain lasts for more than 3 months and is much less common than acute pain.Role of physiotherapist on treating back pain:Lower back pain is one of the leading causes of physical disability, especially at the workplace. Research indicates that almost 80% of the population is likely to suffer from lower back pain in their lifetime.Physiotherapy and Low Back Pain:Physiotherapy is one of the most widely used forms of treatment adopted for gaining relief from low back pain. It is used in both modes, as a single line of treatment as well as in combination with other treatments such as massage, heat, traction, ultrasound or short wave diathermy.The human back is basically a highly complex system of series of interlocking elements including the vertebrae, discs, facet joints, ligaments and muscles. Owing to such a complex structure, an episode of back pain needs a strong physiotherapy-based rehabilitation program, once the basic medication course has been undertaken.Key Aspects:In this section, we have briefly listed the key aspects of the role of physiotherapy in management of lower back pain.Advice and early activity – There is significant evidence to prove that encouraging early movement in case of lower back pain is one of the most significant aspects of treatment in this condition.Mobilization or Manipulative physiotherapy – This aspect concentrates on promoting mobilization of the specific affected area. The approach of manipulative physiotherapy is used to target the specific point of pain for the purpose.Specific stabilization exercises – In this aspect of physiotherapy, stress is laid on improving the strength and stability of the muscles which have been weakened due to the lower back pain.General exercises and stretches – A series of properly structured exercises and stretches are usually carried out in context of the patient’s individual condition and cause of the lower back pain.Ergonomic advice – Since work-related hazards account for more than 65% of lower back problems, physiotherapists also concentrate on providing accurate ergonomic device, guiding the patient on using the appropriate infrastructure at work to avoid and cure lower back pain.Postural guidelines – This aspect of physiotherapy focuses on guiding the patient about the correct postural habits and ways to maintain accurate posture to avoid lower back pain.