Articles on chest pain

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.

Pain Management: Why Is It Important

Dr. G P Dureja, Spine and Pain Specialist
Most of the people suffer from different kinds of pain because of various reasons. Most of the people also tend to ignore it and move on. It is not advisable to ignore pain because you don’t know if that is casual or something serious to pay attention to. Avoiding pain will only make it worse, so it is essential to manage and treat pain. What is pain management? As the name suggests, managing your pain in a way that either it is treated or relieved, is pain management. It is also a branch in medicine called Pain Medicine, which involves in-depth procedures and techniques to ease out the pain. What are the types of pain?Majorly pain can be classified into two types, acute and chronic. Any pain that is short lived or short lasting comes under acute pain while, any pain that is long lasting or forever, comes under chronic pain. Chronic pain generally is the pain that lasts for 3 or more months. Based on, where, in the body, the pain is present, there are further three types. Somatic This type of pain is more like an exterior pain. Caused generally by the activation of receptors on the body surface or musculoskeletal tissues, it can be treated with proper rest and medication. Surgical pain comes under this type. Visceral Internal pain caused due to damage to the organs or tissues is known as visceral pain. This is not localized to just one body part. It might pain in different organs or body parts. Neuropathic Pain related to the spinal cord or peripheral nerves is called neuropathic pain. It generally occurs at the level or below the level of injury. How can you manage pain?Managing acute pain is easier than chronic. You can involve in a healthy lifestyle and physiotherapy but for advanced management and care, there are pain hospitals that manage pain well. These healthcare facilities are established especially to diagnose and manage chronic pain. What are the kinds of pain that can be treated?Various kinds of chronic pain can be treated in pain hospitals such as cancer pain, back pain, knee pain, neck pain, arthritis, fibromyalgia, migraine, etc. What are the treatments available? There are various treatment procedures that are involved in treating pain. These can be simple and complex both. It truly depends on upon the kind of pain you are suffering from. Some pain needs just lifestyle modification and counseling to be treated while the others require more complex treatments. Treatments like X-Ray guided injections, intrathecal pump implants, radiation therapy, Botox therapy and Platelet rich plasma therapy are some from a several more. These treatments can be very effective when performed by experts.

Chest Pain - Panic Attacks/panic Disorder

Dr. Naresh Vadlamani, Psychiatrist
"All of a sudden, I felt afraid and feared that something bad was going to happen to me as if I was going to die for no reason at all. I was having chest pain, my heart was beating faster and I had difficulty in breathing, I felt giddy and thought I was going to die." I immediately wanted to go to the hospital-emergency. From then on, I was afraid to be alone or was afraid of travelling. I started avoiding places, food, rooms or even travel after that attack.Medical professionals generally attempt to reassure the panic attack patient that he or she is not in great danger. But these efforts at reassurance can sometimes add to the patient's difficulties: If the doctors use expressions such as "nothing serious," "all in your head," or "nothing to worry about," this may give the incorrect impression that there is no real problem. The actual problem is in the panic area in the brain. The nerves in this area are dysfunctional. Its is like going to a doctor for cough and all the doctor says is "don’t cough" which sounds ridiculous. Anxiety and worry is what the patient has. That requires diagnosis and appropriate treatment. Not by saying "relax" or "Don't Worry".WHAT ARE THE SYMPTOMS OF A PANIC ATTACK?As described above, the symptoms of a panic attack appear suddenly, without any apparent cause. They may includeRacing or pounding heartbeatChest painsStomach discomfortDizziness, light headedness, nauseaDifficulty in breathing, a sense of feeling smotheredTingling or numbness in the handsFlushes or chillsDreamlike sensations or perceptual distortionsTerror: a sense that something unimaginably horrible is about to occur and one is powerless to prevent itFear of losing control and doing something embarrassingFear of dyingA panic attack typically lasts for several minutes and is one of the most distressing conditions that a person can experience. Most who have one attack will have others. When someone has repeated attacks, or feels severe anxiety about having another attack, he or she is said to have panic disorder.Panic attacks can occur at any time, even during sleep. An attack generally peaks within 10 minutes, but some symptoms may last much longer.Once someone has had a panic attack, for example, while driving, shopping in a crowded store, or riding in an elevator, he or she may develop irrational fears, called phobias, about these situations and begin to avoid them. Eventually, the pattern of avoidance and level of anxiety about another attack may reach the point where the individual with panic disorder may be unable to drive or even step out of the house. At this stage, the person is said to have panic disorder with agoraphobia. Thus, panic disorder can have as serious an impact on a person's daily life as other major illnesses, unless the individual receives effective treatment.No, panic attacks are never life threatening. But yes, panic attacks are real and emotionally disabling, but they can be controlled with specific treatments. Because of the disturbing symptoms that accompany panic attacks, they may be mistaken for heart disease or some other life-threatening medical illness. People frequently go to hospital emergency rooms when they are having a panic attack, and extensive medical tests may be performed to rule out these other conditions.CAN PEOPLE WITH PANIC DISORDER LEAD NORMAL LIVES?The answer to this is a resounding YES -- if they receive treatment.Panic disorder is highly treatable, with a variety of available therapies. These treatments are extremely effective. Once treated, panic disorder doesn't lead to any permanent complications.COMPLICATIONS OF UNTREATED ILLNESSA recent study showed that people who suffer from panic disorder:Are more prone to alcohol and other drug abuseHave greater risk of attempting suicideSpend more time in hospital emergency roomsSpend less time on hobbies, sports and other satisfying activitiesTend to be financially dependent on othersReport feeling emotionally and physically less healthy than non-sufferersAre afraid of going more than a few miles away from home

Killing Your Back Pain Is Easier Than You Think!

Dr. Vishwas Virmani, Physiotherapist
Perhaps you have an old injury that you ignored and is now bothering you. Or maybe you slept in an odd position and woke up to feeling really uncomfortable and uneasy. Whatever might be the reason for your back pain, this is one problem that is hard to easily get rid of. However, there are relief therapies to reduce your back pain, which, eventually completely cure your back pain. These are:Cold therapyEven with all the high tech medical options available, a simple ice or cold pack application can still be one of the more effective, proven methods to treat a sore back or neck. Ice is typically most effective if it is applied soon after an injury occurs, or after any activity that causes pain or stiffness.Ice can also be very helpful in alleviating postoperative pain and discomfort. While any form of applying cold to the injured area - such as a bag of ice wrapped in a towel or a commercial ice pack - should be helpful, combining massage therapy with ice application is a nice alternative for pain relief.Heat therapyWhile the overall qualities of warmth and heat have long been associated with comfort and relaxation, heat therapy goes a step further and can provide both pain relief and healing benefits for many types of lower back pain.In addition, heat therapy—such as heating pads, heat wraps, hot baths, warm gel packs, etc.—is both inexpensive and easy to do. Some patients find more pain relief with heat (either moist heat or dry heat) and others with ice. You can also try alternating the 2 therapies.Note: If you still do not see any changes in your condition, check with your doctor.

Five Causes of Back Pain Arising Out of Our Lifestyle in the Current Age!

Dr. Vishwas Virmani, Physiotherapist
Ouch! The very term back pain makes you wince in discomfort! Unfortunately, back pain is becoming increasingly common. Not only is it affecting ladies after a certain age, but is surprisingly being suffered by youth and working professionals of all ages.We all want solutions to get rid of this really painful problem. After all, your back is the fundamental support system for the entire body!However, rushing to the solutions, it is utmost crucial to go to the root of the matter and understand why and what we are doing wrong so as to inflict back pain upon us!First – Wrong Posture for prolonged hours is the primary cause for Back Pain!Wrong posture is the most common cause for both, lower back and upper back pain. It is very important to be deliberately conscious of your sitting posture, your reading posture and your standing posture.You back muscles are particularly strained when they are forced to be in a wrong posture for long hours.It is amusing because we are all taught the right postures in schools in our growing up years, and yet, as ’grown ups’, we forget the basics and land ourselves in such painful physical ailments!Second – Inactivity and Lack of Exercise can cause your Back Pain to last forever!On an average, we work for anything between 8 to 12 hours in our offices on a regular basis. As a result, we end up sitting all day long barring a few coffee breaks or lunch wherein we end up stuffing our body with more food and caffeine!We come back late evening, too tired and sometimes lazy enough to go for exercise. And we are of course unable to wake up early in the morning for exercise due to working late till night or late heavy dinner. Thus forms a vicious cycle and we are stuck in it!This lack of exercise on daily basis eventually leads to weakening of the back muscles simply because the back muscles are not being ‘used’. And its obvious, that weak back muscles cannot support the whole body. Only strong muscles can. As a result, one fine day, your back starts to scream in pain!Third – Stressful anxious mind and absence of a peace within you can torment your upper back!Stress is one of the major reasons that causes upper back pain in particular.Increasingly today, people suffer from cervical attacks not only due to constant wrong posture of looking down while reading or working, but also because the mind is not at rest due to work or domestic life stresses of various nature which the body is unable to bear.If you are mentally stressed with negative emotions, undoubtedly, it will impact your body sooner or later. And one of the first body parts to suffer is the upper back region comprising of your beck, shoulders, head and upper spine.Fourth – Lack of rest and adequate hours of sleep can aggravateBack pain multifold!It is fundamental truth that if you body is not well rested resulting from a decent seven to eight hours sleep, you will be vulnerable to multiple health problems. Lack of sleep causes a drop in immunity level of the body and weakens it internally.As a result, when you push your body through the rigours of your daily routine, you back is sure to be inflicted with suffering because it has to support your whole body even though it is not well rested and feeling fresh! On the contrary, your muscles are already tense!Fifth – A protruding stomach with fat accumulated in the centre of your body is a cause of lower back pain!Fat is bad in any case. And fat, when accumulated in the lower abdomen region causing a pot belly to develop, can be even more damaging!This is because you are shifting the centre of gravity of the body towards the front thereby causing further pressure on your spine to keep your body straight! Thus, a big belly primarily caused due to our sedentary lifestyle can cause lower back pain.

Back Pain – What You Should Know

Dr. Vishwas Virmani, Physiotherapist
Ow! My aching back! Most of us have stuttered these words at one time or another. Worldwide back pain affects 4 out of 5 people at some point in life. It is one of the top ten high burden diseases and is largely responsible for decreased quality of life and disability in young adults.  Back Pain SymptomsBack pain can range from a dull nagging ache to sudden debilitating pain. It can affect anyone at any age, but becomes more common as you grow older. People, who are overweight, lead a sedentary lifestyle, under extreme psychological stress and smokers have been found to be at a higher risk for back pain. Some of the common symptoms that occur with back pain include stiffness, trouble flexing your back, difficulty with range of motion, sharp shooting pain, pain radiating down the legs and numbness in the legs or groin.Common CausesBack pain that develops abruptly, often after some activity, is known as acute pain. If your pain lasts for more than three months, it is known as chronic pain. Most causes of acute back pain are related to the muscles and/or ligaments, widely known as strains. Back strains usually result from activities such as heavy lifting, overuse, abrupt movement and poor postures. Chronic pains may be associated with infections, trauma, spinal deformities and problems with the discs, nerves and bones.Understanding the root cause of your back pain is key to preventing it from worsening or recurring. A better resolution of this problem can be achieved when you learn more and start identifying the factors that trigger your pain.10 Tips to Beat Back PainMost episodes of back pain resolve within a few days on its own. Sadly, for some people it can return and can be the most frustrating and bothersome problem to manage. Here are few tips that you can try to minimise your discomfort and prevent the back pain from becoming a long-term issue.Ice the area – Keep ice on the area for the first one or two days. Ice helps slow down inflammation that occurs after an injury. You may switch to heat after two days. Do not place heat or ice directly on your skin and do not keep it for more than 20 minutes at a time.Be active  – Continue your normal activities such as walking and mild exercises, but don’t overdo it. Avoid sitting at a place for more than half an hour, get up and do some mild stretching.Make your workstation ergonomic – Use chairs that have proper back support. Avoid hunching forward often and keep both your feet firmly planted on the floor.Maintain good posture – Avoid stooping or bending over from your waist when lifting heavy objects. Lift with bent knees.Wear footwear with low heels – High heels threaten good posture and put more pressure on the lower spine.De-stress – Anxiety, stress and depression can worsen back pain. Engage in activities that keep you happy.Get enough sleep – Inadequate sleep can aggravate your back pain. Sleep plays a major role in healing your body and mind. Sleep on a mattress that provides good back support. Keep a pillow between your knees if sleeping on your sides. If sleeping on your back, keep a pillow under your knees. These measures help maintain neutral spine position.Quit smoking – Smokers are at a greater risk of developing bone problems that worsen back discomfort.Exercise – Once your back pain has subsided, perform exercises to strengthen your back muscles.Shed some weight – Being overweight can put excess pressure on your spine. Losing weight can help relieve your back pain.There is often no single solution for back pain. You may need to explore and find out what works best for you, which often involves a process of trial and error.It is advised that you consult a qualified doctor if your back pain does not subside within 72 hours. Depending on your type of back pain, your doctor may recommend blood tests and/or imaging studies to identify the root cause of your pain. Depending on your specific condition, treatment options can include oral medications, injections or surgery. You may also choose complementary therapies such as exercises, massage, yoga, biofeedback, acupuncture, physiotherapy and chiropractic treatments that may offer some relief.

Tips to Reduce Back Pain as You Grow Older

Dr. Niraj Jha, Physiotherapist
Back pain is common with about nine out of ten adults experiencing it at some point in their life, and five out of ten working adults having it every year.However, it is rare for it to be permanently disabling, and in most cases of herniated disks and stenosis, rest, injections or surgery have similar general pain resolution outcomes on average after one year.  Additionally, it is the single leading cause of disability worldwide.TIPS TO REDUCE BACK PAIN AS YOU GROW OLDER:1. Limit Bed Rest people with short-term low-back pain who rest feel more pain and have a harder time with daily tasks than those who stay active.“Patients should avoid more than three days of bed rest,”2. Keep ExercisingActivity is often the best medicine for back pain.Simple exercises like walking can be very helpful,“It gets people out of a sitting posture and puts the body in a neutral, upright position.”But remember to move in moderation, Stay away from strenuous activities like gardening and avoid whatever motion caused the pain in the first place3. Maintain Good Posture people have poor posture when going about their daily activities, putting unnecessary strain on their backs. You can increase the pressure on your back by 50% simply by leaning over the sink incorrectly to brush your teeth. Keeping the right amount of curvature in the back takes pressure off the nerves and will reduce back pain4. Strengthen Your CoreMost people with chronic back pain would benefit from stronger abdominal muscles,If the abdominals are weak, other areas must pick up the slack. When we strengthen the abdominals, it often reduces the strain on the lower back.5. Apply Ice and HeatHeating pads and cold packs can comfort tender trunks. Most doctors recommend using ice for the first 48 hours after an injury  particularly if there is swelling  and then switching to heat.6. Improve FlexibilityToo much tension and tightness can cause back pain. "Our goal in increasing flexibility is to put an equal load throughout the body from the feet all the way up to the head.One good exercise is to sit on the edge of the bed with one leg extended and the other one on the floor. Give your hamstrings a stretch by leaning forward while keeping your back in a neutral position.7. Sleep the Right WayThe amount of rest you get is important, and so is the position you get it in. “Sleeping in a bad position or on a mattress without support can cause back pain.Back sleepers should put pillows under their knees.Side sleepers should place pillows between their knees to keep their spine in a neutral position.                                                                                                                                                                                                                                                        

11 Ways to Prevent Back Pain

Dr. Apoorva Kumar, Spine Surgeon
Back pain can be... well, painful. To avoid back pain, maintain proper posture and lift things carefully. Staying fit and healthy will strengthen your back and reduce the load it has to carry. Sleeping in a back-friendly position can also help prevent pain and relieve symptoms.1. Get more exercise. If your back is hurting, you may think the best way to get relief is to limit exercise and to rest. A day or two of rest may help, but more than that may not help the pain. Experts now know that regular physical activity can help ease inflammation and muscle tension.2. Watch your weight. Extra pounds, especially in your midsection, can make back pain worse by shifting your center of gravity and putting strain on your lower back. Staying within 10 pounds of your ideal weight may help control back pain.3. If you smoke, stop. Smoking restricts the flow of nutrient-containing blood to spinal discs, so smokers are especially vulnerable to back pain.4. Sleeping position. If you’re prone to back pain, talk with your doctor about the best sleeping position. Sleeping on your side with your knees pulled up slightly toward your chest is sometimes suggested. Prefer to sleep on your back? Put one pillow under your knees and another under your lower back. Sleeping on your stomach can be especially hard on your back. If you can’t sleep any other way, place a pillow under your hips.5. Pay attention to your posture. The best chair for preventing back pain is one with a straight back or low-back support. Keep your knees a bit higher than your hips while seated. Prop your feet on a stool if you need to. If you must stand for a prolonged period, keep your head up and your stomach pulled in. If possible, rest one foot on a stool -- and switch feet every five to 15 minutes.6. Be careful how you lift. Don’t bend over from the waist to lift heavy objects. Bend your knees and squat, pulling in your stomach muscles and holding the object close to your body as you stand up. Don't twist your body while lifting. If you can, push rather than pull heavy objects. Pushing is easier on the back.7. Avoid high heels. They can shift your center of gravity and strain your lower back. Stick to a one-inch heel. If you have to go higher, bring along a pair of low-heeled shoes and slip into them if you become uncomfortable.8. Stash the skinny jeans. Clothing so tight that it interferes with bending, sitting, or walking can aggravate back pain.9. Lighten your wallet. Sitting on an overstuffed wallet may cause discomfort and back pain. If you’re going to be sitting for a prolonged period -- while driving, for example, take your wallet out of your back pocket.10. Pick the right handbag or briefcase. Buy a bag or briefcase with a wide, adjustable strap that’s long enough to reach over your head. A messenger bag (like the ones bike messengers wear) is made to wear this way. Having the strap on the opposite shoulder of the bag distributes the weight more evenly and helps keep your shoulders even and your back pain-free. When carrying a heavy bag or case without straps, switch hands frequently to avoid putting all the stress on one side of the body. To lighten the load, periodically purge bags, cases, backpacks, and other carriers of things you don't need.11. Forget about back braces. Various back supports are available, from elastic bands to special corsets. They can be helpful after certain kinds of surgery, but there is not much evidence that they help treat chronic back pain.

Comprehensive Approach to Back Pain

Dr. Rakesh Kumar, Physiotherapist
Perfect physio is always with you in your pains. Please read specially who are in chronic back or musculoskeletal pains. The mind-body issue Traditionally we have thought of pain as a signal transmitted from the periphery to the brain – such as when a finger touches a hot plate. This understanding of pain serves well for very brief acute pain; however, it is only a small part of the story when pain is longer lasting. Just as there are nerve tracts that carry pain signals upward to the brain, there are also tracts coming down from the brain that regulate the sensitivity of the spinal cord and thus determine how much pain we perceive. These tracts can amplify pain – making a trivial stimulation seem terrible – and can block it, which probably explains why quarterbacks and combat soldiers can carry out remarkable activities, and only after some time realize that they’ve been injured. Additionally there are genetic differences in the responses to stimulation. For example, a metal disc heated to exactly 120° and placed on the forearm will be experienced by some as barely uncomfortable (pain of 1/10) and by others as excruciating (pain of 9/10). Functional brain imaging at the time of the experiment confirms that those who report severe pain actually have greater activation of several areas in the brain that process pain, while those who feel little pain have little brain activation. Thus we conclude that, unless other factors interfere, pain is whatever the patient tells us it is. Is it mental? Psychological factors rarely seem to be an important cause of prolonged pain, but they invariably affect it – for better or for worse. Attention and vigilance account for much of the psychological modulation of pain. Pain that the brain thinks is important will be amplified, and those that it thinks are of no consequence will be lessened. (Just as a mother in a noisy New York apartment sleeps soundly as ambulances and car horns sound through the night, but awakens instantly when her baby whimpers.) Mood profoundly affects pain, and even something as simple as reading a short story that it either funny or tragic changes people’s thresholds and tolerance to experimental pain. Research over the last 35 years has demonstrated that pain, as well as numerous other factors, change the central nervous system in ways that lead to prolonged pain, even when the illness or injury that initiated it has healed. In fact, most chronic pain is more attributable to sensitization of the nervous system than to problems in the body parts that hurt. These findings help to explain why people with normal-looking feet can have constant burning, why perfectly healthy people have headaches, and why the majority of people with chronic back pain have no findings on exam or imaging to account for it. In the past, it was often assumed that when people had serious complaints of pain in healthy body parts, that their pain was imagined, psychologically induced, or exaggerated. We now know that this was a misjudgment on the part of medical providers. What you think governs what you do Behavior, however, is another matter, and here psychological and environmental reinforcers play a prominent role in determining function. So we see people with very severe health problems and very severe pain who have well preserved work, play, and socialization, while we see others with far less pathology whose lives appear to have stopped. In addition to such obvious factors as anxiety, stress, and depression, there are others that impact function. One is the person’s intellectual understanding of their health – the person who believes that activity endangers their spinal fusion may become an unnecessary invalid, while a more confident person with the same medical condition may be golfing. A person’s confidence in his/her own strength and abilities is also important. Those who feel competent tend to function better and have better quality of life than those who lack self confidence.Catastrophic thinking Catastrophizing, the tendency to assume that the worst that can happen is true, has been shown to promote pain and dysfunction. In the case of back pain, a person whose thoughts tend to run in the direction of, "This is horrible, there’s no way I can stand it, I’m damaged for the rest of my life," will likely suffer more (and have less fun) than one who thinks, "the majority of people have back pain, and I’m getting more than my share of it, but I know there will be days that are better and days that are worse."Who’s got the power? People who believe that their future depends on others – surgeons, spouses, Workers’ Compensation insurors, foremen, etc, – tend to be more depressed, more functionally impaired, and in worse pain than those who recognize that they are in charge of their own lives.Learn to Live with It These may be the most feared words that a person with chronic pain can hear, with the implication that the rest of your life is going to be about enduring suffering. Fortunately that is not the case. Those who learn to live with pain do have to accept that there is so far no cure for most chronic pains, but most go on to have joyous and productive lives in which they feel a blessing and not a burden to their loved ones. It’s not easy or automatic, and we don’t come with instruction manuals telling us how to do it. These may be useful hints:Acceptance In order to do what we can, we need to stop trying to do what we can’t. At some point, it’s time to stop looking for diagnoses and cures, and to decide to make the best life possible out of an unfortunate situation. Acceptance does not mean giving up; it means taking charge and having the fullest life possible, despite the pain.Fitness There may be nothing more important for reducing pain and increasing function than maintaining physical fitness. It clearly improves not only pain, but the anxiety and depression that often accompany it. Yes, it hurts at first. Yes, it would feel better at first to take a pain pill and go to bed. But over the long term, the fitter you are, the better you’ll feel – and the more you’ll be able to do with those who love you. You do need advice for this, though. The wrong exercises can increase many pains, and most patients require a slow and gradual increase in activities in order to avoid overdoing and crashing. Fitness means weight management as well. Many studies show that obesity is associated with chronic pain. Weight loss is difficult, but with commercial weight loss programs that provide food guidance along with ongoing support, one can lose weight and keep it off without ever going hungry.Staying active One of the fathers of pain psychology noted that patients who have something better to do don’t seem to hurt as much. The converse of this is the aphorism that if your life is empty, pain will fill it up.Indeed, most patients find that when they’re preoccupied with their grandchildren, or involved in some activity that consumes them, they are much less aware of the pain. Medical advice to "let pain be your guide" is great for acute pain, but it is toxic for chronic pain. Seek clear answers from your physician as to whether you are at risk for harm to your body (as distinguished from hurt), and then let life be your guide. Interpersonal support During acute pain, most have loved ones who are sympathetic and helpful. As the pain becomes chronic it seems that whatever they do is wrong. If they note that there isn’t much physical disease going on and wonder if you’re exaggerating the pain, it tends to lead to depression, anger, and decreased function. If they baby you, wait on you, and/or begin to make decisions for you, it tends to lead to regression, helplessness, and then depression. If friends get tired of hearing about the pain and drift away, it leads to loneliness and resentment. It seems that the best response for those who love you is to accept that the pain is real, that they can’t take it away, and that you aren’t sick and don’t need to be treated like a child. It helps if they give attention in the form of an invitation to the movies or a picnic rather than in the form of caretaking. It is important that loved ones ensure that your pain does not govern their lives.