Articles on hip pain

Total Hip Replacement - Learn More

Dr. A Mohan Krishna, Orthopedist
HIP JOINT: Basic AnatomyHEALTHY HIPJOINT: Hip joint is formed by head of the femur (Thigh Bone) and cup like acetabulum of the pelvis. The upper end of the thigh bone is shaped like ball which snugly fits into the socket (Acetabulum) of pelvis bone.The ball and cup of the hip joint is lined with smooth firm material cartilage, which cushions and allows smooth movement.The joint is also lined with synovial membrane which produces joint fluid.The ball of the thigh bone has a precarious blood supply, so any trivial trauma or insult can cause avascular necrosis of the femoral head.Causes of hip pain: Damaged or Arthritic HipWhen the cartilage lining of normal joint wears or gets worn out it may result in pain and stiffness in the hip.The cartilage may be damaged byAgeing: a result of natural wear and tear which is termed as Osteoarthritis of hip.Avascular necrosis of femoral head.Injury / fractures around hip joint.Diseases like Rheumatoid arthritis, Ankylosing spondylitis, etc.In some individuals genetic factors may also predispose to early damage to cartilage.OSTEOARTHRITISOF HIP JOINT (OA):Osteoarthritisis the most common type of arthritis. Primary osteoarthritis is commonly seen in elderly, above the age of 50 years. Osteoarthritis is a chronic condition characterized by wear and tear of the cartilage. As cartilage wears off the ends of bone rub against each other causing pain and stiffness. A young individual can develop secondary osteoarthritis due to trauma or diseases like Rheumatoid arthritis, Ankylosing spondylitis etc.AVASCULAR NECROSIS OF FEMORAL HEAD:Avascular necrosis is a condition in which there is loss of blood supply to the bone due to fracture or vascular damage.  Avascular necrosis of femoral head can occur following trauma, using certain medicines and some medical diseases. As a result bone cells in the head of femur dies,then collapses, the joint is destroyed and patient develops painful and stiff joint. This can take 2-8 years to develop, but can happen at an early age too.The most common causes of Avascular necrosis of femoral head are:Trauma:Fractures and dislocationsNon Traumatic causes: Alcohol abuse, Use of steroidsCertain blood disorders TREATMENT OPTIONS:When medication,physical therapy and other conservative methods of treatment fails to relieve pain, total hip replacement may be recommended by surgeon. How will Hip replacement help you?Improvementof quality of lifeSignificant pain reliefMobility is increased.Help to lead independent and comfortable lifeMost of the replaced hip joints last for 10 to 15 years and patient can have pain free lifeGetting ready for Hip replacement surgery:Medical evaluation:  Cardiac evaluation: Tests: Lab tests include Blood, urine and cardiac tests.Preparing your Hip: Surgeon examines your Hip prior to the surgery. There should be no skin infection, wounds around the Hip and skin should be clean.Others:Anaesthetic evaluation:  after getting all the blood tests and cardiologist opinion you will be examined by anaesthetist. He will evaluate you and gives you fitness for giving anaesthesia and advises different modalities of pain relief during postoperative period. SURGERY:On the day before surgery:You will be admitted in the hospital or asked to come directly to the hospital on the planned day of surgery.You need to take the medications as advised by the anaesthetist.You should have light dinner without much oil and spices and plenty of water. You should start fasting from 11PM on the day before surgery till further advice.You should give consent and sign an informed consent.Follow you anaesthetist and surgeons orders if any given to you in writing.Have a neat shower.On the day of surgery:You should be on fasting, take your regular blood pressure and thyroid medications if any with sips of water at around 6 AM.You can have a plain shower bathLimb to be operated will be marked by the surgeon.You will be shifted to operation theater half hour prior to surgery.Anaesthetist will evaluate once again and prepares you for giving you anaesthesia.Anaesthesia: Most of the Hip replacement surgeries are carried under Epidural and General anaesthesia. In rare cases when a patient is not fit for general anaesthesia, Hip replacement is performed under Spinal anaesthesia.Postoperative pain relief is achieved by continuous Lumbar epidural pump.Total hip replacement surgery:Total Hip replacement is a surgical procedure in which damaged bone and cartilage is removed and replaced with prosthetic components.There are 2 main components used in total hip replacement:The acetabular shell replaces the hip socketThe femoral stem and head replaces the worn out top of femurThere are two types of Hip replacementCemented Hip replacementUncemented Hip replacementCemented hip replacement:The damaged femoral head is removed and thigh bone medullary canal is prepared to take the femoral stem component. Bone cement is used to fix the femoral stem. A metallic ball is inserted on the top of the stem. The damaged lining of cup (acetabulum) is removed by using special reamers. A plastic cup mimicking the original anatomy is fixed using bone cement.The artificial joint is relocated and supporting tissues around the hip are sutured back.Uncemented Hip replacement:The damaged femoral head is removed and thigh bone medullary canal is prepared to take femoral component. The femoral stem is made to press fit into the boneThe artificial head is available in two materials – Metallic head                                                                                   Ceramic headThe damaged lining of cup (acetabulum) is removed by using special reamers. A metallic cup mimicking the original anatomy is fixed using press fit and sometimes augmented with screws. There are three types of liners which can be inserted into the metallic cup:Plastic linerCeramic linerMetallic linerAfter inserting appropriate liner the artificial joint is relocated and supporting tissues around the hip are sutured back.There are various combinations of head and liners to make upnew jointMetal on metalMetal on polyMetal on ceramicCeramic on ceramicRECOVERY IN HOSPITAL:  POSTOPERATIVE PERIODFirst 24 hours:Immediately after Hip surgery you would be shifted to ICU (intensive care unit) and observed for at least for 24 hours.After a day you will be shifted to ward of your choice.First postoperative day:On the bed you are advised to perform deep breathing exercises.Ankle pump and static quadriceps exercises on the bed.Gentle mobilization on bed with legs hanging down the bed and knee movement exercises.If you are strong enough you would be made to stand. Cemented hip replacement: walking with full weight on operated leg with walker.Uncemented Hip Replacement: Walking without weight on operated leg with walker.You will be shifted to ward. Second Postoperative day:To continue the exercises on bed and walking with help of walker.Drain tubes urinary catheter will be removed on the second day.You need to take plenty of fluids and regular diet.Third Postoperative day :Depending on speed of your recovery discharge would be planned.The dressing on the hip is changed to simple dressing.You are advised to continue exercises and walking, gradually increasing the pace.Fourth post operative day:Some patients with slow recovery are discharged on 4th postoperative day.Before you are discharged from the hospital, you will be helped to achieve:Getting in and out of the bed independently.Walking with the help of walker.Using toilet or commode chairDISCHARGE ADVICE:RECOVERY AT HOME You should continue to stay active when you are at home for full recovery. However remember not to overdo it. You will observe gradual improvement and increased endurance over the next 6 to 12 months.Tips to make you return home comfortable:Planning your work:You will be able to walk on crutches or a walker soon after surgery. But you will need help for many weeks with tasks like cooking, shopping, bathing and doing laundry. Make advance arrangements to have someone assist at home.Home planning:Before going for surgery, follow the steps given below to make your recovery at home easier.Fix safety bars in your shower or bathroom.Secure your stairways for support and safety.Keep a stable chair, for your early recovery period, with firm cushion, firm back, two arm, and foot stool for leg elevation.If you have low toilet seat, fix a seat raiser with arms.Walking up or down the stairs within you pain limits and depending on your recovery.DO’S AND DONT’S DURING YOUR RECOVERYDO’S Keep the wound area clean.If your wound appears red or begins to drain, inform your doctor.Check temperature regularly and inform your doctor if it exceeds above normalInform your doctor immediately if you have calf pain, chest pain, or shortness of breath.Practice / initiate regular walking using crutches or walker.Perform exercises to strengthen calf and thigh muscles.Keep pillow between the legs if you want to turn to one side.DONT’S Do not bend.Do not cross your legs.Do not squat or sit on the ground.Do not play high impact sports.Do not jog, run or jump.Avoid gaining weight as it can hasten wear and tear of the implant.Do not shower or bath until the sutures are removed.EXERCISES AFTER HIP REPLACEMENT SURGERYPhysical therapy exercise :Continue to exercise as instructed by your physiotherapist or doctor for at least 2 months after surgery.Frequent deep breathing exercises.Ankle Pumps: Move your ankle up and down to squeeze the calf muscles.Static quadriceps:  Sit with your legs straight and keep a rolled towel under your knee. Press the knee against the towel while tightening the thigh muscles. Hold this for a count of 5 to 10.Knee straightening exercises: place a small rolled towel just above your heel.Tighten your thigh. Try to fully straighten your knee such that the back of your knee touches the bed. Hold for 5 to 10 seconds.Knee bending: Sit on your bed side or chair with your thigh supported. Gradually allow your leg to fall down gently on its own weight. Now gently try to push your leg backwards till the back of the leg touches the chair or cot edge. Hold your knee in this position for 5 to 10 second. Gradually try to lift the leg upwards initially with support of other leg or physiotherapist. When the leg becomes straight maintain it for 5 to 10 seconds. Weight bearing

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.

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.

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.

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.

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.