No Human is free from LOW BACK PAIN.

Yes its true- each and every person has suffered or will suffer from back pain, at least once in his lifetime. The curves of the back are absent in a baby, they are developed when we start standing. It’s the curse of being UPRIGHT.

As the name suggests it’s a back pain occurring mostly in the lower back region. That is the region just below the ribs insertion in the back to the iliac crest (prominent bones forming your waist).

Back pain can be categorised in to two types Acute and Chronic. Pain persisting beyond 3 months is called as chronic and between 1-2 months is called sub-acute and less than 4 weeks is Acute. The necessity for back pain being classified is because the etiopathogenesis and thus the treatment varies.

Acute low back pain can present as only localised pain in the lower back- central over the spinous processes (bony tips at the mid-line of back) and/or over the adjoining muscles and/or over the waist and less commonly radiating to the hips and one or both legs. There can be a point tenderness indicating the pain generators or generalised tenderness around the area limited to the low back.

This pain can range from dull aching to severe in intensity. It usually proceeds some stimulation in form of-  sudden jerk, lifting weight (not necessarily heavy), pushing something heavy, direct impact on the back, prolonged sitting episode, weight gain in a short period!! The list is never ending. Mainly forward bending from back and rotation at the same time is the deadliest form for your back. And add carrying or lifting weight – seals the deal for acute back pain. IMAGINE- bucket full of water which you regularly lift but today your muscles are fatigued and you are tired, you bend from your back and without getting back up straight you slightly rotate and keep the bucket aside. Inside your spine many things have gone wrong- your muscles couldn’t protect or perform the movement correctly so your vertebral joints (facet joints) were overloaded, also your intervertebral disc pressures have increased 20 folds. I need not tell you what may happen as its very obvious. Something breaks or sprains—OBVIOUSLY.

To summarise, the main culprit is weak back muscles. Our back muscles consists of two groups- the superficial and the deep. Superficial muscles are called the erector spinae and span our entire back from scapulae, upper ribs to ilium and sacrum. The deep muscles are the multifidus and the short and long rotators which are attached to the spinous processes and the transverse processes of adjacent vertebraes. The vertebras protecting the spinal cord are joined to each other with ligaments and the joints are called the facet joints. The intervertebral disc is present between the two vertebrae.

The injury to any of the above mentioned structures can cause the acute low back pain.

Our first baby steps of life form our lordotic curves of lumbar and cervical spine. Our back muscles start their support to our entire spine/ vertebrae. Common question is WE JUST SIT THE WHOLE DAY- STILL WHY DO WE HAVE BACK PAIN?

When we stand- the weight of our upper body is transmitted from our back to the legs and then to the ground. But when we sit the upper body weight is entirely borne by our back muscles. So prolong sitting can increase fatigue in your back muscles and thereby injuries. POSTURE- its because of the tone of muscles that you have a posture. WOLFF’S law- is a theory developed by the German anatomist and surgeon Julius Wolff(1836–1902) in the 19th century that states that bone in a healthy person or animal will adapt to the loads under which it is placed. The muscles molded our lumbar vertebrae into lordotic posture. When we overload or fatigue our muscles they cannot sustain the correct posture so we slouch which is now against the normal curvature thereby leading to pain.

Also, now you can imagine what if we increase weight? The work our back muscles have to do to keep you upright increases many-fold.

We constantly are using our back muscles which also protect the vertebrae and the discs which in turn protect the spinal cord. So the algorithm is quiet direct- damage from outside in or inside out.

There comes the importance of exercise, especially back exercises and maintaining BMI to normalcy. Core strengthening consists of abdominal exercises also.

FOLLOW THE BELOW TIPS FOR AVOIDING ACUTE BACK PAIN-

  1. Inculcate back exercises to your routine exercises
  2. We are not getting any younger as days and years pass so reduce the physical stress or do it correctly- learn correct form while lifting things from ground. Avoid bending in back. Instead bend from hip and knees.
  3. Avoid sitting for long duration. Take a break every hour and just stand up or walk a few steps.
  4. Keep your weight in check. (above tip no.3 will also help you loose calories).
  5. Avoid jerks in sitting position like driving on bumpy roads on two wheeler. Core strengthening will help to protect you till age finally catches up.
  6. Use lumbar support on your office chair or car seat as they will provide support to your muscles and assist in keeping correct form.

Above tips will safeguard you against acute low back pain. But like I said, no one is immune from it.

If you still have back pain, do not shy from visiting an orthopedics surgeon thinking it will pass. Like I have tried putting in simple terms how everything is connected to your spine, at the first sign of trouble treat and rehabilitate to avoid further damage.