LOW BACK PAIN AND EXERCISES

LOW BACK PAIN

Commonly seen in people with sedentary jobs more than those who work in varied activities. More commonly seen in Software professionals, surgeons, Dentists, Miners, Truck drivers. Also seen in persons who will do Bending activities more, sitting in a bad position, Standing for a long time, Fall injuries, Maintains static position in the bed for long time (Bed ridden).

Low back pain is of two types:

Acute low back pain which subsides within a month and

Chronic back pain recurs more.

Some of the causes are:

1.     In children the Back pain is uncommon but if present then it may be due to some organic diseases.

2.     In adults occurs due to Postural and traumatic back pain, spondylitis, disc prolapse.

3.     In Elderly persons because of Degenerative arthritis, osteoporosis, bone diseases.

4.     In women who have had several pregnancies, and, in these women, lack of exercises leads to poor muscle tone which results in low back pain and also seen in women who gain more weight during pregnancy and later develops Mechanical back pain.

5.     Occupation plays a major role in back pain, seen more commonly in people who will do sedentary jobs (less mobility).

6.     Any history of spinal diseases such as Traumatic or Inflammatory disease causes back pain.

7.     Psychoneurotic back pain due to anxiety, stress at work place or due to any family problems

People with Low Back Pain suffer from

• Pain may be localised or radiating to other areas,
• Stiffness early in the morning,
• Paraesthesia, 
• Numbness or weakness, 
• Spasm in acute back pain
• Localised Tenderness,
• Swelling if any underlying disease  and
• Limitation of movements.

Treatment

After complete assessement of your problem your doctor will prescribe you treatment.Absolute bed rest on a hard bed in Acute phase of back pain and some analgesics, Anti-inflammatory drugs, and in stiff spine Muscle relaxants.

Temporary use of any corset (Back pain belt).

Physiotherapy Treatment

Physiotherapy treatment plays a major important role in treating the persons with low back pain. The treatment consists of Strengthening exercises, Modalities treatment for pain and for nerve root compression Spinal Traction and ergonomic advice or educating the patient to avoid straining of back in activities of daily living such as sitting, standing, lifting weight.

Your physiotherapist will take proper assessment before starting the treatment programme.

The Assessment includes:

Detailed History of previous problem with the current problem.

Examination of Posture and gait (way of walking) to evaluate any spinal curves deviations like Scoliosis, Kyphosis, Flat back, Lordosis.

Evaluation of Pain: Type of pain, site of pain and characteristics of pain by using Visual Analogue scale.

Palpation to recognise specific tissue at fault.

Range and Rhythm of Spinal Movements

Neurological Examination for specific nerve root involvement and for sensory status, tendon reflexes.

Specialised diagnostic neuro musculoskeletal tests

After the assessment according to your problem he will plan the treatment.

Physiotherapy Modality treatments are:

For Pain and Relaxation: Ultrasound massage

For Radiating pain: Interferential therapy treatment

For Localised pain: TENS Machine treatment

Hot packs application

Spinal Traction 

Acupuncture

Spinal Manipulations

Massage techniques

Spinal Exercises

Many of us neglect doing exercises regularly and properly but 

Do you know the importance of Spinal exercises?

Helps to decrease pain. 

Strengthen the weak muscles, bones and ligaments.

Reduces mechanical stress to spinal structures.

Improve nutrition to joint cartilage

Improve posture.

Stabilise hyper mobile structures.

Improve mobility and flexibility.

Enhance oxidising capacity of skeletal muscles.

Reduces the symptoms like Anxiety and depression.

Increases the level of endorphin in the blood and cerebrospinal fluid, this endorphin helps in reducing pain and it is very less in people with the Low back pain.

Improves over all fitness level and prevents the recurrence.

Uses of spinal forward bending exercises: 

To strengthen abdominal muscles

To stretch back extensors

To open intervertebral foramen and reduces compression on the nerves.

Protects lumbar disc.

To increase endurance of abdominal muscle.

 Uses of spinal backward bending exercises:

Improves strength and endurance of back spine and hips.

Improves mobility of the spine.

Promotes normal physiologic lumbar curve.

Improves tone in the back muscles which is often reduced because of natural forward bending attitude in the humans.

Contraindications/People who are Not advisable to do exercises:

For the spinal flexion or spinal forward bend exercise programme:

Osteoporosis -weakness of the bone

Compression fracture

After prolonged bedrest the disc is hyper hydrated and is more susceptible to injury.

In acute disc prolapse which exerts more load on lumbar disc and open the posterior intervertebral space.

For the spinal extension or backward bend exercises programme:

In any acute disc lesions like wound, abscess or any tumour,

In Spinal stenosis: Narrowing of the spine which put pressure on the nerves that travel through the spine.

In Spondylolisthesis: Forwarding slipping of one vertebral body on the other.

Multiple surgeries on the back.

EXERCISES PROGRAMME:  

All exercises are not fit to everyone so meet your physiotherapist before starting the exercise programme he will assess and plan the treatment for you. The following are the few spinal exercises

1) Pelvic bridging exercises, Lie on your back, bend your knees and lift your pelvis up by pressing knees together hold this position for 5-10 breaths and relax. Repeat 5 times initially and then progress to 10 times

2)Prone kneeling back humping or arching, hallowing slowly hold for 5 breaths

and repeat for 5-10 times and then relax.

3)Lie on your back, raise your head and shoulder to look at feet

      and hold for 5 breaths then relax. 

       Repeat for 5-10 times.  

4)Raise your head, shoulder and right hand and look at feet with your legs straight and then repeat for the other hand. Hold for 5 breaths and repeat for 5-10 times.

5)Now raise both the hands and look at the feet. The same procedure can be done with the knees bent first with one hand try to touch the knee and next with the other hand and then repeat for both the hands.

6)Lie on your back bent both the knees and raise one bent knee in 90 degrees and then raise your head, shoulders and right hand and look at the knee and repeat the same for the other hand and then with the both hands. Repeat for 5-10 times and hold for 5 breaths.

7)Lie on your back with knees bent and raise your knees up and do cycling movement (one knee in bent position and keep other leg straight off from the bed) at this position.

8)Lie on your back one leg should be straight and other leg should be bent at the knee and pull it towards your chest by holding with both the hands and 

 then hold for 5 breaths and then relax and repeat the same with the other leg and then with the both legs. Repeat the exercises for 5-10 times.

9)For the whole spine exercise in standing position separate your feet for 3 feet distance and foot should be supported sideways and now bend your trunk sideways with opposite arm swinging overhead. 

10)For spine rotators- Ride sitting, trunk rotation to alternate sides with loose Arm swinging. 

11)Now lie on your tummy raise your head up and look at the ceiling upwards and then repeat the same with straight hand raise with right hand first, hold for 5 breaths and repeat for 5 times and repeat the same with other hand and with both the hands.

12)Now repeat the same exercise by raising your right hand straight and then lift the left leg straight upwards off from the floor and then with the left hand and right leg and then repeat the same for both the legs with both hands raising by holding for 5 breaths in each position and repeating for 5-10 times.

13)Aerobics like Jogging, brisk walking, swimming, cycling, rope jumping, dancing helps in controlling and preventing the back pain.

14)Yoga

NOTE: Please consult your doctor before starting the exercise programme.