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Low back pain affects almost everyone at some point of time and has adverse effect on an individual’s ability to work and participate in daily activities. It is the commonest cause of work related disability and in US alone 50 billion dollars

Causes and risk factors for development of low back pain

Low back pain affects almost everyone at some point of time and has adverse effect on an individual’s ability to work and participate in daily activities. It is the commonest cause of work related disability and in US alone 50 billion dollars are spent yearly on low back pain treatment.  

There are many reasons for development of low back pain. Factors such as lifting heavy weights, injury or trauma to the back, arthritic conditions, bone diseases and osteoporosis are some of the common reasons for low backache. in certain instances, low back pain can indicate the presence of more serious disorder such as disc disease or neuropathy (a commonly noted condition in diabetics). Other risk factors for low back pain include obesity, inappropriate postures, absence of physical conditioning, improper sleeping position, and stress. Low back pain can affect both genders and can even affect school children who carry heavy backpacks.  

Types of back pain

Acute

Acute back pain is one which lasts for a short time (days or weeks) and occurs mostly due to sudden jolt to the back (such as injury while paying sports, or accidents) or due to arthritic conditions. The pain can radiate to the surrounding regions of the back. A stabbing or shooting pain can also be felt, which can be so severe that it can restrict the movement as well working capacity of the affected individual.  

Chronic

Chronic pain persists for long time (duration of more than 3 months). The cause could be difficult to identify and therefore this type of pain is difficult to treat.

How is low back pain treated?

Diagnosis of lower back pain can be made using X rays and further tests could be done if need arises. Most of the incidences of low back pain are preventable. Those arising due to over-stress or heavy weight loading or inappropriate postures can be prevented easily by following adequate precaution while performing such tasks or avoiding them.

Treatment of low back pain usually consists of symptomatic relief measures which include use of cold and hot compresses. These might help in decreasing inflammation associated with back pain. Hot and cold compress can even effectively relax muscles as well as improve mobility in individuals with back pain. Non-invasive methods of correction of spinal abnormalities may be required in certain cases where involvement of the spine is suspected. In severe back pain bed rest is advised for duration of 1-2 days. Persons afflicted with back pain can be started on simple exercises as prolonged bed rest might be deleterious to recovery.

Medications frequently advised include pain relievers and anti inflammatory agents. In severe cases, drugs belonging to the group of opioids may also be prescribed for effective pain relief. In some, traction could be advised in which weights are used to align the affected bones. In chronic back pain additional steps such as weight reduction, quitting smoking, aerobic exercises are usually advised. Antibiotics may be advised if infections are believed to be the cause of back pain.

Rehabilitation, stretching and back strengthening exercise 

Rehabilitation exercise

Exercises that could be initiated in persons suffering from low back pain are aerobic, strengthening and stretching exercises. These may help in conditioning the muscles and improving flexibility.

Stretching exercises

Stretching exercise could be advised to almost everyone suffering from low back pain. These exercises help by stretching the muscles, ligaments and tendons surrounding the back and spine. These exercises when performed appropriately will help in maintaining normal flexibility of the spine.

Some of the commonly advised stretching exercises include:

  • Sitting leg stretch
  • Hamstring stretch
  • Knee to chest stretches
  • Hip and quadriceps stretches

Individuals suffering from chronic back pain may benefit from these stretching exercises only when these exercises are performed for a longer period time. Nevertheless, it provides a long term relief when compared to other treatment modalities. Stretching exercises relaxes the vertebral discs present in the backbone and thereby improves the flexibility and elasticity. It also improves the functions of the muscles of the back enabling them to perform better and sustain the stresses they are exposed in a better manner.

Back strengthening exercise

Strengthening of back prevents recurrence of back pain and weakness associated with it. Two forms of strengthening exercises are usually used.

  • McKenzie exercise: includes a series of spine extension exercises that are done to decrease pain arising from abnormalities in the backbone.
  • Lumbar stabilization exercise: helps to find a comfortable spinal position for the affected individual. Performing this exercise will not only strengthen the backbone and related muscles, but also keeps it well positioned.

Other exercises that are advised to strengthen the back muscles include:

  • Pelvic tilts
  • Abdominal curls

Aerobic exercises and rehabilitation tips 

Aerobic exercises

Aerobics are certain low-impact exercises that help in the rehabilitation of the back. Further these exercises are also helpful in preventing the recurrence of back pain in most of the individuals. Regular performance of these exercises can both increase the stability and the flexibility of the lower back. While these exercises may be difficult to be performed by individuals suffering from chronic back pain, avoidance of these exercises can further hamper the ability to perform day to day activities. Some of the aerobic exercises that are advised for people with back pain include: walking for 20-30 minutes every day, water therapy and other exercises such as riding a stationary bicycle. An appropriate exercising regimen depending upon the affected individual’s physical state, his capability as well as his preference can be chosen and be practiced on a regular basis.

Rehabilitation tips

Some of the tips which are helpful for treatment as well as for prevention of low back pain are given below

  • Staying active can reduce low back pain
  • Before performing any strenuous exercise or physical activity always do stretch exercises to relax the muscles; low to moderate exercises should be done after a long period of immobility
  • The sitting and standing postures should be such that the back doesn’t bear the brunt of body weight.
  • Low heeled shoes should be worn by those having back pain
  • Adequate nutrition intake prevents bone loss and diets rich in calcium, phosphorous and vitamins especially D should be consumed
  • Sitting on a conformable chair with height adjustments will help in preventing back pain
  • Sleeping on the sides as well as on a firm surface will helping avoiding the back curving
  • Get enough sleep
  • Stop smoking as it will improve oxygen delivery to the back
  • Pain medications should be used in moderation

  • www.spine-health.com/treatment/physical-therapy/back-exercise-pain-relief
  • www.merck.com/mmhe/sec06/ch094/ch094b.html
  • www.ninds.nih.gov/disorders/backpain/detail_backpain.htm#119463102
  • www.med.umich.edu/1libr/guides/Adult%20LBP%20Exercises.pdf

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