Dr Atul H. Dekate, PT
Physiotherapy DepartmentOrange City Hospital & Research Institute
Back pain ( upper or lower ) is the common health problem that every individual irrespective of age and sex can experience at any stage of life. It causes activity limitation which leads to absence at workplace. This increases stress and reduces the productivity of an individual. It varies from a very mild form, like getting pain during or after prolonged work in the same posture, especially in sitting or standing ( gets relieved after rest ), to an intense form of back pain which affects their normal way of functioning & troubles even at rest. Sometimes it leads to some kind of disability that badly affects their work performance.
As said, it is a very commonest form of complaint, affecting teenagers( 16 years ) to elderly ones in mild to severe form. Everyone is prone to developing back discomfort (if they don’t follow the habit of regular exercise). The non-specific ( common ) low back pain is estimated to be 60% to 70% in industrialized countries. The prevalence rate for children and adolescents is much lower but is rising.
Normally, Spinal discomfort or back pain starts with mild fatigue of spinal elastic supporters and mild stiffness-like feeling at whole or some part of the back. It is mainly due to overuse of flexible structures that support the spine. Along with this, lack of knowledge about correct posture and regular exercise also play important role in the development of back pain. These mild form of aches or discomforts are likely to progress in some mild form of spinal pathology as age progresses or if we tend to run away from the habit of regular exercises, good posture, healthy diet and best ergonomic practices. In the middle-age group, the tendency for sedentary work style is very much common nowadays, which results in abdominal muscle weakness, exaggerated lordosis, tightness of muscles and thus faulty posture.
So it creates much higher prevalence of back pain in people of age group 35 to 55 years and tends to land up in very serious issues of spinal pathology like spondylosis, spondylolisthesis , nerve root compression or muscular imbalance that leads to severe backache. Apart from this, direct trauma to spine or violent spinal movement, some spinal diseases, pregnancy or post-pregnancy time, are also the causes for development of acute or chronic back pain.
BACH PAIN COULD BE DUE TO:
• Fatigue of back musculature
• Faulty posture
• Sedentary lifestyle or Overuse
• Direct or indirect injury to ligaments or muscles
• Structural or functional pathology of spine
( spondylolisthesis, spondylosis, PIVD, Pott’s spine, compression fracture. )
• Disturbed muscular balance around the pelvis and spine etc.
• Secondary to other surgical and medical condition (abdominal surgeries, generalised weakness, ANC, PNC etc. )
SIGNS & SYMPTOMS
- Localised or radiating pain
- Dull aching pain, tingling and / numbness
- Muscle spasm
- Limited ROM at spine
- Postural deviation
- Disability ( temporary or permanent )
TYPES OF PAIN IN BACK
- Acute pain: Immediate pain experienced due to tissue damage
- Chronic pain: It is experienced for a longer period of time as structural or actual tissue damage remains present(identifiable/unidentifiable)
- Neurological: It is experienced due to compression or damage to the spinal cord and / nerve roots
1. Medications 2. Physiotherapy 3. Surgical
To alleviate pain .
To Induce local relaxation.
To improve spinal mobility.
To improve the flexibility of muscles.
To strengthen the muscles to give strong support to the spine and pelvis. To improve posture and overall functioning.
- Hot fomentation: It is used to increase the local circulation to induce relaxation and reduce the pain. Modalities: Heating pad, SWD, IRR.
2. Pain relieving modalities:
IFT: For local pain for larger area TENS: For neuropathic pain
US: for small area of local tissue damage
3. Spinal manipulation
4. Stretching: To stretch tightened structures that have altered alignment
5. Spinal mobilisation: To reduce pain and improve mobility
6. Postural correction :
Advice the proper way of maintaining posture while sitting and standing.
Re-correction of deviated posture by Postural correction programme & advising correct corset.
7. Workplace modification: By giving ergonomic counselling.
8. Strengthening programme for correcting muscle imbalance:
– It is a set of various exercises designed individually to improve the strength.
– Core strengthening or core stabilisation technique is very impactful for people with acute or chronic back pain.
– Strengthening of the musculature around the spine and pelvis creates strong
effect for relieving back discomfort by giving strong support to the spine.
9. Planks: To reduce your abdominal wall weakness and improve the strength of our spinal and pelvic muscles.
10. Swiss ball exercises: To improve dynamic stabilisation.
(Note: The above-mentioned exercises MUST be learnt and practised under your Physiotherapist’s supervision only, to avoid any complications)