Lowback/ Bad back is so common that
4 out of 5 adults above 18 years
experience it some time during their
life. The spine is complex structure,
which provides both mobility &
strength to the body. Almost all
activities you do in your day to day life
require the proper functioning of the
spine. Pain in the lower back can
restrict your activity and affect your
quality of life and working capacity.
Proper understanding of your back,
and a few preventive measures can
ease the pain in majority of the
people. Preventive techniques coupled
with lifestyle changes that can help
avoid and manage backache.
Know your Back
Your spine is made up of 24 bone
blocks called vertebrae, stacked on
each other. It rests on your pelvis
(hips) and has the skull on the top……
Between each vertebrae are tough
and spongy cushions called discs,
which act as shock absorbers of the
vertebrae and give the spine its
Structure of your back
Strong elastic ligaments hold all the
vertebrae firmly together in a column.
Muscles are attached to them by
rubbery connections called tendons.
Contraction & expansion of muscles…
Produce the movements of your back
and upper body. The spine also
provide protection to spinal cord,
which runs from the base of the brain
into a hollow canal down the
vertebrae. This is the main
communication cable between brain
and rest of the body. So keeping your
spine healthy is very vital if you want
to live an active life and enjoy. The
spine branches of into 31 pairs of
nerves as communication channels.
The normal spine is shaped like an ‘S’
when viewed from a side. This shape
will allow the distribution of weight to
withstand stress. The lower portion of
your spine holds most of the body’s
weight. There are 3 segments of the
spine as follows.
Cervical (7 vertebrae)
Thoracic (12 vertebrae)
Lumbar (5 vertebrae)
Rely on the strength of the others to
function properly with coordination.
Back pain is caused by no of factors
that will add to stress & strain of back.
List is very long and not complete.
Familial (family history)
Lack of exercise
Stress & Strain
Long term use of steroids
Some Diseases can cause back pain
and are likely to need long term
treatment and expert care. Like
Inflammatory Joint Diseases
Protruding disc (herniated disc)
Spinal Anesthesia during surgery
Low back pain is classified as follows
1.Acute(sudden fresh attack)
2.Sub-Acute(continuing for weeks)
3.Chronic(continuing for years)
How to avoid back pain?
Most backaches are avoidable. Correct
techniques while lifting objects,
sitting, sleeping and standing to a
great extent, help avoid back pain.
Following are some of the tips.
One of the main reasons for backache
in school children is carrying a heavier
school bag. This has become a point
of criticism from parents & others.
•Using a hip strap
•Using a back pad
•Bag should be 2” above the waist
•Regular exercise to the muscles
•Pack heaviest items close to your
•Correct posture while lifting the
(bend both knees when picking up
•Avoid high heel shoes
•Use back supporting firm chairs
Avoiding Back pain in adults:
Good posture will help a lot
While lifting objects bend both knees
Use firm supporting chairs to your
lower back while sitting
Stand straight without slouch. Avoid
Adjust your seat while driving,
support your lower back with small
cushion and take regular breaks.
Use firm mattress to sleep which will
not sag. Pillow supporting neck.
While using computers take 5 min.
break for every hour get up from the
chair and massage your back gently.
Reduce your stress level through
techniques like walking/ cycling/
breathing/ gardening/ swimming/
listening to good music/ yoga/
dhyana/ reading good books etc.
While getting up from the bed role to
a side and get up slowly
Use western commode to reduce
stress on your back.
Try periodic hot water fomentation for
pain relief/ a hot shower also helps.
Avoid too much.
Eat food which will not cause gas
formation. Excess gas also cause
pressure and pain on the back.
Avoid constipation and train bowels
with natural foods and adequate fluids
to evacuates regularly
Don’t be in the same posture for
more than 1 hour.
Read humarology with family &
Usually the back recovers naturally if
allowed to do so and in most people,
the pain settle down in 3-4 days. If
pain lessens try and get moving again
avoiding stress & strain. Avoid lifting,
bending, twisting for few days to avoid
recurrence. Avoid the activity which
caused the pain. Gradually build up
your exercises with an expert advise
to develop the resistance and
elasticity of the muscles and activities
day by day. Stop smoking.
Try some of these exercises
You can minimize the back pain with
exercises that make the muscles in
your back, stomach, hips, and thighs
strong and flexible. They are stretch
and strengthen your back muscles for
better functioning. Before starting
them take your doctors advice. Do
them either morning/evening on
empty stomach in a calm place. Do
25-30 deep breaths before for
*Lie on your stomach. Tighten the
muscles in one of the legs and raise it
from the floor, hold it till you count 10
and bring it back slowly to rest. Take
a deep breath it for 5 times. Repeat
the same for other leg.
*Stand with your back against a wall
and feet, shoulder width apart. Slide
down into a crouch with knees bent
about 90°. Count 5 and slide back up
the wall. Repeat 5 times.
*Lie on your back with your arms at
your sides. Keep one knee bent and
the foot flat on the ground raising the
other leg. Do it 5 times for each leg.
*You can also sit upright in a chair
with legs straight and extended at an
angle to the floor. Lift one leg waist
high. Slowly bring back your leg to
floor. Do the same with other leg.
Repeat each leg 5 times.
*lie on your back with knees bent and
feet flat on floor. Slowly raise your
head & shoulders off the floor and
reach with both hands towards you
knees. Count 10, repeat 5 times.
*Stand behind a chair with your
hands on the back of the chair. Lift
one leg back and up while keeping the
knee straight. Return slowly. Repeat 5
times with each leg.
*Lie on your back with your knees
bent and feet flat on the floor. Raise
your knees towards your chest. Place
both hands under your knees and
gently pull your knees close to your
chest. Don’t raise your head. Do not
straighten your legs as you lower
them. Start with 5 times and
gradually increase to 20 times a day.
*Stand with your feet apart. Place
your hands in the back. Keep knees
straight. Bend backwards hold 2 sec.
What to do when you
have back pain?
1.Maintain a comfortable posture as
for as possible. Don’t stay in one
posture for very long.
2.Apply hot/cold fomentations
alternatively to improve circulation
and relaxation of muscles to relieve
3.Take a pain killer for a while in acute
pain under medical supervision.
• Relax by various techniques like
yoga, dhyana, reading, listening to
good music, talking to
friends,watching humorous TV
programs, cards, chess etc.
• See the doctor if the pain is
increasing, no relief even after 3-4
days or if there are any other new
symptoms like difficulty in passing
urine, numbness, pins & needles &
shooting pain in legs, unsteadiness.
What your doctor can do?
•Check that you have a serious
•Prescribe a suitable medicine
•Refer to a specialist if situation
He may ask you the following
probable questions when
When did the pain start?
What were you doing at that time?
Any past similar episodes?
1.Where is the exact location of pain?
2.Is the pain dull/piercing/shooting?
3.Does it stay in the same place?
4.What makes the pain better/worse?
5.Any other symptoms?
6.How your work is hampered?
7.What are the contributing factors?
8.What to do and what not to do?
Diagnosis of acute back pain
There are many ways, tools and tests
for a doctor to diagnose your back
X-Rays: painless, noninvasive and
very useful in diagnosis
CAT Scan (computer axial tomography scan):
Also called as CT Scan painless
procedure. Helps in more accurate
MRI (magnetic resonance imaging):Non
invasive technique, most helpful test..
In diagnosis of back pain and various
Bone Scan: the procedure involves
injecting radiographic marker in to the
patient and then run the scanner. It is
done when there is a suspicion of
bone tumor, infection and hair cracks
in the bone. Helps in diagnosis.
Ayurveda is having good
remedies in chronic pains
related to rheumatism
including back pain/sciatica
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