BACK PAIN? The cure is in the front!

Most of us suffer from back pain and stiffness at some time or the other through the severity and frequency may vary. Pain can start after a specific event such as twisting or bending over at the waist or in some cases pain can occur for no apparent reason. Most of the time acute back pain (pain which goes on for a limited time) will get better by itself, usually in less than 4 weeks. When pain keeps recurring or continues at a mild level it is referred to as chronic back pain.


What causes back pain?

Back pain can be caused by a number of factors from injuries to the effects of aging. Most acute back pains in 3rd to 5th decades are caused by muscle or ligament strain which is often a result of:

  • Poor posture (both standing and sitting) and muscle tone
  • Bad lifting technique
  • Lack of fitness or being overweight
  • Over-stretching or overuse of your back muscles


Risk increases with sedentary occupations, strenuous and infrequent physical activity such as occasional sports participation, wearing high heel shoes and smoking. The strained muscles go in to spasm, especially those muscles which are weak or have been underused.


Other causes of back pain

Sometimes problems with bowels, Kidney, and other abdominal organs may present as back pain. Some of the conditions can be serious and may present only as back pain with no symptoms in the abdomen. It is a common experience for many women to get back pain during their periods. Diseases of womb, ovary and other pelvis diseases can present as back pain.


Can osteoporosis cause back pain?

Osteoporosis is decreased amount of bone. It is usually associated with reduced strength and elasticity of muscles and ligaments. “Wear and tear” in the discs and the small joints of the back is also normally present. Osteoporosis can also cause back pain due to minor fractures in the spine particularly in postmenopausal women.


Does one need to worry about back pain?

  • Feel numb or have pins and needles in one or both legs or around your back passage, genital area, or inside the tops of your thighs
  • You are incontinent (bladder or bowel) or are unable to pass water
  • You feel unsteady on your feet or both legs feel weak
  • You feel generally unwell, such as if you have a high temperature as well as severe back pain
  • You have weight loss or night sweats
  • Your back pain is getting worse over a period of time (more than 4 weeks) for no apparent reason.


What is sciatica?

Sciatica is pain that shoots down the leg from your buttock to foot. It may be due to a bulging disc in your spine pressing on a nerve (also known as a slipped disc) or it could be caused by spasm of the muscles around the nerve in the back, buttock or leg.


What can you do to help yourself?

If you do not have any of the warning signs, then your pain is likely to be caused by muscular spasm. In such cases during the First 1-2 days, take it easy. Try not to bend forwards and try not to strain yourself or sit in a chair for long periods of time. You can apply a heat or ice pack to the area for your comfort. Take medication as advised.


If the pain lasts longer than 1-2 days “Keep Active and Get Moving”.

Moving around won’t do your back any harm even if it hurts – in fact, it may help pain get better faster. Lying in bed for too long will not help and it may even make it worse. Carry out your normal activities like going to work (non-strenuous) or going for short walks and cooking etc. But try not to overdo things.


What is the role of physiotherapy?

Physiotherapy is a good adjuvant treatment and a therapist can advise you on the posture, movements, and exercises in addition to using some local pain relief measures.


What is the use of a corset or a back belt?

A well-fitting corset can provide warmth, comfort and a degree of support to your back. It’s best to use a brace only for short periods or during back-straining activities as prolonged use may weaken your back muscles. The best brace you can give yourself is your own muscle corset by building up your muscles with exercises. Strong muscles in the front mean less back pain.


How can you reduce the risk of back pain?

“Keeping your back fit and maintaining a good posture”. Regular aerobic activities that don’t strain your back can increase strength and endurance in your lower back. Strengthen your back and abdominal muscles. Flexibility in your hips and upper legs allows for proper pelvic bone alignment, which improves back pain.

  • Walking is usually helpful – start slowly on the flat ground, building up to longer walks and gentle slopes.
  • Swimming is an excellent exercise – do back or front-crawl instead of breast-stroke which can strain your neck.
  • When your back pain has settled, using an exercise bike is a good way of getting fit. Keep the saddle at the correct height to keep the natural curves in your spine.
  • Proper shoes and reduction of weight, if one is obese.


What are the simple tips to avoid back pain?

  1. Follow correct lifting techniques
  2. Sit upright and try to lift your head and stretch yourself into a tall, relaxed posture in a proper chair. Avoid sitting for longer than 30 minutes at a stretch. Take a break from standing, even if it’s just for a few seconds.
  3. Sleep on a firm but comfortable bed. No need to sleep on the floor! Get up sideways when you rise from bed, and not in haste.
  4. If you have been standing for a long time (e.g. while cooking), keep one leg on a footrest (at a comfortable height) and alternate the legs after 20 minutes. Try tucking in the abdomen. Try reaching overhead cabinets slowly not to twist/strain your back.
  5. While driving a car to adjust the seat so that your arms are comfortably positioned on the steering wheel. Sit upright and do not hunch over the steering or slouch in the seat. Avoid long drives especially if you already suffer from back pain.


A few simple back exercises 
Lie on your stomach. Tighten the muscles in one leg and raise it from the floor. Hold your leg up for a count of 10 and return it to the floor. Do the same with the other leg. Repeat five times with each leg

Lie on your back with your arms at your sides. Lift one leg off the floor. Hold your leg up for a count of 10 and return it to the floor. Do the same with the other leg. Repeat five times with each leg. If that is too difficult, keep one knee bent and the foot flat on the ground while raising the leg.

Lie on your back with knees bent and feet flat on the floor. Slowly raise your head and shoulders off the floor and reach with both hands toward your knees. Count to 10. Repeat five times.

Lie on your back with your knees bent and feet flat on your bed or floor. Raise your knees toward your chest. Place both hands under your knees and gently pull your knees as close to your chest as possible. Do not raise your head. Do not straighten your legs as you lower them. Start with five repetitions, several times a day.


Piriformis Stretch – Lie on back with both knees bent. Cross one leg on top of the other. Pull opposite knee to the chest until a stretch is felt in the buttock/hip area. Hold 20 seconds. Relax. Repeat 5 times each side.

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