Backache

                       

                       Low Back Pain

                            (Lumbago, Ankylosing Spondylitis, कटिशूल, कमर दर्द, कटिग्रह   पृष्टिशूल)

                                                                          

                                                                                                AAUUUCH

    Is your lifestyle taking  a toll on your spine

Are long office hours causing pain ? Backache is the most common health problem that office goers face. A sedentary lifestyle makes the back and legs stiff, thereby, increasing strain on the joints. Those who perform physical exercises regularly can deal with this problem easily. But those who don’t have the time to hit the gym because of their hectic work schedule may suffer from the strain due to long sitting hours.

Back pain are very troublesome. The reason for it can range from a minor muscle spasm to a bone infection or even tumor. They can be structural or functional origin.  Medically low back pain is termed as Lumbago. Low back pain is becoming a major public health issue not only in India but all over the world. Four out of every five adult experience at least one bout of back pain at some times of their lives, However there is no gender specifications. It affects both men and women 1:1 ratio . 87% youth has backache today. Pain in the lower back restricts  activity and reduces work capacity and quality of enjoyment of  every day  living and turns daily life into a misery. Occupations such as software engineers, nurses, policeman, barber, drivers, shopkeepers are more prone to back pain.

                                                                 "Never ignore a backache."

"Sleeping on floor is good for backache. "                                      


                                                              “Keep your spine erect” 

Introduction

Backache can be defined as a cry of a muscle/ligament/joints/disc of our back. When they are put under stress more than they are trained for. Healthy spine Most Of us take the health of a spine for granted… until something goes wrong. Luckily there are ways to make sure your spine stays in tip- top condition throughout the year. Back pain can originate anywhere in the elaborate spinal architecture.

   

    

"Our spine is a pillar of our body, please bend it with caution. If the pillar is weak the house can fall."

Our spine is inverted S shaped, there are two curvatures which are free to move, cervical and lumber.  Any change from normal spine curve can stress or pull muscles. This leads to increased muscles contraction, which causes pain. Each of the vertebrae can develop sudden pains which could become a chronic condition. People find these kinds of pains to be more common as they grow older.

Back muscles are the weakest of all groups of muscles but they play a very important role in every physical activity we perform. So one has to be conscious about what activity can hurt the back and cause a problem. We twist, bend and flex with the help of spinal column. There are vertebrae placed one on another from skull to pelvis. Spongy discs are present in between vertebrae. Discs are those gelatinous substances that not only act as a shock absorbent but also helps to give mobility and laxity to spine. The spinal column is tightly bound  by muscles and ligaments. The spinal cord is enclosed within vertebral canal which is formed by alignment of vertebrae. The ligaments and tendons holds the bones

and muscles together.

"Balanced posture decreases stress on your back by keeping the muscles,bones and other supporting parts in their natural position”.

Causes

Herniated Disc



• Herniated Slip Disc : The uneven pressure on the discs causes protrusion / bulge / herniation of the disc. A condition in which the soft, central portion of the spinal cord bulges out of the outer ring. A slip disc occurs when a disc  (a tissue that act as cushion  in your spinal column) protrudes. Lower back pain, pain radiating from the back to the  legs, neck pain, difficulty bending, and muscle weakness are all common symptoms.

           

                 

• Cervical Spondylosis : This condition is a result of ageing and chronic wear and tear of the spinal discs in your neck. Its very common and is usually get worst ats you get older.It is distinguished by neck pain and stiffness as well as a lack of coordination and difficulty walking.

• Muscle Strain : The majority of us  spend a lot of time  in front of a a our electronic devices, which leads to poor posture. Muscle strain in the neck and back can be causeed by incorrect posture and overuse.

• Osteoporosis : Osteoporosis is a condition caused by weakened bones in te spine.This condition is often characterized by  symptoms including back pain, stooped posture and damaged bones.

• Osteoarthritis of spine This is a slow deterioration of cartilage around joints in the lower back 
• Back pain occurs due to problem at any of the three core levels of the body.These are: vertebrae, soft tissue and muscles supporting the spine and nerves.
• Wrong posture
• Lack of appropriate back exercises are the most common causes of back pain.
• Sciatica ग्रधंसी  Nerve Irritation. It is caused due to compression of nerve roots in the lower back.
• Tuberculosis  of spine.
• Degenerative disc disease This happens when cushion between the bones dried out and flattened.
• Obesity : Increases the mechanical stress on joints and therefore on the cartilage.
• Stress & insufficient diet keeps the muscles under tension and they become stiff. lack of calcium in the diet.
• Gout: Uric acid crystals deposits in the cartilage can cause cartilage degeneration and osteoarthritis
• Congenital anomalies some people are born with abnormally formed joints since birth and are vulnerable to mechanical wear, causing early degeneration and loss of cartilage. Hip joint is commonly related to structural abnormalities.
• Psoriasis arthritis Back Pain will occur if the spine is involved.
• Ankylosing spondylitis Ankylosis means the fusion of vertebrae to each other. They fuse together because of the chronic inflammation and irritation of the spinal joints.This leads to Sacralization of lumbar vertebra or lumbarization of sacral vertebra.
• The psychological conditions associated with emotional stress, which brings about spasm of the muscles,may also cause backache.
• Metabolic factors: especially osteoporosis and diabetes which Increase rate of disc degeneration.
• Inflammation may lead to calcification of discs.
• Anemia: Due to improper nutrition that causes insufficient blood supply to all organs leading  to general weakness and backache.
• Kidney or prostate problem and influenza can cause backache..
• Women: Gynecological Conditions such as endometriosis, menstrual cramps, fibroid tumors. Pelvic inflammatory conditions like uterine infections, and  ovarian cyst. Osteoporosis also causes backache. Back ache is very common in pregnancy.
• Endocrine factors Corpus luteum causes relaxation of ligaments which may precipitate prolapse of disc.
• Pregnancy :
• Poorly fitted bra etc.Spinal anesthesia.
• Scoliosis : It is the sideways curvature of the spine. It is mostly diagnosed during adolescent. Back pain, uneven shoulders or waist,and body leaning to one side are common symptoms.

General

• Modern lifestyle : (Sedentary & Busy Lifestyle) long hours of sitting in one position for long period of time at work, home, airplane  or in car can lead to imbalance between weak muscles and those that are chronically contracted.
• Occupational factor If your job requires you to constantly bend and lift weight, you are greater risk of back injury. Or if your work demands you to stand or sit for a long period of time. I.e construction workers, barbers, nurses often suffer from some type of back pain
• A previous back injury makes you more prone to back pain
• Poor lifestyle Lack of exercise can lead to back problems.It has been seen that excessive weight can cause lower back pain.
• Poor posture Sitting or standing the wrong way can cause back pain. For instance, if you are constantly. slouching over your desk, you are more likely to experience backache at some point.
• Sudden jerky movements, two wheeler  driving and travelling causes stress on back muscles.
• Frequent twisting, bending, improper lifting of weight and static posture.
• Uncomfortable angle of car seat (normal 45 degrees)
• Chair without a proper Back support.
• Different gadgets causing pain
• High heels Shoes or chappals with high heels place a tremendous strain on the back and other muscles of the body
• Sleeping on too soft a mattress which results in an improper back and neck posture, can cause tension, headaches and pain in upper and lower back.
• Gadget: Sitting on computers for long are responsible for your back pain.
• Uncomfortable angle of car seat (normal 45 degrees)
• Constipation which lead to gas formation which lead to pain.
• Ayurveda : According To Ayurveda it is called Katigraha कटिग्रह and Prishteshool  पृष्टिशूल At the physiological level, back pain is viewed as a result of vitiation of  Air (Vata, वात) . Back pain arises when Vata in the back gets aggravated. Unwise physical activities (मिथ्या योग), such as bending over too sharply, lifting things unwisely. Excess physical exertion (अति योग ) such as too much of bending, lifting or twisting. Less physical activity (हिन योग) for example sit or stand for long periods.
• Controlling of natural urges
• Excess of salt intake will increase swelling and pain.
• Intake of sour things causes inflammation such as tomatoes,curd.

Sources of Pain

• Inter-vertebral disc : .Probably most coon site due to disc degeneration.
• Facet joints & Supporting structure : Such as ligaments and joints capsules.
• Sacroiliac joint:
• Muscle & Fascia : Myofaciacitis
• Metabolic factors : Specially osteoporosis and diabetes which increases rate of degeneration.
• Psycho social factor :

Signs & Symptoms

• In backache, the pain is usually felt either in the middle of the back or lower down. It may spread to both sides of the waist and the hips and legs.
• With acute pain, the patient is unable to move and is bedridden.
• Wrenching spasms provoked by muscles, tendon and ligament injuries, which can drop grown men to floor.
• In slip disc the nerve is affected in such a way that the pain radiates down the thigh and leg.
• Back pain can be triggered when we sneeze, climb or bend
• In Ankylosing spondylitis pain and stiffness are worst at night, and in the morning, when you are not active. It May wake you up from sleep.
• Pain typically gets better with activity or exercise
• Back pain may begin in the sacroiliac joints (between pelvis and spine). Over time it may involve all or part of the spine.causing stiffness
• Loss of appetite, Weight loss, Fatigue
• Stiffness of the muscles of the back
• Loss of normal curvature of the spinal column.
• Dull constant aches to a sudden sharp pain.
• Acute back pain comes on suddenly and usually lasts from a few days to a few weeks. It is called chronic if it lasts for more than three months.
• It may be associated with burning, stiffness, numbness or tingling with the pain shooting down the buttocks and the legs.
• Low back ache is often precipitated by moving, lifting objects or twisting of the waist.
• It reduces the activity and reduces work capacity and quality of enjoyment of everyday living and turns daily life into a misery.

When should one be alarmed?
A regular dull pain in the back , which comes back every day with the routine activities, should be enough to alarm,and make one see a spine specialist. Also if the pain starts to go to any of the arms or legs , then one should immediately consult a spine specialist.

• Backache in pregnancy  : The weight of the baby is supported by the backbone, with the assistance of the muscles of the back and abdomen. When these muscles are weak, the pressure on the backbone is greater and causes discomfort. 
• Bad posture also causes backache. So to correct your posture, pull your tummy in , tuck your bottom in and try to keep your back straight.You can practice this by standing with your back to the wall and pressing the whole length of your spine against the wall and trying to maintain the posture. 

• Rest should help your backache. Don't let your self over tired. Lie down more often. Lying on your back a small pillow or cushion in the hollow  of your back and bend your legs at the knees, with feet flat on the floor. If you prefer to lie on your side, take a pillow between your knees and another between your tummy and the bed. Lie on the hard bed, so that your backbone  has adequate support. 
• Place hard wooden board under your mattress.

Severe low backache may be caused by a lack of  calcium or by a baby's position. The doctor would recommend supplementary calcium.

Upper backache may be caused by poor posture or heavy breast. Correct your posture  and wear a good  well fitting cotton bra, adjusted at the straps to carry the weight of the breasts.

Carrying heavy laptop bags.

               

Effective sitting posture

 “The mystery about back problems is the frequent disconnect between anatomical defects and pain”.

Diagnosis

Patient history
Physical examination

Blood Test : Uric acid to rule out gout.

Neurological testing
Imaging : X -Ray Radio logical examination showed degenerative changes in the lumbar spine, predominantly at L 4 and L 5. And to rule out osteoporosis.
MRI of the spine  : Imaging can precisely identify the location of damage or displacement of muscular or skeletal tissue in the spinal column.
CT Scan,bone scan, D.X.A Scan or a PET CT Scan.
Bone biopsy to diagnose spine tumor.

                                               “Keep your spine flexible by yoga”

Lifestyle

To keep your back in perfect condition it is advised to sleep on floor on plain mattress.

Step for maintaining a healthy back

• Spend 15 minutes strengthening : Carry out the following basic strengthening exercises :

Neck roll

Shoulder Shrugs

Shoulder Rolls

Standing Trunk Stretch

Seated Knee to Chest stretches 

Planks

Side Planks

Isometric Back Extensions

Leg Raises

• Lift right by leading with hips : Unsupported lifting may cause your spinal joints to lock or yours pinal discs to rupture. when lifting heavy weights. It is best to lead with your hips and keep your chest forward.

• Take breaks : After every 30 minutes stand up from your desk or sitting position and walk around.

• Correct your posture : Remind yourself to stop slouching at your desk to practice good ergonomics, and to correct your posture every 20-30 minutes. The will prevent lower spine leading and relieve pressure on lumber disc.

• Massage : At a moderate level massage has several therapeutic benefits, including increased blood flow, decreased inflammation,loosening tight muscles and connective tissues, restoring spinal range of motion, and increasing feeling of relaxation.

• Water Therapy : Work out in a pool to relieve downward pressure on the spine and reap the benefit of gentle resistance through friction, which can strengthen the back.

• Heat Therapy : It can help relieve pain by  increasing blood flow and bringing healing nutrients to the muscles, as well as providing relief from the muscle spasm.

• Sleep to rejuvenate the spine : Use a firm or medium firm mattress and a pillow that fits your sleeping position. to keep your spine naturally aligned.

• Support your feet: Do not leave your feet dangling from a chair, use a footrest.                             

Keep your thighs support: Thighs should be at right angle to the chair and completely supported by it.
Arms must be at right angle: The armrest of your office chair should  support your arms and keep them at a right angle.
No back or neck support: makes the muscles weaker
Foot exercise: Keep a cylindrical thing like a pipe under your feet  and rotate it every hour

  

   
Take breaks: Get up and move around for a few minutes every hour.
Vit D Ensure that your body has adequate stock of vit D which is made naturally  by sunlight.
For proper absorption of calcium your intestine should be healthy
Soft cushion seats  to be avoided and position should be changed as often as possible.One should sleep on firm mattress.

One should take care never to bend from the waist down to lift any object but instead should squat close to the object, 

 

bending the knees but keeping the back straight, and then stand up slowly.

 

Sleeping horizontally in a day time aggravates the congestion which may lead to swelling and worsen the back pain. So try to be out of bed as early as possible.
Remember that one should not stand as erect as a soldier. The posture will strain the back muscle.
Make sure that the stool is soft and bowel movement is without strain.
Take a break from constant sedentary work and stretch your back. Walk a while after every half an hour.

Make sure your bed is not too soft and better to be firm

Do not sleep on your stomach that can cause aggravation.
Regular walking serves the best in prevention and cure for chronic pain.

If you are not able to sleep on your back, try lying on one side with knees folded in the fetal position.
Sedentary lifestyle and no exercise can also lead to backache gradually.
Have a proper posture: When standing feet slightly apart, knees straight, chin slightly tucked in and shoulders back and down. Take a look at the mirror. Are your ears, shoulders, hips, knees and ankles aligned in one straight line?
Use a stool under your feet while sitting so that your knees are higher than your hips. Place a small pillow or rolled towel behind your lower back while sitting or driving for long periods of time
If you drive a long distance, stop and walk around every hour. Bring your seat as far forward as possible to avoid bending.
At times, sufficient rest brings down the stress and backache is reduced.
Invest in proper footwear: Wear shoes that are well balanced, flexible and comfortable. An average person takes 6,000 steps per day, and supportive footwear will help ensure the spine is aligned correctly.
Hydration Drink plenty of lot of water
Keep moving Regular physical activity is an important way to stay healthy.
Weight control: The more you weight, the greater the stress on your spine

Sleep well: A firm mattress allows you to rest in a neutral position; muscles are relaxed and sleep is more refreshing. Take a look at where and how you sleep.
A naturally positive attitude
Take short breaks during work
Mind your posture while on the computer, laptop or tablet.
Take a regular night sleep for 8 hours.
.Do not lift objects that are too heavy for you, like boxed, bucket  or furniture. It you must lift, bend your knees, don't twist your body and keep your head pointed down and in line with your back.
Stays active: If You have been inactive for long period of time, it is important to begin a low impact exercise program to strengthen your back.

                                    Tip for Software Professionals to Avoid Back Pain:

Use an ergonomically designed chair.

Select a correct chair, with a relatively straight back and a good lower back support. If the chair doesn’t offer lower back support, keep a rolled up towel or cushion to support the back.

Correctposition of chair, keyboard and monitor. Feet should be on floor,,

with knees at hip level; forearm should form a right angle with upperarms; and the computer terminal  should be at eye level.Adapt a relaxed, upright working posture and allow the cair to support.

Avoid slouching forward or leaning back too far.When you are at work stand up, walk around, stretch forward,backward,and side to side once in 30 minutes.

                                 “Must workout regularly to strengthen the muscles”.

Avoid

• Avoid sleep during day time..
• Ensure proper evacuation of bowels.
• Avoid constipation at all cost.
• Avoid high heels  and any other troublesome shoes.
• Do not wear tight outfits.
• Avoid extensive and long traveling
• Do not overdo it at gym or at work.

                                            “Correct your sitting posture”

Exercise

Walking, swimming, bicycling The later should be done keeping the back upright. Walking improves circulation of calcium in every part of the body
Easy chair exercises:
Lateral trunk stretch: Remain seated on the chair and raise one arm over the head. Bend towards the side of the hand that has not been raised.
Hamstring stretch: Rest your heel on the floor and keep your knee straight. Lean forward until you feel a stretch behind your knee or thigh. Keep your lower back straight during the process.
Knee to Chest stretch: Hold your knees with both hands and raise it till it touches your chest. You will feel a gentle stretch on your lower back during the process.
Forward bend: Bend forward and try to bring your head closer to your lap. Lock your hands from below the thigh. Your upper back will feel the stretch.
Hip flex or stretch: Stand near your chair and put one foot behind on the seat. Point the other foot forward on the ground with the knee bent. Contract your glutes and push your pelvis forward. The thigh and hip will feel the stretch.
Back mobilization exercises:
Range of motion exercises-
a . Try gentle stretches and bending. Do these every day to keep joints flexible and to relieve stiffness. While lying down, try bringing up your knees to your chest. Then,put a little pressure on your knees. Stretch, and relax.
Aerobic exercises such as walking, biking, tennis and swimming are also helpful.
Strengthening exercises such as with weights or machines. Do this everyday to increase muscles strength.
Regular exercise of back should be performed
Jogging or brisk walk also gives good tone to the back muscles.
Swimming is highly recommended for prevention & treatment of back pain it is non impact safe and less stressful on discs and joints.

Yoga    

Yoga brings energy and flexibility to the body, reduces stiffness of muscles and joints
The forward, backward and side ward bending asanas mobilize the inter vertebral joints, develop the supporting musculature of the spine, strengthen the ligaments and massage the nerves and blood vessels.

Cat Cow Pose

For low back pain

How

Begin the cat portion of this exercise by placing your hands and knees on the floor. Knees are under hips hands under shoulder and the spine is long neutral. you Abs and inhale into the belly. On the exhale round your spine, tailbone reaching down. Reach the top of your head down and let the back of your head be long. On the inhale move into the cow portion by sinking your belly towards the floor reaching your tail bone up and chest forward as you gaze forward and slightly upwards without putting extra pressure on your neck flow from the cat to the cow pose for at least 10 rounds inhaling for the cow and exhaling for the cat.

Why

While no single move will bring relief . Yoga lengthens muscles such as the abdominal, oblique and hips extensors and hip flexors and the movement helps supply blood in the spinal discs. Cat cow pose is great warm up exercise that stretches and strengthens the deep small muscles in the area of spine. Deep breathing relaxes the nervous system. Yoga can improve mood and lower stress which helps reduce the psychological aspect of pain.

Dandasana

Makarasana (Crocodile pose) It relaxes the the body and mind.

Bhujangasana (Cobra pose) Breath in while going up and breath out while going down. This strengthens muscles of the back.

Apanasana

Good for back pain, this exercise relax the back. When you breath out the knees are drawn towards chest, by tucking the abdomen in.The hands just rest on the knees and do not pull the knees towards chest.

Setu Bandha Sarvangasana (Bridge pose) In this Asana, the muscles of the back are stretched and totally relaxed.

Shalabhasana

Pawanmuktasana

Baddha konasana (Butterfly pose) :

Tadasana ( Palm tree pose)

Marjariasana (Cat stretch pose)

Dhanur Asana

It gives good stretch to back and abdomen.

Padahastasana

Paschimottanasana The forward bend pose. This Asana tones and flexes spine.

Adho Mukha Svanasana Come down on all fours. Keep your back extremely straight.

                                       

“Avoid bending forward, when you have a sore back”

Pranayama

Pranayama is the efficient way to cleanse the body of waste. It is the manipulation of the life force energy (or chi) using the breath.
Bhastrika or bellows breath
Bhramari : or the bee humming breath
Udgeeth pranayama Pronouncing  ‘Oum’ while taking. Deep breath.
Nadi shodhana: or alternate nostril breathing

                         

Meditation

                     

Progressive Muscle Relaxation

 Meditation reduces anxiety and stress in painful conditions

Acupressure point

                                                             

Sunlight exposure

 

Mudra

Merudanda mudra

Merudanda means spinal column.This mudra removes the  strain in the back.This mudra is formed differently by each hand.

Formation :

• Right Hand : Thumb finger, little finger and middle finger tip  touch together. Index finger and ring finger  stay extended.
• Left Hand : Place the thumb joint on the nail of the index finger.

Effect :

Space and water elements are balanced hence the vertebrae can move flexibly with the help of wind. Placing the index finger tip at the thumb joint helps in adjusting the level of wind.

Benefit :

The following strains on the back  are relieved by performing the Merudanda mudra :

• Strain on back due to gardening.
• Strain on back due to house cleaning.
• Strain on back due to working for extended period of time on computers.
• Continues mental strain, fears, heavy meals, little sleep, little exercise also cause back pain. Such pain is also relieved by performing this mudra.
• Slip disc problem will be set right  by persistent practice of this mudra daily for 30 minutes  followed by 10 minutes of Prana Mudra.

Sahaj Shankha Mudra

                        

                           

         

This mudra is the version of Shankha Mudra. Benefits are also the same with a few exceptions.

Formation :

Join both hands together interlocking the fingers and press the palms together. Apply a gentle pressure with both the thumbs by laying them parallel to each other on the index finger..

Effect :

According to Yoga physiology, all 10 main nerves get activated and the body becomes very strong with this mudra.

The ten main nerves are Sushumna, Ida, Pingla, Ganghari, ,Hasti, Jiva, Poosha, Yashaswini, Alamboosha , Kuhoo and Shankhini..

सहज शंख मुद्रा is useful in the treatment of anus related diseases like piles, Fistula etc. 

Benefits :

• Slip disc problem is resolved.

Marma point

Katikataruna Marma This point is located at the back (on the sciatic notch).Two in number. Stimulation - Sit in Vajrasana, buttock resting on the heels. The stimulation of Marma energizes the body, relieves the back stress and improves the blood circulation over the area.

                                                  

Chakra

Chakras or energy centers are whirlpools of energy located along the spine (invisible to the eyes) and are also called psychic centers. Concentrate on these chakras.  Chakra meditation therefore is the way to bring healing and wellness into the body and mind because of the way chakras can influence the organs in the body.

Mooladhara chakra
Location: Below the sacrum bone ( base of the spine) Disorder : Chronic lower back pain.

Swadhisthana chakra
Location: Lower abdomen
Disorder chronic back pain, sciatic.

Reiki

It is a Japanese technique which believes in spiritual kind of healing also called as palm healing. Reiki is good for pains.

Diet

Vitamins D & Calcium: groundnut 100 gm/day, Jaggery 50/day, milk 250 ml/ day, curd one cup per day, betel leaves, eggs, fish, buttermilk, mushrooms 150 gms / day. Ragi and drumstick leaves are also good source of calcium.
Proteins: for proper nutrition of muscles , moong sprouts, boiled black Chana, Amla, tofu, cheese are good. Non vegetarians can eat eggs, fish, chicken, mutton.
Vitamin B 12 by eating eggs and yogurt.
Iron & Vitamin  C for best absorption and metabolism.
Omega-3 supplements may reduce diseases activity e.g. flax seeds, walnuts, Soya bean, spinach, green salad, fish like salmon, tuna.
Pulses They give strength to muscles.
Natural oils give strength to nerves are found in flax seeds, walnuts, almonds, sunflower and olives.
Drumstick soup: Cook drumstick in water, remove the skin, dilute the pulp again in water and boil for 5 minutes. Add 1 tsp of ghee, rock salt to taste a bowlful of this soup should be a part of daily diet for women.
Laddu wheat flour, along with deep fried edible gum in cow’s ghee, almonds and jaggery, mix all ingredients in lot of ghee and make laddu. Eat one laddu everyday and have a glass of milk after half an hour.
Payasam Take 4 tsp of yellow moong, cook it grind it, fry it in a pan with ghee for 3-4 minutes, Add milk and jaggery to it ,stir well.
Protect your gut lining: Many people take non- steroidal anti inflammatory drugs which can cause damage to your gut lining. 

Banana and Yogurt protect it.
Drink hot water with your meals in a proper amount.
Have green salads / vegetables daily

Eat wholesome diet: Horse gram, wheat, red rice, pomegranate, raisins, drum stick, snake gourd, milk, ghee, meat soup, castor oil, sesame oil.

Avoid

Avoid excessive pungent, sour  and Astringent food. Avoid Vata (Air) causing food such as  potatoes, colocynth ( Arvi), sprouts, cabbage, cauliflower, legumes, gram, Chana, lobia, Rajma. Dry, cold things (especially at night such ice cream, cold drinks etc. Milk shake, fruit salads, fruit + milk or ice cream combination etc.) bakery products with milk stale food.
Rich high calorie foods lead to obesity so stop them at once.

Curd
Refined foods
Avoid frozen and preserved foods.
Do not skip the meals.
Avoiding fast food, little food, starvation
Uncooked food is not good for you.
Rice must be reduced.

“Consult an Neurosurgeon / Orthopaedic surgeon, or physiotherapist or a yoga practitioner”.

Home Remedies

Pain relieving additives:

• Guggulu (Commiphora wightii) A safe and effective alternative to N.S.A.I.Ds. The analgesic & anti inflammatory feature of Guggul resin is instant. Helps to maintain flexibility of joints. Also helps to reduce the stiffness of joints, neck, leg and muscles. Mahayogaraja Guggulu. Or a paste of Guggul (Commiphora wightii) Gum is prepared on sarson (Brassica campestris) oil and applied externally in muscle pain and swellings.
• Methi (Trigonella foenum- graecum) It reduces pain & inflammation in joints. Soak a tbsp of methi seeds in a cup of water overnight, consume the methi seeds first thing in the morning and drink the water too. Or roast and grind fenugreek seeds. Then mix them with rock salt. Our 2 tsp of these in hot water every morning and evening and let the fumes come in contact with the region where the pain is persistent.
• Ginger ( Zingiber officinale) Dry ginger is used to reduce inflammation. Consume 1 tsp dry ginger (सौंठ) powder mixed with honey, twice a day for a period of one month. Or Ginger & Honey  It contains anti- inflammatory compounds and has mild aspirin like effects. Take a one inch fresh ginger root and cut into slices. Place a slices in one glass of boiling water. Cover  and simmer, for half an hour. Cool it and mix some honey into it and drink.Make a paste of ginger, and apply it to affected area.

• Eucalyptus oil : Massaging with eucalyptus oil is very effective.
• Guduchi (Tinospora cordifolia) It is good for Ankylosing spondylitis. Consuming Guduchi stem decoction.1 tbsp,twice a day for two weeks will help.
• Nirgundi Nirgundi (Virechana  negundo) Collect fresh leaves of Nirgundi and karanja (Pongamia piñata) take them in a thin cotton cloth to form a big ball. Boil these leaves ball in water and when it is tolerably hot, apply this on the affected part. When the leaves become cold reheat them by putting them into the boiling water. Leaves past can be applied on the affected area.
• Ashwagandha (Withania somnifera) It is good for Ankylosing spondylitis. The Dried root powder is taken orally 2-6 gms per day along with milk.
• Dasamula
• Shallaki (Boswellia Serrata) excellent anti inflammatory herb, analgesic in nature, To be taken one gram per day.
• Turmeric (Curcuma longa) Due to its anti inflammatory action it is used. Paste of turmeric with honey, twice a day gives lot of relief. Or turmeric Latte.
• Harad (Chebulic myrobalan) Eat it after meals as it is quick back pain relief provider.
• Betal Betal is one of the traditionally used herbs in the treatment of backache. The juice of The betel leaves is mixed with refined coconut oil. When the juice is applied on the loins, it provides relief from the sudden pain.
• Garlic (Allium sativum) 1-2 cloves of garlic should be taken in the morning As It  provides relief from back pain. Oil prepared from garlic and rubbed on the back will give great relief. Preparation of oil: Fry 10 cloves of garlic in 60 ml of oil (mustard, sesame, or coconut oil) on slow fire till they turn brown.After the oil has cooled it should be applied on the back and allowed to remain for 2-3 hours.There after the patient should be allowed to take warm bath. This should be done for minimum of 15 days.
• Aloe ( Aloe Vera) The pulp of a single leaf of aloe consumed on a daily basis provides relief from backache problems
• Lemongrass (Cymbopogon citratus) Lemon grass is mixed with twice its bulk of coconut oil and applied externally on the affected regions. This eases the pains.
• Castor (Ricinus communis) Apply castor oil over the affected part
• Agnimantha or Arni (Clerodendrum phlomidis) ) It acts as an anti inflammatory,and act as analgesics to NSAIDs.
• Lemon is a natural remedy for back pain. Extract a juice of fresh lemon mix rock salt (sendha namak).
• Harsingar (Nyctanthes arbor-Tristis) leaf decoction with honey is given 3 times a day for three weeks in sciatica.
• 500g Sitafal (Annona squamosa) leaves are boiled in water for 5 minutes and if taken bath.
• In Sciatica , Tulsi (Ocimum sanctum) leaves, ginger and castor oil is mixed and applied externally for back pain.
• Poultice of seed powder and Ariel part of Amarbel (Cuscuta reflexa) to cure back pain.
• Powder of Palash (Butea monosperma) seeds along with honey can be applied on the painful parts.
• Grind some sesame seed in water. Warm this solution and apply it repeatedly on the part  where it pains the most.
• Put 2 tsp of cumin seed powder in a glass of water and warm the solution. Soak a towel in this water and use it to foment the affected area.
• Mix 2-3 pieces of cardamom in warm milk. Add a pinch of turmeric to it. This should be consumed every night before going to sleep.
• Mix a equal proportion of limestone and honey. Apply this paste on the region where the pain is the severest.
• Mix 1 gram of asafoetida and mix it with egg yolk. Apply the paste on the affected spinal region.
• Cinnamon Mixing honey and cinnamon  in a warm cup of water relieves pain. Or used in a paste or powdered form when applied to the painful area and massaged into the skin.
• Kalonji ( Black seeds) It is used as an analgesics. It’s oil is used for backache.
• Massaging oil : Take 2-3 gloves of garlic and cut them into small pieces . Put them in 100 ml of sesame oil or mustard oil. Boil on slow fire for about 5 minutes. This oil is very good gor massaging the area of backache.

“In rainy season the complaint of back pain, along with stiffness always increases”.

Prevention

Buy hard orthopedic mattress

Guard your bones: Calcium rich foods

Strengthen your muscles: Regular work out

Nourish your nerves: Oils & vitamin B complex

"For Disc prolapse: Change in lifestyle,good posture and precautions help to reduce pain and prevent progression,"

Treatment

Allopathic
Bed Rest
Pain killers
Muscle Relaxant
A complete bed rest for 24-48 hours relieves back pain in most of the cases.
Walk a little,every few hours to keep the blood flowing and the muscles toned.
Followed by : Walk a little every hour to keep the blood flowing and muscles toned.
Most back pain goes. Away on its own, though  it may take a while.
Improving  the general health
Reduction of weight

Vitamin D and calcium : For bones health. exposure of the body to the Sunlight for 30 minutes every day. 

• Vitamins & Calcium supplement- Calcium 1.5 to 2 grams per day
• Vitamin D 3 Vitamin D is commonly known as the “sunshine vitamin.”That’s because your skin makes vitamin D when it is exposed to sunlight

                                           

                                      

• If calcium mal-absorption cholecalciferol 0.25 mg (10,000) I.U
• Estrogen therapy for small thin women or early menopause
• Calcitonin also inhibits bone re absorption and has been shown to prevent menopausal bone loss.

Analgesics:
Heat is a wonderful treatment for back. Use hot water bottle or electric pillow for the affected area. Infrared  radiations can also be taken.
Application of heating pads on affected area relieves pain and stiffness in an easy way.
Hot Fomentation:
Simple home Remedies like heating bag, a long hot shower can help
Sitz  bath

                                             

  

Alternate sponging, or application of heat to the back will give immediate relief .

Ice pack: Apply ice pack immediately After back injury or strain. It reduces inflammation and helps numb pain. To prepare a cold compress, pack a few crushed cubes of ice into a plastic bag cover this bag with a towel and apply it to a back for 15-20 minutes.
Epsom salts:  It alleviate muscle aches. These salt reduce swelling there by relieving back pain. Two cup salt should be mixed in bathtub and the patient should soak in it for about 30 minutes. They also remove dead cells from the skin, unclog pores and clear breakouts.

Spinal bath: The patient lies down on a specially constructed wooden bed in which a central column has been carved as a channel for alternate washes  of hot and cold water, helping to heal neurological disorders.
Back support belts: lumbo - sacral belt.

                                          

Medicines : Pain reliever paracetamol, Ibuprofen, Aspirin, Acetaminophen, opioids (Tramadol) along with antacids.
Vitamin C 2,000 mg daily.
Injections : Nerve blocks.

Pain relieving ointments have the ingredients such as camphor, eucalyptus and menthol, which relieve pain.
Hot & cold packs
Topical medication

                                                          

Lidocaine patch

Thermotherapy It involves the application of heat. It improves the circulation and relaxing muscles. Heat can be conveniently delivered by using heating pads, hot towels or paraffin wax.

Do all back pain require surgery?
No on the contrary most back pains do not require surgery. These can be easily treated by mild medication and proper advise for exercise.
Surgery intervention is indicated for severe continuous pain or motor/sensory deficits
If the surgery is imminent,which is best?
All surgeries have their side effects but the less tissue damage done the better, and so is the long term results. So endoscopic spine surgeries are the best  as their do least tissue damage  and are very precise.

Ayurveda
According to Ayurveda: back pain starts with poor digestive power wherein the break down is either partial or complete which leads up to a buildup of negative toxins (ama) within the body. When all the negative matter comes together, it aggravates Vata which causes pain in the affected area.
Panchkarma
It is usually done as treatment for back pain.
Massage (अभ्यंगम )
Whole body massage achieves deepest healing effects by naturally harmonizing body, mind, soul and the senses.
Massage with sesame oil along with garlic, ginger and Ajwain locally. (or sesame oil + salt massage)

Medicated oil used for massaging are Narayana, Mahanarayana, Ksheerabala oil, Dhanvantari, Nirgundi oils, mint oil etc.These oils must be used for Fomentation or mixed in warm water to give a hot tub bath.
Application of camphor in sesame oil / mustard oil: The oil is warmed. Application of this oil on the back with gentle massage reduces inflammation and stiffness.

                                                      

Hot Fomentation (स्वेदन) Svedanan Massage should be followed by hot Fomentation.
Medicated Steam Bath (नाड़ी स्वेदन )
Or therapeutic sweating. Sweda  karma like Patra Potala Swedam, churna pinda sweda, Snehadhara,Panchamladhara have good effect in treatment.
These procedures provide lubrication to the backbone hence maintaining easiness in movements and alleviate stiffness from back bone.
Rice: Take one cup of uncooked rice and tie it on a thick cloth (or fill it in a thick sock)  heat this cloth pack in a microwave for 30-60 seconds on medium low. apply it to the back.
Petra- Pottali Swedana:
This is the process of including perspiration on a well anointed person with the help of blooms containing fried leaves of medicinal plants along with pieces of lemon, turmeric powder etc.dipped into a vessel containing warm oil.
Pitchu It is keeping cloth dipped in warm oil on the affected part for 20-30 minutes.
Elakizhi Herbal leaf bundle massage.
Pizhichil Medicated oil bath
Churna Pinda Sweda:
In this process the blooms containing powder Drugs is warmed by dipping in warm oil and gently massaged over the body to induce perspiration.
Kaya- Seka: It is the process by which the body is made to perspire by means of application of warm medicated oils. Warm oil is poured on the body by dipping clean clothes the warm oil and squeezing the cloth over the body at a medium speed.

Electric Gel Pillow

Basti Medicated enema for  managing back pains. This consist of  liquid medication administered through the rectum.The liquid administered through the rectum  is Basti therapy. May be medicated oils or aqueous extracts of herbs. The medication is absorbed in the intestines and it regulates the neurological dysfunction (vitiation of Vata)
Kati Basti A treatment done on to the back to decrease spinal compression.
Fasting: To burn of toxins( ama) the patient should undergo a short period of fasting to revive the digestive fire.

Purgation : ( विरेचनम) It is recommended to restore the vitiated Dosha to the state of normalcy.
Constipation:  2 big tbsp of Isabgol husk half an hour before dinner or take a spoonful of Triphala powder  or 8-10 Munakas (dried raisins) boiled in milk. Also have fiber rich food. It is very true that when your bowels are normal, back pain reduces to a good extent.
Medicine:
Yograj Guggul, Lakshadi  Guggulu, Triphala Guggulu.
Rumalaya gel
Tab Rumalaya forte.
Take Triphala churna with milk.

• Abhyanga Massage with til/mustard oil daily for strengthening the bones
• Panchkarma treatment that involves snehana (oleation), swedana (sudation), and mild purifying therapies
• Intake of foods, which are of sweet, sour and salt taste

Specialised hospitals

Indian spinal injury center 7303255225 / 011-42255225  Sector C Vasant kunj. New Delhi
Spine . city 7056666448 C 203 Greater Kailash 1 (Near CCD, opp  Gate no 3, M Block market) New Delhi 
Fortis Hospital Noida

 Vardan Functional manual therapy 4358072022

 Mayo Clinic Spinal chord injury 20377890

“Back pain can be prevented by balanced diet, healthy metabolism, appropriate exercises, and correct body postures, maintaining suitable body weight and not sleeping on soft, spongy surfaces”.

“So say goodbye to backache.”

* Medicine as suggested above should only be taken under the consultation and supervision of registered medical practitioner.

https://madhuchhandacdmo.blogspot.com/2019/03/backache.html