Low Back Pain

There is 80% chance that you will have suffered from low back pain at least once in your life. Although it is very common, it renders a person in a quite desolate condition. Routine tasks become very difficult and it is tough to go through the day.

Causes

There are many causes of Low back pain (LBP).  Some of them are:

  • Kidney stones
  • Premenstrual syndrome
  • Endometriosis
  • Cancer

and many more.

The most common causes of LBP are Degeneration and overuse/overloading. Both of them are broad fields themselves.

Most of us tend to bear low back pain which usually okay. But there are some situations where you should not ignore low back pain and get it checked immediately by a healthcare professional.

This article will focus on pain due to degeneration and overuse.

Red flags

red flag

Red flags are situations when you have some specific complaints along with LBP. If these complaints are present, there are chances that some pathology other than degeneration or overuse is present.

  • Age younger than 18
  • Age older than 50
  • Pain at rest or night
  • Unexplained fever
  • Unexplained changes in weight
  • History of any cancer
  • History of untreated Tuberculosis
  • If the patient is taking steroid pills since long.
  • Severe reduction in trunk movement
  • Difficulty in controlling urination and defecation.
  • History of any trauma. For example, fall from a height, Road traffic accident etc.

Pathology

LBP has many causes. Following is the pathology of what happens in degeneration and overuse.

This image shows a normal vertebral column. The part highlighted in red is called the Lumbar Spine. The lumbar spine is what messes up things and leads to LBP.

Spine and parts

The highlighted structures in the image below are the Intervertebral discs. They are the shock absorbers.

Intervertebral discs

What goes wrong?

The intervertebral disc, ligaments and muscles around spine maintain its normal functioning.

As there is degeneration, the disc loses its volume. This leads to instability at that vertebral level and eventually pain. Sometimes the disc slips back into the canal where there is spinal cord. This leads to Lumbar radiculopathy. You have Lumbar radiculopathy if there is tingling and numbness in your legs along with LBP. Sciatica can also result from degeneration.

Overuse conditions result when the spine has to bear more load than it is able to bear. Overuse is a subjective concept. Climbing a few flights of stairs is overuse for a person not used to it. Overuse also results from improper techniques used while exercising.

Low Back Pain and Obesity

To state that obesity is a cause for low back pain is inaccurate. There are conflicting pieces of evidence for the same.

Obesity is a risk factor for low back pain. It may worsen LBP which has occurred due to some other reason. Obesity may also prolong the recovery duration of the LBP.

Hence, it is quite beneficial to maintain your BMI in the normal range.

Read more about Obesity and Diet in Obesity.

Low Back Pain and Pregnancy

Pregnancy leads to many changes in a woman’s body. The changes which contribute to LBP are:

  1. Hormonal Changes- There are some hormonal changes in the body. One of the effects of those changes include loosening of ligaments and muscles. As ligaments and muscles lax, support to spine reduces and hence, pain.
  2.  There is a weight gain of around 10-12 kg during pregnancy. Stress on Spine increases due to this weight gain and thus pain.
  3. Change in shape and size of uterus leads to change in curvature of the spine. This change in curvature makes the spine more susceptible to stress.

These factors combined lead to LBP in pregnant women.

LBP in pregnancy is preventable. With proper nutrition, supplementation and fitness exercises (mild mobility and strengthening) , one can be free of any hassles.

Low Back Pain and Gym

LBP is a common complication of improper gymming. There are many exercises which when done incorrectly can even lead to a slipped disc.

High weight exercises, when done with improper form and techniques, result in back pain. Care should be taken while performing exercises like squats, barbell squats, Deadlifts etc.

Follow proper form and technique while performing these exercises. Also, if you already suffer from LBP modify your training program to reduce the load on the Spine.

Go for these exercises only after you have adequately strengthened the muscles around the spine.

Low Back Pain and Pilates

Pilates are basically full body exercises with a focus on controlling the body. Pilates help in full body conditioning. But its role in specific LBP has limited evidence. Pilates, when compared to the traditional exercises for low back pain has no superior edge. Hence, You can go for pilates if you want a change.

Low Back Pain and Yoga

Yoga is a popular remedies for LBP. Yoga involves meditation, breathing exercises, specific poses or asanas. Studies show that Yoga does not have any better effects than the established set of exercises.

You can go for Yoga if the selection of poses is tailor-made for you.

For example, If you have Extension bias (LBP reduces when you arch backwards).

  • Dhanurasan and Chakrasan are likely to help
  • Naukasan and Adho Mukha Shvanasan are not likely to help.

Treatment

Treatment for LBP involves:

  1. Painkiller and muscle relaxant pills
  2. Physiotherapy (Exercises and other options for pain relief)
  3. Steroid injections in the spine, and,
  4. Surgery if everything else fails.

What can you do at home?

  • Hot Packs are helpful in relieving LBP.
  • Exercises. Every form of treatment has its own set of advantages and disadvantages. Exercises which are basic in nature and are less likely to cause any trouble are listed below.
    1. Cat and Camel Exercises
    2. Lumbar Rotation
    3. Bridging Exercises

For a more specific treatment plan, contact your Physiotherapist.

Should you go for bed rest?

Bed rest is advised in cases of very severe back pain. In mild to moderate LBP, bed rest of more than a day is not advised. Start mild movements and exercises for reducing the pain. Bed rest of long duration makes muscles around spine go weak. As muscles weaken, pain increases.

Prevention (Ergonomics)

Most of the low back pain is preventable. Some directions if followed, are a considerable help for LBP.

  1. For lifting objects from ground: Squat and lift rather than bending forward. Lift with your legs not back.
  2. Getting up from bed: Get up after turning to one side.
  3. Sitting: Sit with proper support to lower back. For example support with a pillow, ergonomic chairs etc.
  4. Gymming: Follow precise form and technique while gymming.

Conclusion

Low Back Pain is a common and debilitating condition. It is also preventable if precautions are taken at home, work and gym. Trending activities like Pilates and Yoga are beneficial if their routine is tailor-made for you. Mild mobility and strengthening exercises are beneficial for the prevention and treatment of LBP during pregnancy. Spine, if ignored, can make one’s condition desolate. Hence, it is very much helpful to keep the spine moving.

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