Back pain is a very common problem. Now a day’s people are engaged with their computer works in their offices and do not get the time to get up from the chairs. Prolonged sitting causes back pain. There might be poor quality chairs instead of proper ergonomic chairs which effects the posture of your back.
EPIDEMIOLOGY
In developed countries, there is 12-33% prevalence of back pain. Eighty percent of people suffer from back pain in their lifetime ( 2 ) . One-year prevalence of 22-65% and lifetime prevalence of 11-84%. Low back pain involves quite expensive treatment. In 1998, total health expenditures by individuals with back pain in U.S. were 90.7 billion dollars. Medical treatment for chronic low back pain is estimated to cost 9000 dollars to 19000 dollars per patient annually. (1)
CAUSES OF BACK PAIN
1. Muscle strain – the muscles of the low back provide strength and mobility to the backbone. Whenever there is a load on the muscles especially when the muscles are weak strain occurs.
2. Ligament strain – ligaments connect the vertebra together and provide the stability to the spine. They get injured if there is sudden pull, forceful movement, or prolonged stress.
3. Poor posture – due to abnormal posture like slouching in front of t.v. or prolonged sitting in front of a computer in the offices. Prolonged maintenance of this posture causes muscles tightness and muscle weakness and hence, can cause back pain
4. Disc bulge, herniation – this is generally caused due to sudden weight lift while abnormal bending. This may cause nerve compression and travel of pain to legs accompanying with numbness and tingling. This may require surgery at times. Mostly, physiotherapy and muscles strengthening program correct it.
5. Other causes – it may include kidney infection, cancer, stomach infection, ovarian problems, pregnancy etc.
6. LIFESTYLE – not enough exercise, or exercises in wrong ways, being overweight, continuous high level of stress, lifting heavy weights.
7. INFLAMMATORY CAUSE – Conditions like rheumatic disease, spondylosis.
8. METABOLIC CAUSES – conditions like osteoporosis and osteomalacia.
Classification of back pain depends upon the duration.
- ACUTE – lasts up to 12 weeks
- SUBACUTE- refers to second half of acute pain 6-12 weeks
- CHRONIC – Persists beyond 12 weeks
The anatomic classification of back pain includes
- Neck pain (cervical)
- Middle back pain (thoracic)
- Low back pain (lumbar)
- Coccydynia( tailbone or sacral pain)
DIAGNOSIS OF BACK PAIN
- X – RAY – this is the primary diagnosis method for back pain.
- MRI- If diagnosis is not made through x- ray, then go for MRI.
- CT SCAN
- OTHER TESTS – BONE SCANS, EMG.
EXERCISES
NECK PAIN (CERVICAL) AND MID BACK PAIN ( THORACIC) (2)
1. While standing squeeze the shoulder blades together so that it causes the shoulder to rearward. Hold for 5 sec. and then relax. Repeat this 10 times. Gradually you can hold for 10 seconds.
2. Neck movements – bend the neck downwards 5 times. Extend the neck 5 times. Bring your neck to sideways. First right then rest for 2 sec., then left side and then again neutral.
3. Standing forward flexion – stand with hands rotated so that thumbs face forward. Raise the arm upward keeping the elbow straight.try to hold the arm at 90 degrees for 10 seconds and then relax.
4. Standing sideways abduction-stand with hands rotated so that thumbs face upward. Bring the arm sideways keeping the elbow straight. Try to hold the arm at 90 degrees for 10 seconds and then relax.
5. COW’S FACE – stand with feet hip width apart and pointed straight. Attempt to interlock the fingers behind the back. If it is not possible, try to hold with the towel in between. Hold for 10 seconds and then release. Repeat this 10 times.
6. SHOULDER SHRUGS – try to raise the shoulders upwards hold for 10 seconds and then relax. Repeat this 10 times.
7. CHIN TUCK IN – you can do this in sitting or standing posture. One can also do the exercise in lying position. Try to bring the chin slight back and down so that the ears are in line with the shoulders and you feel the stretch at the back of the muscle. Keep your shoulders and upper back well supported in sitting position. While tucking, hold for 5 seconds. Repeat this 10 times. Breathing should be normal. Perform this exercise many times a day. It helps to strengthen the muscles as well as keep the posture correct
8. Self-resistance exercises- place both hands on the forehead and press the forehead into the palms in a nodding fashion while not moving.
Side bending – press one hand against the side of the head and attempt to side bend, as if trying to bring the ear towards the shoulder but not moving.
Axial extension – press the back of the head, which are placed in the back, near the top of the back.
Rotation – press one hand against the region just superior and lateral to the eye and attempt to turn the head to look over the shoulder but not allowing motion.
9. For lower cervical and upper thoracic – Lie on the stomach, forehead on the bed or table. lift the forehead off the table or bed, keeping the chin tucked and eyes focused on the table to maintain the neutral spine position. lifting the head is a small motion. Hold for 10 seconds and repeat 10 times.
10. Stand straight against the wall while keeping the ball behind the neck supporting the wall. Try to bring the arms straight up to 90 degrees, hold for 10 seconds 10 times. Similarly, bring your arms sideways up to 90 degrees, hold for 10 seconds, 10 times. You can strengthen the muscles by holding a weight in your hand. Keep the ball static.
11. Self stretch
Sit on a firm, straight – back chair with the hands behind the back. Clasp the fingers together. Bring the elbows together. Then bring the elbows apart and stretch to the maximum. Hold for 10 seconds and repeat 10 times. This exercise can be performed in the offices. One can coordinate with the breathing pattern by inhaling as the elbows are out and exhaling as the elbows are together.
12. Self stretch
You can do this exercise either in the sitting position or in standing position. Reach up with one arm, bend your elbow and put your forearm down behind your head and between your shoulder blades. With your opposite arm, reach up and grab your raised elbow. Pull your elbow towards your head. Repeat with another hand. Hold for 10 seconds and try to repeat it 10 times with each hand.
13. WALL PUSH UPS – stand in front of a bare wall. Lift your arms up to shoulder level. In this position try to inhale to the maximum, and then while exhaling, pushes off the wall until your arms are in an outstretched position with elbows slightly bent. Hold for 10 seconds and repeat 10 times.
14. To stretch neck muscles – sit upright in a chair and turn your head to the right, place the right hand on the top of the head. Slowly bend neck towards the right shoulder. Do not pull the head, simply allow the hand to support the head and neck in this position. With the left hand grasp the chair and slowly lean towards the right so that the stretch is felt. Hold for 10 seconds and repeat for 5 times.
15. Aerobic exercises – it increases the blood flow to the muscles of the neck and upper back, thus help them to loosen the muscles and increase the range. These include – stationary cycle, treadmill, cross trainer.
EXERCISES FOR LOW BACK PAIN AND COCCYX( 2)
Low back exercises are specific-to-specific conditions. In certain conditions, bending or flexion exercises are contraindicated, in some conditions extension exercises are contraindicated, and flexion exercises are indicated. One should consult a proper physiotherapist to choose the set of exercises.
The following exercises are simple back exercises, which can be performed daily at least two times a day to keep the back healthy. In case of back pain, kindly consult a therapist.
1. Lie on the stomach. Prop yourself up on the elbows, allowing the pelvis to sag. Breathe and hold for 5 seconds and then come back to starting position. Remember not to bend your neck backwards and always keep the hips grounded.
2. Lie on the stomach. Progress the above exercise. Prop yourself up on the hands, allowing the pelvis to sag down. Breathe and hold for 5 seconds and then come back to starting position. Remember not to bend your neck backwards and always keep the hips grounded.
3. STANDING BACK BEND – Stand with feet hip distance apart. Place the palms of your hands on the low back with fingers pointing down. Take an inhale as you lift up focusing on drawing the belly in, keeping your core strong. Exhale and arch the body backwards until you feel comfortable. You can keep your neck in line with spine or drop it back. Hold for 10 seconds and repeat 10 times.
4. KNEE TO CHEST EXERCISE- lie straight on the back in a comfortable position on the yoga mat. Bring one knee towards the chest, clasp the hands around the thighs and pull it towards the chest. Hold for 10 seconds and then repeat with another leg.
Progress the exercise by bringing both the knees towards the chest elevating the sacrum off the mat.
5. PELVIC BRIDGING- Lie on the flat surface like a yoga mat. Bend your feet flat on the floor with feet 6-8 inches apart. Palms should be flat on the floor. Relax your upper body and back while you draw in your abdominals and squeeze your pelvic floor muscles- thinking of stopping your urine. while exhaling press your hands into the floor and lift the pelvis up towards the ceiling. Hold for 10 seconds and then while inhaling slowly bring the pelvis down. Keep the abdominals tight. Repeat for 10 times.
6. PELVIC ROLLING – Lie on your back. Keep your knee bend and together. Keep your upper body relaxed and chin gently tuck in. Roll your knees on one side followed by the pelvis keeping both shoulders on the floor and then back to neutral position. One should move until the comfortable position. hold for 10 seconds and repeat 10 times.
7. PELVIC TILTING – Lie on your back. Keep your knee bend and feet hip width apart. Keep your upper body relaxed and chin gently tuck in. Gently flatten the low back into the floor and contract your abdominal muscle. Now tilt your pelvis towards the heels until you feel the arch on your back and then relax. Hold the contraction for 10 seconds and repeat 10 times.
8. QUADRUPED EXERCISE – Maintain the quadruped position as shown in the figure. Try to bring one arm straight up. Hold for 10 seconds and then back to normal. Repeat with another arm.
In the next step extend the leg and hold for 10 seconds. Repeat with another leg.
In the next step extend alternate arm and leg and hold for 10 seconds and repeat 10 times.
9. PRONE STRAIGHT LEG RAISE- Lie on the stomach on the yoga mat. Hands under the head well supported. Extend one lower extremity by lifting it off the mat. Avoid arching of lower back. Hold for 10 seconds and repeat 10 times.
10. CURL – UPS – Lie straight on the back on the yoga mat. Try to tilt the pelvis back as done before. Now try to bring the head up. Hold for 10 seconds. Hold for 10 seconds and repeat 10 times.
Progress the exercise by lifting the shoulders until the shoulder blades and thorax clear the mat, keeping the arms horizontal.
11. DIAGONAL CURL – UPS – Lie straight on the back on the yoga mat. Try to bring one hand toward the outside of the opposite knee while curling up, and then alternate. Hold for 10 seconds and repeat 10 times.
12. ABDOMINAL STRENGTHENING EXERCISE – Lie straight on the back on the yoga mat. Try to tilt the pelvis back as done before. Bring both the knees to the chest as done before and then progress it by decreasing the angle of hip and knee flexion. This means that the angle between hip and knee should be 90-90. Hold for 10 seconds and then relax. Repeat 10 times.
13. SUPERMAN EXERCISE- Lie on the stomach on your yoga mat. Hands straight at the side of the body. Lift both upper and lower extremity simultaneously. Maintain for 10 seconds and repeat 10 times.
You can also do this exercise by raising both the hands up in the front rather than sideways.
14. STABILIZATION EXERCISES – The position should be quadruped. Try to keep the back rest on the heels, then shift the body forward on to the hands In the press-up- position. Try to control the pelvis in its neutral position while shifting from heels and back to normal. Hold for 10 seconds and repeat 10 times.
15. CLAMSHELL EXERCISE- Lie on the side, anchor the thumb on the belt line bone. Keep the heels together, open the heels like a clamshell. Hold for 10 seconds and repeat 10 times. This exercise is for back pain as well as coccyx pain.
Source Link: https://www.medlife.com/blog/15-simple-exercises-back-pain/
Source Link: https://www.medlife.com/blog/15-simple-exercises-back-pain/
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