Back pain is a common form of discomfort that can affect people of any age. It is often termed as one of the leading causes of disability with a whopping 60-80% people experiencing it at least once in their life.
One of the most common reasons for seeking medical intervention, back pain can be caused by injuries, activity, or a medical condition. It can be defined as discomfort, or even devastating pain in the rear section of your body extending from your shoulders to hips. Back pain can manifest in various ways ranging from an aching muscle, to a shooting or stabbing sensation. Back pain can also lead to a pain that radiates down your leg or worsens when you walk, stand, or lift something.
This affliction could include pain in the neck, upper back, or lower back. The most common type of back pain occurs in the lower lumbar region. A back pain could be acute, with a severe pain that lasts for a short period. It could also be characterised as chronic, with a pain that lasts for more than three months, or sub-acute, with a mild but nagging pain.
In order to determine the cause of the back pain, a thorough physical examination as well as history is essential. Other important factors that decide the course of action are age, location, duration, and nature of pain. Factors such as occupation, events before onset of pain, and psychological disturbances, if any, also play an important role. Certain cases may also involve imaging studies such as X-rays or more advanced radiographic studies. Certain conditions that lead to back pains include ruptured disks, muscle strain, ligament strain, or arthritis. Risk factors that increase chances of a back pain include age, weight, lack of exercise, inappropriate lifting, smoking, diseases, or psychological conditions.
Kyphosis is a condition in which the spine has an excessive curvature in the upper back section. It is also known as round back or hunchback. Kyphosis can afflict patients of any age but is commonly observed in adolescents. The upper region of the spine has a natural slight curve to support the weight of the head and absorb shock. However, in kyphosis, this natural arch is larger than usual.
In most cases, kyphosis doesn’t cause a lot of problems. In some cases, a patient may be asked to wear a back brace or exercise to improve posture and strengthen the spine. However, if severe, it can lead to spinal deformity and breathing issues. Surgical intervention may be required in such severe cases to reduce the curvature of the spine.
A normal spine has a slight curvature in the neck, upper and lower back. These curves give the spine its ‘S’ shape. The curves in the neck and lower back are called lordotic while in the upper back are called kyphotic. These curves help the body to absorb shock, support the head, align the head and pelvis, move, and bend.
If the curve arches too far, it is termed as lordosis, or swayback. Lordosis can affect the neck or the lower back. Lordosis can lead to excess spinal pressure and cause pain and discomfort. If left untreated, it can get severe and affect your ability to move.
Most cases of lordosis affect the lower back. In this case, if the patient will lie down on a flat surface, significant space between the lower back and surface will be visible. In the case of lordosis of the neck, the condition can lead to spasms, neck pain, or even reduced mobility. Lordosis can be found in people of any age. However, certain conditions like spondylolisthesis, achondroplasia, osteoporosis, and obesity may increase the risk.
Posture can be defined as the position of your body when you are sitting or standing. It explains how your spine aligns with your shoulders, hips, and head. Though good posture cannot really be defined, it generally refers to a neutral spine, where all the ligaments, joints, and muscle groups are aligned to reduce stress, maintain balance, and maintain flexibility. Posture that is unsupported can cause the loads on your spine to distribute unevenly. This can lead to weaker tissues in your back, leading to pain and discomfort.
Additionally, a sedentary lifestyle or lack of exercise can also lead to stress and pain in the lower back.
If you use incorrect posture, you may facilitate the development of several areas of stress in your spinal joints, muscle tissues, and discs. If this practice is continued, it may slowly weaken the structure. Prolonged hunching may lead to stiffness and weakness of the lower back and trunk. Unsupported sitting may lead to load on the lower spinal discs and herniation. Similarly, incorrect lifting can cause the lumbar disc to herniate and lead to pain in the lower back or legs.
Physiotherapy is an effective mode of treatment for back pain. A back pain that doesn’t subside for long, or is caused after an injury should be checked at the earliest. Symptoms such as fever, numbness of the legs, or weight loss should also not be ignored.
A physiotherapist will first diagnose the cause of the back pain. Physiotherapists generally focus on restoring function and movement to the body after illness or injury. The physiotherapist will determine how the nerves, bones, and muscles are affected and use exercise and manual therapy to help. Treatment may include aerobic exercise, stretching exercises, and strengthening exercises. You will be encouraged to take active part in your rehabilitation. This will help you to manage your pain, get moving normally, and reduce the risk of a back injury again.
Physiotherapy can help with non-specific lower back pain, sciatic pain, degenerative back pain, or spinal stenosis.
A chiropractor will generally use alternative treatments like hands-on spinal manipulation. They follow the theory that alignment of the musculoskeletal structure will enable the body to heal without medication or surgery. Manipulation can be used to restore movement to joints. Chiropractic treatment is often used as pain relief for muscles, joints, connective tissue, etc. It may be used in conjunction with conventional treatment.
A chiropractor, after evaluation, might formulate a treatment plan that involves manual adjustments. The doctor will manipulate the joints with sudden force to improve the quality of movement. Treatment plans may also include exercise and nutritional counselling.
Lower back pain is one of the most common reasons for a visit to the physician. According to certain studies, up to 23% adults are affected by chronic low back pain. Most patients suffering from low back pain are referred to physiotherapy as the initial treatment before opting for more aggressive forms such as surgery. Physical therapy aims to reduce pain, improve function and movement, and teach the patient to prevent future problems. According to various studies, the exercises included in physiotherapy play an important role in pain management as well as improved function. Evidence also supports the role of physical therapy before and after back surgery.
Physiotherapists generally suggest some simple exercises you can practice for back pain in the comfort of your own home. Regular exercise can lead to better pain management as well as improved function of the back. After consulting with a physiotherapist, you will be given exercises which you can practice at home. Exercises such as holding your knees to your chest, knee rotation, lower back rotation, cat-cow pose, child pose, and hamstring stretches can help alleviate back pain.
Physiotherapy will include a progressive course of treatment that helps to correct muscular imbalances. This will include strengthening of muscles with the help of weight machines, stretch bands, or free weights. The exercises will be performed either on one side of the body to equalize function or within opposing muscle groups. It will also include stretching tight muscles that have contracted due to stronger opposing muscles, repetitive drills to awaken dormant neural connections, manual massage techniques, and ice, heat, or ultrasound therapy to treat injuries or inflammation.
When aligned properly, the body maintains a relatively straight line from the head, shoulders, to the hips. Proper alignment helps to prevent future pain, motion impairment, and other issues. Physical therapists can use spinal manipulation and other therapies to align the spine. Exercise, along with these techniques, can help you to maintain correct form and get your bones and muscles moving properly.
A physiotherapist can also design a treatment plan that includes various exercises that help in improving lumbar stability. Exercises such as the hamstring stretch, pelvic tilt, and arm or leg raises help in strengthening the spine as well as treating instability. Lumbar stabilization helps to reduce back pain, strengthen the spine and muscles and improve movement.