Pain in the lower back or low back pain is a common concern, affecting up to 90% of people at some point in their lifetime. Up to 50% will have more than one episode. Low back pain is not a specific disease. Rather, it is a symptom that may occur from a variety of different processes. In up to 85% of people with low back pain, despite a thorough medical examination, no specific cause of the pain can be identified.

Back pain can have many underlying reasons, but often no specific cause will be found and the pain will stop. We try to touch on many of the causes of back pain and proper evaluation and diagnosis. Please make sure to discuss your individual symptoms as well as the suggested treatments with us to determine the appropriate diagnostic and treatment plan for your circumstances.

• Low back pain is second only to the common cold as a cause of lost days at work. It is also one of the most common reasons to visit a doctor's office or a hospital's emergency department.
• Doctors usually refer to back pain as acute if it has been present for less than a month and chronic if it lasts for a longer period of time.

Causes
Back pain is a symptom. Common causes of back pain involve disease or injury to the muscles, bones, and/or nerves of the spine
• (a nerve is directly irritated), often due to a herniation (or bulging) of the disc between the lower back bones.
• Herniated discs are produced as the spinal discs degenerate or grow thinner. The jellylike central portion of the disc bulges out of the central cavity and pushes against a nerve root.
• Spondylosis occurs as intervertebral discs lose moisture and volume with age, which decreases the disc height.
• Spinal-canal narrowing (spinal stenosis)
• Osteoporosis , degeneration of the bones
• Poor postures while sitting, Standing etc
• Work related repeated

Symptoms
Pain in the lumbosacral area (lower part of the back) is the primary symptom of low back pain.
• The pain may radiate down the front, side, or back of your leg, or it may be confined to the low back.
• The pain may become worse with activity.
• Occasionally, the pain may be worse at night or with prolonged sitting such as on a long car trip.
• You may have numbness or weakness in the part of the leg that receives its nerve supply from a compressed nerve.

o This can cause an inability to plantar flex the foot. This means you would be unable to stand on your toes or bring your foot downward. This occurs when the first sacral nerve is compressed or injured.
o Another example would be the inability to raise your big toe upward. This results when the fifth lumbar nerve is compromised.

Tips for preventing back strain
• Don't lift by bending over. Lift an object by bending your knees and squatting to pick up the object. Keep your back straight and hold the object close to your body. Avoid twisting your body while lifting.
• Push rather than pull when you must move heavy objects.
• If you must sit at your desk or at the wheel of a car or truck for long hours, break up the time with stops to stretch.
• Wear flat shoes or shoes with low heels (1 inch or lower).
• Exercise regularly. An inactive lifestyle contributes to low back pain.
• Sit in chairs with straight backs or low-back support. Keep your knees a little higher than your hips. Adjust the seat or use a low stool to prop your feet on. Turn by moving your whole body rather than by twisting at your waist.
• When driving, sit straight and move the seat forward. This helps you not lean forward to reach the controls. You may want to put a small pillow or rolled towel behind your lower back if you must drive or sit for a long time.
• The best way to sleep is on your side with your knees bent. You may put a pillow under your head to support your neck. You may also put a pillow between your knees.
• If you sleep on your back, put pillows under your knees and a small pillow under your lower back. Don't sleep on your stomach unless you put a pillow under your hips.
• Use a firm mattress. If your mattress is too soft, use a board of 1/2-inch plywood under the mattress to add support.
Some specific exercises can help your back. One is to gently stretch your back muscles. Lie on your back with your knees bent and slowly raise your left knee to your chest. Press your lower back against the floor. Hold for 5 seconds. Relax and repeat the exercise with your right knee. Do 10 of these exercises for each leg, switching legs.

While some exercises are specific for your back, it's also important to stay active in general. Swimming and walking are good exercises to improve your overall fitness.

Home Remedies
If you're not experiencing any of the above symptoms, there are several things you can do at home to help soothe your sore back:

Bed Rest Isn't Best. Going about your normal, everyday activities--but perhaps at a slower pace, and definitely avoiding what may have caused your pain in the first place--is a good way to start the healing process. A little "couch time" won't hurt, but light activity speeds recovery, so avoiding lying down for long periods of time.

Hot And Cold. Heat and cold, in the form of a hot bath or hot and cold compresses, can help relieve sore and inflamed muscles and tissue. Remember--cold comes first! Wrap an ice pack (or a bag of frozen vegetables) in a thin cloth to avoid frostbite, and apply to the affected area for up to 20 minutes several times a day. Ice slows inflammation and swelling, numbs tissue and slows nerve impulses to the injured area.

Once the acute pain and muscle spasms subside (about 48 hours after the first onset of pain is recommended), you can apply heat--to loosen muscle tightness - by taking a warm bath or using a heating pad, heat pack or heat lamp.

Pain Relief In A Pill. Non-steroidal anti-inflammatory can ease pain, swelling and stiffness.
Support Yourself. If you must sit or stand for long periods of time, consider using a brace or corset. Worn properly, they can relieve pain and provide warmth, comfort and support. But, don't rely on this type of external support too long--allowing it to perform your muscles' job will eventually weaken them, making re-injury easier.

If your back pain hasn't improved noticeably after 72 hours of self-care, contact your health care provider.

Modalities
These methods are called passive therapies, or modalities. They are done to the patient and not by the patient. There are other modalities that are commonly used. Heat and ice packs are a well-known form of passive physiotherapy. They can be used separately, or they can be used alternately by a person who is suffering from acute lower back pain.

A transcutaneous electrical nerve stimulator (TENS) can be used as another modality for lower back pain. The patient will feel the sensation of the stimulator instead of his pain. If the TENS unit seems to work well for him, he will be sent home with one to use at his convenience.

Ultrasound is especially useful as a passive therapy for anyone with acute lower back pain. It delivers heat deep into the muscles of the lower back. This not only relieves pain. It can also speed healing.

Back exercises may be assigned by a physiotherapist. These exercises will help with lower back pain if one does them correctly and faithfully. The only exception is if the back is in an acute condition requiring emergency care or surgery.

The exercises that will help with lower back pain the most will be assigned and supervised by a physiotherapist. They may be done at home, but it will be necessary to follow instructions and check in frequently.

These exercises include ones for lower back pain that stretch or extend the back and ones that strengthen it. One is an exercise where one lies prone and moves as if swimming. This protects the back while giving the surrounding muscles a workout.
Aerobic exercise such as walking is excellent for reducing and preventing lower back pain as well. Exercises can make the back stronger to both relieve and prevent lower back pain. Any physiotherapy that can help relieve lower back pain will help millions of people.

Postural Correction and Ergonomics
Strengthening the muscles that support the spine with back exercises, along with correcting posture, using proper lifting techniques, and understanding the physical limitations of the back.

Ergonomics is another name for Human Factors. It commonly refers to designing the work environment in a manner to maximise safety and efficiency. It is a scientific discipline that seeks to understand human requirements and introduce necessary changes in products, equipments and the work environment, as a whole.


The science of Ergonomics deals with the relationship between people and their technological tools. The equipments at the work place such as the computer, chair and the desk should be designed according to the capabilities and limitations for the human body.

A proper ergonomics design prevents strain and injuries to the nerves, muscles and spinal cord which otherwise can lead to long term disabilities. Ergonomics should be followed to fulfill two important human goals - health and productivity.

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