LOWER BACK PAIN – AN OVERVIEW

If you are experiencing lower back pain, you aren’t alone. Lower back pain is a very common condition affecting almost 80% of the population at some point in their lives and the #1 reason for orthopedic visits. Men and women are equally affected by low back pain, which can range in intensity from a dull, constant ache to a sudden, sharp sensation that leaves the person incapacitated.

Lower back pain or LBP as we are going to call it here, may be caused by a variety of problems with any parts of the complex, interconnected network of spinal muscles, nerves, bones, discs or tendons in the lumbar spine. It is basically a symptom for an underlying condition or injury.

The most common causes for LBP (Lower Back Pain) are

• Sprains/Strains: This accounts for the most acute back pain. Sprains are caused by overstretching of ligaments and strains are tears in tendons or muscle.
• Disc Degeneration: This is again one of most common causes and occurs when the intervertebral discs lose their cushioning ability.
• Herniated or Ruptured Discs: This occurs when the discs compress and project outwards, thereby causing a great deal of discomfort and pain.
• Radiculopathy: This is caused by compression, inflammation and/or injury to your spinal nerve root. Pressure on the nerve root results in pain, numbness, or a tingling sensation that travels or radiates to other areas of the body that are served by that nerve.
• Sciatica: This is a form of radiculopathy caused by compression of the sciatic nerve, the large nerve that travels through the buttocks and extends down the back of the leg.
• Spondylolisthesis: This is a condition in which a vertebra of the lower spine slips out of place, pinching the nerves exiting the spinal column.
• A Traumatic Injury: Such as from playing sports, car accidents, or a fall can injure tendons, ligaments or muscle resulting in low back pain.
• Spinal Stenosis: This is a narrowing of the spinal column that puts pressure on the spinal cord and nerves that can cause pain or numbness with walking and over time leads to leg weakness and sensory loss.
• Skeletal Irregularities: Include scoliosis, a curvature of the spine that does not usually cause pain until middle age; lordosis, an abnormally accentuated arch in the lower back; and other congenital anomalies of the spine.

Serious underlying conditions that are pretty rare but could still be the causes for LBP include:

• Infections: These are not a common cause of back pain. However, infections can cause pain when they involve the vertebrae, a condition called osteomyelitis; the intervertebral discs, called discitis; or the sacroiliac joints connecting the lower spine to the pelvis, called sacroiliitis.
• Tumors: These are again a relatively rare cause of back pain. Occasionally, tumors begin in the back, but more often they appear in the back as a result of cancer that has spread from elsewhere in the body.
• Cauda Equina Syndrome: This is a serious but rare complication of a ruptured disc. It occurs when the disc material is pushed into the spinal canal and compresses the bundle of lumbar and sacral nerve roots, causing loss of bladder and bowel control.
• Abdominal Aortic Aneurysms: This occurs when the large blood vessel that supplies blood to the abdomen, pelvis, and legs becomes abnormally enlarged.
• Kidney Stones: They can cause sharp pain in the lower back, usually on one side.

Other underlying conditions that predispose people to low back pain include:

• Inflammatory diseases of the joints such as arthritis, including osteoarthritis and rheumatoid arthritis as well as spondylitis, an inflammation of the vertebrae, can also cause low back pain.
• Osteoporosis is a metabolic bone disease marked by a progressive decrease in bone density and strength, which can lead to painful fractures of the vertebrae.
• Endometriosis is the buildup of uterine tissue in places outside the uterus.
• Fibromyalgia, a chronic pain syndrome involving widespread muscle pain and fatigue.

Symptoms Of Lower Back Pain

Symptoms range from a dull ache to a stabbing or shooting sensation. The pain may make it hard to move or stand up straight. Acute back pain comes on suddenly, often after an injury from sports or heavy lifting. Pain that lasts more than three months is considered chronic.

Ayurvedic Treatment For Lower Back Pain

Ayurvedic Treatment for low back pain generally depends on whether the pain is acute or chronic.

Acute LBP (Lower Back Pain) often resolves within a short time. It is treated with muscle relaxants or anti-inflammatory drugs. Applying hot or cold compresses also help with pain relief. Chronic pain most often requires a thorough diagnostic workup to understand the root cause so that it can be addressed effectively. Patients with chronic back pain are treated with a combination of medications, physical therapy, and lifestyle changes. Physical therapy for chronic low back pain usually includes regular exercise for improving fitness and flexibility. For more severe cases, tractions, epidural injections or even surgery maybe recommended by orthopaedics to aid pain relief.

While Ayurvedic treatment comprising of Medication, Oil applications is often enough for back pain due to muscle related issues, severe low back pain for which surgery has been recommended also, responds well to Ayurvedic massages and Therapies like Podikkizhi (Herbal powder massage), Ilakkaizhi (Herbal leaves massage), kativasthi (Pooling medicated oil in the back), Pizhichil (Pouring medicated oils as a stream), Nhavarakkizhi (Massage with rice boiled in medicated milk) and most importantly Kashaya Vasthi (enema with medicated decoctions) and Ksheeravasthi (Enema with medicated milk). When recommended and supervised by experienced Ayurvedic physicians, these therapies are very effective in relieving the symptoms, strengthening the back and preventing back pain in the most severe cases as well.