Lower Back Ache

(L.B.A in short) is one of the most common pain disorders today .It is a chronic condition characterized by a persistent dull or sharp pain per the lower back. It may be also associated with burning, stiffness, numbness or tingling with the pain shooting down the buttocks and the legs.

When we stand, the lower back functions to hold most of the weight of the body. When we bend, extend or rotate at the waist, the lower back is involved in the movement. Low back ache is often precipitated by moving, lifting objects or twisting of the waist. Severe pain in the low back can be quite debilitating to patients. Pain in the lower back restricts activity and reduces work capacity and quality of enjoyment of everyday living and turns daily life into a misery. Survey indicates that 70 per cent of the people suffer from low back pain at some time in their lives. The highest rate of back pain occurs among the 45 to 64 year age group.

Causes

One of the common causes for the backache is poor posture habit. Balanced posture decreases stress on your back by keeping the muscles, bones and other supporting parts in their natural position. Any change from normal spinal curve can stress or pull muscles. This leads to increased muscle contraction, which causes pain. Low back pain can result due to health problems like osteoporosis, scoliosis, and spinal stenosis. Sprain or strain of muscles or ligaments in the area can also manifest in low back pain.

Other possible causes include fibromyalgia and benign or malignant tumors. A fall or blow to the back can strain or tear tissues around the spine, or even break a bone leading to back pain. Lack of exercise or incorrect exercise can also lead to low back pain. Too much weight or overweight also is a cause of low back pain.

Treatment

Conservative treatment is the most likely course of action for most patients. Treatment options include rest, Traction, Short wave diathermy, non-steroidal anti-inflammatory medications, weight control, and steroid injections in step by step order.

If a patients does not get relief after 8 to 12 weeks of conservative therapy surgical intervention is considered. The most common surgical procedure is a discectomy, which involves removing the soft gel-like material in the disc. This procedure returns the disc to a more normal shape, relieving the pressure on the nerve. The neurosurgeon can also perform a foraminotomy, which is a procedure designed to expand the opening the nerve travels through. Drugs and knives don’t always work because from 60% to 90% of disease is not the result of structural injury, but rather of the mind-body response to stress.

Ayurvedic Perspective

Ayurveda holds that low back pain is a result of vitiation of one of the three principal ‘doshas’. ‘Kateegraham’/’Prishtasoola’ or low back pain is an indication of Vata aggravation and bone and muscle weakness.

Nidana (Causative factors):

The nidanas explained for Vata kopa which can be considered in case of kateegraham include:

  • Controlling the natural urges (like defecation,micturition etc)
  • Forceful voiding of the natural urges.
  • Late night sleeping
  • Excessive work
  • Intense exercise
  • More indulgence in sex.
  • Excess travelling in uneven surface
  • Abhighatham (Trauma)

Samprapthy (Pathogenesis)

Due to the above reasons, VATA may vitiate and gets localized in the lower back area leading to pain and restriction of the movements of those joints. Other Doshas ( Pitha and Kapha) may also have associate involvement in the samprapthy and cause symptoms like inflammation and swelling. The lifestyle of the person also will have relevant involvement in the samprapthy as the ‘amavastha’ of the body will have ill effects on the symptoms as well treatment.

Chikitsa (Treatment)

Treatment in Ayurveda is to bring the vitiated ‘dosha’ back to the state of equilibrium and thereby to the state of health. The main treatment aspect of any vata vitiated disease is snehana (oil application) and swedana (fomentation). Treatment procedures like Abhyanga, Patrapotala sweadam, choornapinda swedam etc., done according to the condition of the patient can bring the vitiated doshas to koshta from where it can be cleared by purgation or vasthi. This can be considered as the sodhana part of chikitsa.

In the Samana part, internal medicines can be administered so as to pacify the remaining dosha if any. They are decided depending on many factors like body strength of the patient, Season of treatment, digestive capacity, Prakruthi, Age etc. Treatments like Kateetharppanam, Pradesika Pichu, Lepanam can also be performed as Samana procedures.

Yoga and Yogasana

The source of the pain is due most often to pushing oneself beyond physical or emotional capacity. The spine needs stability and, therefore, the mind must first be steady. So, the first step is to learn to relax the mind and focus on the specific areas of back pain. With practice, you can redirect the body’s energy and affect the pain.
Among the Yogasanas, when there is pain, start with simple back-bends, such as Padahasthasana, Pavanamukthasana, Salabhasana, Bhujangasana etc. To keep the spine aligned practice Veerasana.

Caution – Before trying any of these postures, consult a yoga teacher to determine the best postures for your condition.

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