Understanding Lower Back Pain

Greetings!!

 

This blog will help you understand how one can cure lower back pain by practicing these simple steps! Let me put a disclaimer that it is my personal experience and following the below mentioned steps on a regular basis has helped me improve my condition. You could definitely try these postures but I request you to avoid them if it starts aggravating your situation.

Sitting at a single place for long hours, bad posture, walking in a wrong orientation or sudden jerks to the body are the major causes of lower back pain. Many people do face this problem in some phase of their life (mainly in the age range of 35-50 years). But as it is said that age is just a number, I fell a victim to lower back pain at the age of 22!

Let us understand our backbone first. Spinal cord is a long tubular bundle of nervous tissues and supporting cells which extend from the Brain to the lumbar region (Lower back). It is the main support system of our body. This spinal cord is protected by a rigid column known as Vertebral column. Vertebral column has 26 individual vertebrae which are joined end to end in a similar fashion.

Vertebral column is classified into 3 main divisions,

• Cervical Vertebrae (7) – It supports the neck and allows its flexible movements.
• Thoracic Vertebrae (12) – It helps in the attachment of the ribcage to protect vital organs.
• Lumbar Vertebrae (5) – They allow significant flexibility as well as side bending.

                             

 These vertebrae have different structures depending upon the region they protect. But they have 3 common components - The main body (Centrum), spinous process (Helps in the attachment of the muscles and ligaments of the spine) at the top and transverse processes at the sides (Help in attachment of the ribs in the thoracic region). The gap is termed as neural foramen which allows various nerves to pass through it. (Photo: Starting from Top right – thoracic vertebra, cervical vertebra and Lumbar vertebra)

                              

Sandwiched between the vertebrae are the shock-absorbing discs called as ‘Intervertebral Discs’. Intervertebral discs have a unique structure which allows soft movement of the interconnected vertebrae along the vertebral column.

There are 2 major components of these discs,

•  Inner gel-like substance called as ‘Nucleus Pulposus’. It is a mucoprotein gel which acts as a shock absorber.

• Outer ‘Anulus Fibrosus’ which surrounds the above mentioned gel.

                                            

Sacrum and Coccyx are the remaining two components but they have a different structure as they consist of fused vertebra. Sacrum anchors the spine whereas the coccyx is a vestige of the mammalian tail.

During my masters, I sat continuously in any manner without caring for my lower back. I didn’t even exercise much which had an adverse effect on my flexibility. I used to play sports like Cricket or Football occasionally which gave my body sudden jerks. Eventually, I started feeling pain on the left side of my lower back during my final semester examinations. But life gives you stress when you don’t want it and you got to take it. You know why? Because you don’t really have a choice!

I thought the pain would disappear if I sleep properly at night. I tried that for some days but all in pain! (Pun intended). Now as many people tend to do, I did the same. Procrastination!

I thought I’ll recover in some days but my condition worsened. Now I couldn’t even sit, walk or sleep properly. I had excruciating pain in my left leg. I realized finally that this problem was way too serious. After some days I got numbness in my left foot followed by a tingling sensation. Due to the numbness I couldn’t balance my body weight when I tried walking.

I decided to go to my family doctor and he gave me some anti-inflammatory medicines. I took the medications for 5 days and it did not show any significant effect. So finally on my Doctor’s advice, I did an X-ray of my lower back and got an idea that the distance between my L4-L5 discs had reduced due to Disc Damage. The L4 and L5 are the two intervertebral discs in the last part of Lumbar region. Due to damage or possibly a herniation, the distance between the two discs had reduced and the inflammation gave rise to severe pain in the lumbar area.

So finally I had to approach a Physiotherapist who can relieve me from this pain. But honestly speaking, being a Biotechnologist, I do my homework before I go to the doctor. So I searched for similar problems on the internet and found out that one of my nerves would be pinched at the lumbar area.

Until I got my appointment date, I was at my native place. The pain was increasing day by day. So as any individual would’ve done, I contacted an MD at my native. He gave me anti-inflammatory medications which gave me relief for a day at least. But the flare ups did not stop. They kept showing up every day. So I decided to contact a friend of mine who was pursuing Bachelors on Physiotherapy. She told me that I have Sciatica. Sciatica is a condition in which your longest nerve in the leg (Sciatic nerve – Which extends from the lower back to the foot) gets pinched. She sent me some photos depicting lower back exercises. I did it on a regular basis but the approach gave results only for a short time. I required some really long term beneficial results.

So when I came back to my City (Mumbai), I instantly got an appointment with the Physiotherapist and I explained him my entire problem. He informed me that one of the nerves was getting impinged. He gave me medications for 2 weeks and told me to focus only on getting enough rest and do some simple stretching exercises. And as every Doctor, he advised me to sit up straight at all times (Worst Advice Ever). He even told me to stop bending forward, place a pillow below my thighs and always get up from sideways after waking up.

I did what I was told and in 2 weeks, the numbness in my leg had reduced considerably. I was quite happy that finally I could walk without any pressure on my left foot. Though many weeks went; the pain in the lower back was still there. So once again I went to the Doctor and this time, he was least interested in understanding my problem. The only thing he was iterating was to get an MRI (Magnetic Resonance Imaging) done. I told him that I get pain in the lower back mainly when I get up after sitting and apart from that, I was feeling much better. The reply I got was, “Do an MRI immediately or else perform the same exercises”.

The second meet was quite unsatisfactory. So I decided to get into the details of spinal column and improve my condition instantly. I will mention my approach and it has worked brilliantly for me.

STEPS I TOOK TO MINIMIZE LOWER BACK PAIN:

STEP I: The most important thing when you suffer from a lower back pain, is to always be in a good posture (Whether you are Sitting/ Sleeping/ Standing).

Many a time people follow the technique of sitting up straight. Even I tried that but it doesn’t really decrease your pain. On the other hand, it might increase it.  Your intervertebral discs are in a lot of pressure when you are standing or sitting without a support for your back.

So I researched a lot regarding the structure of spinal cord. And I finally understood one simple loop hole in this entire problem - ‘Shape of Spinal Cord’. It is written everywhere that our spinal cord is an ‘S’ shaped structure. Though it’s not a complete S but it shows quite a similarity. So based upon the structure, I adopted some key changes in my posture.

      a)      Sitting: Instead of simply sitting straight, I kept a small pillow or a folded towel (White Gap in the picture below) exactly at the inner curve of the lumbar region. This was mainly to keep a soft support and do not let the spine misalign while sitting. The thoracic region was completely resting on the chair whereas the cervical region had to be in proper curve. (Keep your head straight). I kept my legs in a perfect alignment depicting the structure of an inverse ‘L’.

Things to Avoid: Keep an extremely comfortable pillow. The pillow should be small enough to align your back and your abdomen should not lean ahead. Basically don’t overdo it.

                                         

     b)      Sleeping: Sleeping is the most important aspect in improving the lower back condition. When I slept straight, I took 3 pillows – one supporting the cervical region, one supporting the lumbar region and the last on below my thighs.

When I slept on either side, I kept a pillow between my legs. This avoids misalignment of your back and prevents further inflammation and pain of the corresponding area.

Things to Avoid: Do not sleep on your stomach. It has an adverse effect on the spine.

      c)      Standing: Standing puts a lot of pressure on the spine. In order to reduce the pressure, maintain the ‘S’ shape precisely. The head, thoracic region, buttocks and ankle are in a straight line. I stopped bending my lower back and started to bend my knees to do any kind of work.

Things to Avoid: Never bend sideways as it can aggravate your pain.

                            

STEP II) After integrating the ‘S’ shape theory into my mind, I started focusing on some stretching exercises. Since lower back pain is extremely painful, doing some intense workouts will lead to intense pain. So doing various stretching exercises is more reliable as it also strengthens the core muscles.

But first I understood ‘When’ I was feeling the pain. And I would recommend you to follow the same. I was feeling immense pain only when I used to bend forward. So I made a basic equation,

PAIN WHILE BENDING FORWARD – Damage is on the Posterior (Back side) part of the intervertebral disc. So we need to perform back stretches which would ‘Pull’ the disc back at the center.

PAIN WHILE BENDING BACKWARD – Damage is on the Anterior (Front side) part of the intervertebral disc. So we need to perform front stretches which would ‘Push’ the disc back at the center.

STEP III) So depending upon the above mentioned condition, you need to do stretches. I’ll show you all the stretches that you can perform but avoid it if it adds up to your pain. Stretches with proper breathing have a vital role in curing lower back pain.

      a)      Cat-Camel Stretch: This is one of the most easiest and useful stretches. It will allow an individual to align his/ her spine. This is the first stretch I do on a regular basis.

     

     b)      Quadruped Arm / Leg raise: This is the second stretch which I prefer. It provides a proper elongation of the spine releases all the stress which has been collected. You can modify this stretch by just doing leg raises at the rear end.

       c)      Press Up:

                            

     d)     Straight Leg Raise: Actually this is a test undertaken by doctors to check whether you have a herniated disc. Initially I couldn’t even lift my left leg to 30^o. But after regular stretching and taking care of my back, I can now lift up to 60^o.

              

       e)      Hip Bridges: This was the most helpful of all. It allows you to strengthen your lower back. Do it very slowly and effectively. You can modify by raising legs after performing a hip bridge.

                

          f)       Knee to Chest: It tightens the buttock muscles.

                             

     g)      Wall Slide: This strengthens the quadriceps and the buttock muscles. It has a key role in relieving pain from the lower back. Proper breathing is required.

                                            

So these are the exercises or stretches that I follow on regular basis along with maintaining the ‘S’ shape of my spine. Apart from the ones mentioned above, as I have less pain now, I’ve shifted to a slightly more intense exercises like Planks, Side planks, Jump rope, Lunges, Calf raises, Push-ups etc.

So depending upon the severity of your situation, you can start from above mentioned techniques and then graduate to any level of work out. Maintaining your posture would do 80% of your work. The remaining 20% would be your stretches.

I have written this article for the people who just don’t think about their medical condition and just jump at the Doctor’s clinic. People just need pills for instant treatment. They don’t want to understand what their body is indicating and how to understand those indications. 

I am not against Doctors nor am I someone with a high intellect. I am a layman who tries to understand biology and make more people aware of it. Follow this approach and remember one thing – Don’t overdo it. Do within limits. Glad if I could help anyone!