Updated: Sep 19
As a leading cause of discomfort, reduced life quality and productivity loss for many people, back pain needs closer examination and efficient remedies. People not only miss their work due to chronic severe low back pain, but also suffer from psychological stress and depression because they are forced to avoid many recreational activities, hobbies and exercises because of it.
The broader notion of back pain may refer to either of pain in neck, middle back (thoracic area), lower back (lumbar region) and coccydynia (tailbone). Amongst, lumbar pain is most common and neck pain comes next.
Why is back pain a ‘life style disease’?
There are of course pathological causes of back pain like arthritis, tuberculosis of the spine, infections, ankylosing spondylitis etc. Acute injuries and trauma to muscles and vertebrae will also cause pain. But these causes do not account for around 90% of back pain. (1) That 90% is caused without any underlying structural or pathological problems. That is, by our lifestyle, at least for the major part.
Of that 90% of the cases, most numbers come from muscular problems. The other cause is issues with the inter vertebral disc. Vertebral disc problems are often result of repeated stress and degeneration. That also can also be caused or prevented by lifestyle changes and habits.
Muscular causes of back pain:
They are mostly caused by strains, sprains or spasms. These can be a result of sudden extreme movements like jerking or pulling. Also continuous strain like exercise or working with heavy objects for long time may be the cause. Next reason is repeated stress because of bad posture or continuous sitting which may weaken some muscles and stiffen others. Apart from injuries from sudden violent movements, the other causes can be prevented by actively minding to your posture and habits.
Muscle injuries, either from repeated stress or from sudden movements can be prevented to a great extent by making the flexible and strong enough. Flexing and strengthening exercises for back need a place in your daily routine. Also maintaining good posture while lifting heavy objects is essential.
Back pain from inter vertebral disc:
Disc problems accounts for around 5% of all back pain. A large percentage of all people above 30 is supposed to have some levels of intervertebral disc bulges or protrusion, but only about 3% will have symptoms. (2)
An intervertebral disc is composed of a gel like material enclosed in a fibrous capsule. Sometimes the fibrous player enclosing the gel becomes weak and the compression from vertebrae make that region bulge out. Protrusion and herniations are terms used to indicate various levels of disc bulge.
The disc bulge is caused when the gel becomes less hydrated and the fibre becomes weak due to reduced circulation and nutrition to the disc. This is a natural process as we age, but some of it can be prevented by regular exercise and proper posture.
Herniated disc cause pain when the bulged portion of the disc touches the nerves passing out through the vertebral canal. Pain from herniated disc can be identified by its burning and stinging character. Also the pain will radiate to hands or legs. Numbness and tingling sensation is also common along the areas which the nerve supplies.
Back pain which are not from the back:
Some conditions like gall bladder stone, pancreatitis, kidney stone, urinary infections, ovarian cysts and pelvic inflammations can cause pain in different regions of the back.
When is back pain an emergency? When to do surgery?
You need to treat back pain immediately if you have the following symptoms along with back pain. These symptoms mean that you have a major problem with your spinal nerves.
Difficulty to control urination and/or defecation
Inability to move the hand or leg completely.
Saddle anaesthesia (loss of sensation in the groin, anal area, buttocks, and inner thighs).
Difficulty in fine movements (like buttoning your shirt)
Pain severely worsening and disabling over days.
Surgery shall be the best option only when a bulged disc will compromise too much space of the spinal canal and/ or inter vertebral foramen.
Research shows that drugs offer only temporary relief from back pain. Also relief by physical therapies and manipulations alone are inconclusive. Surgery too is less effective except for the right indication and doesn’t prevent recurrence.
Ayurveda back pain treatments include medicines, different massage techniques, application of oils and herbal pastes, rehabilitation exercises and also panchakarma.
Medicines are generally anti-inflammatory and strengthening. The common medicines used are ‘sahacaradi kashayam’, ‘rasnadi kashayam’, ‘gandha tailam’, ‘ksheeraguluchi’ etc.
Ayurvedic massage techniques for back pain incorporates heat, controlled pressure and anti-inflammatory effects of the oils and herbs. They provide the best solution for ‘vata’ dosha, which is the cause for degeneration, stiffness and pain.
Some special massages like ‘kizhi’ (herbal bundle massage will break the inflammation points and relaxes the para spinal muscles. Other massages like ‘njavara kizi’ strengthens and nourishes the muscles and spine. Other special treatments include ‘kativasti’ and ‘pichu’ which are pooling of medicated oil over areas of pain. There are also herbal applications called ‘lepam’ which will decrease inflammation and pains. These therapies will help to improve the circulation and nutrition of the muscles, vertebrae and inter vertebral discs.
Oils and applications used include ‘sahacaradi tailam, ‘saplint’ liniment, ‘murivenna’, dhanwantaram’ gtailam, ‘mahanarayanam, tailam etc.
Panchakarma treatments like Virechana (purgation) and vlasti (ennema) are powerful anti-inflammatory therapy for the spine and low back. They are also proven to provide best results with back pain.