Back pain is one of the most common physical complaints among
adults; some estimates say that over 20% of adults have some
chronic back pain. It is the chief cause of misery for many. At
some point in their lives, most people will experience some sort
of back discomfort. It is pain or discomfort felt in the upper,
middle, or lower back. The pain may extend to the hips and legs.
Causes of Back Pain
The back consists of a complex arrangement of bone, ligaments,
joints, muscles, and nerves, and pain can result from a problem
with any of these components.The most common type of back pain
is low back pain. That's because the lower portion of the back
is under the most pressure when a person is sitting or lifting,
and it can be easily damaged.
There are many causes of back pain
• The most common cause is a strain of the back, which is a
small tear of the back muscles or ligaments. This usually
results from a sudden or awkward movement, or from lifting a
heavy object. But often, a person can't remember a particular
incident that brought on the pain.
• Poor posture, back strain from poorly designed furniture, weak
back and stomach muscles from lack of exercise, and injuries.
• Other common causes include poor muscle tone in the back,
tension or spasm of the back muscles and problems with the
joints that make up the back
Symptom of Back Pain
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. An example of this would be 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.
Another example would be the inability to raise your big toe
upward. This results when the fifth lumbar nerve is compromised.
When you feel pain, it is really a reaction to signals
transmitted throughout your body. These signals are sent from
the pain source such as a sore back, through the nerves in the
spinal cord, and up to the brain, where they are perceived as
Different Types of Pain
The origin of some pain is neuropathic, while other pain is
nociceptive. This is important to know because different
treatments work better for each type of pain.
Neuropathic pain is caused by damage to nerve tissue. It is
often felt as a burning or stabbing pain. One example of
neuropathic pain is a "pinched nerve."
Nociceptive pain is caused by an injury or disease outside the
nervous system. It is often an ongoing dull ache or pressure,
rather than the sharper, trauma-like pain that is characteristic
of neuropathic pain. One example of nociceptive pain is
arthritis pain.Some people experience mixed pain, which is a
combination of neuropathic and nociceptive pain.
Chronic versus Acute Back Pain
Chronic back pain is commonly described as deep, aching, dull or
burning pain in one area of the back or traveling down the legs.
Patients may experience numbness, tingling, burning, or a
pins-and-needles type sensation in the legs. Regular daily
activities may prove difficult or impossible for the chronic
back pain patient. They may find it difficult or unbearable to
work, for example, even when the job does not require manual
labor. Chronic back pain tends to last a long time, and is not
relieved by standard types of medical management. It may result
from a previous injury long since healed, or it may have an
ongoing cause, such as nerve damage or arthritis.
Acute back pain is commonly described as a very sharp pain or a
dull ache, usually felt deep in the lowerpart of the back, and
can be more severe in one area, such as the right side, left
side, center, or the lower part of the back. Acute pain can be
intermittent, but is usually constant, only ranging in severity.
Mechanical back pain is a form of acute pain aggravated by
movement and worsened by coughing. This type of pain is usually
alleviated with rest. Mechanical back pain is typical of a
herniated disc or stress fracture. For patients with this
condition, forward movements of the spine usually cause pain. In
addition, posture, coughing, sneezing, and movement can all
influence pain coming from the spine. When acute back pain is
severe and travels down both legs, it could be caused by lumber
disc diseases the most common cause of Sciatica.
Diagnosis of Acute Back Pain
• X-rays - Painless, non-invasive
imaging process that utilizes photographic film to absorb
electromagnetic radiation — having an extremely short wavelength
and the ability to penetrate solids of various thicknesses —
transmitted through a material body. These images, also known as
radiographs or roentgenograms, are used to diagnose and monitor
the treatment of various disorders.
• CAT Scan (computed axial tomography scan also called a CT scan
(computed tomography scan) - Another painless imaging technique
that utilizes a computer to produce detailed three-dimensional
images of a body from a collation of cross-sectional X-rays
taken along an axis. Of all the imaging techniques that are
currently available, the CAT scan is best able to produce images
of bone, blood, and soft tissues.
• MRI (magnetic resonance imaging)
- Non-invasive technique for imaging the spine that involves
rotating a magnet around the body and exciting its hydrogen
atoms. A scanner is then utilized to detect the energy emitted
by the excited atoms. MRIs provide exceptional detail of the
spine's anatomy, since the human body is composed primarily of
water, which is two parts hydrogen. The single most useful test
available for diagnosing spinal disorders.
• Myelogram - A test procedure that
involves injecting a radiographic contrast media (dye) into the
sac (dura) surrounding the spinal cord and nerves, and then
taking X-rays of the spine. This allows the radiologist to
specifically X-ray the nerve roots. In this way, any
abnormalities within the spinal canal can potentially be
identified to aid in the diagnosis of certain spinal problems,
such as nerve compression or a disc rupture.
• Bone Scan - A test procedure that
involves intravenously injecting a small quantity of a
radiographic marker into the patient, and then running a scanner
over the area of concern. The scanner detects the marker, which
concentrates in any region exhibiting high bone turnover. A bone
scan is utilized when there is suspicion of tumor, infection, or
small fractures, i.e., conditions that all result in high bone
turnover. A Bone Scan does not replace the above tests, but may
provide additional information by eliminating other serious
Treatment of Back Pain
Yoga has been used for thousands of years to promote health and
prevent disease, and many people with back problems have found
yoga to provide several benefits, including: Relieving pain,
Increasing strength and flexibility and teaching relaxation and
Many people believe that rest is best for a painful back, but
actually, what your back really needs when it’s hurt is
exercise. Regular exercise relieves back pain by strengthening
and stretching the muscles that support the spine and helps to
prevent future injury. This is a use it or lose it situation:
the more you rest, the weaker your back gets, even if it is
hurt. Studies have actually shown that you can heal your back
pain faster and get back to your regular activities with just
two days of rest.
Many physicians recommend Yoga exercise as a way to gently
stretch and strengthen back muscles. In fact, if you’ve had
physical therapy, you’ll probably recognize several Yoga
movements. In Yoga, a strong, flexible back is very important
for maintaining posture, for insuring that the nervous system
pathways are strong and clear, for improving circulation to the
brain, and for maintaining the erect posture necessary for
seated meditation in intermediate practice.
Yoga exercises can be helpful both in preventing and in healing
from an injury. Many Yoga exercises gently stretch and
strengthen the muscles in the hips, back, and legs; others
improve muscle strength in the abdomen, which supports the lower
back. In most people, muscles on one side of the body are
stronger than those on the other; Yoga exercises stretch and
strengthen both sides equally. If you practice every day, you
will soon notice more relaxed posture and a more fluid carriage,
and your back muscles won’t tire as easily. You’ll also learn
how to recognize tension in your back and neck muscles more
quickly so that you can release it before the muscles become
tight and sore.
If you have suffered an injury to your back or neck, begin with
extremely gentle movements that do not hyperextend the neck or
back in either direction. In a class, your instructor will
modify the Yoga exercises for you to be sure you don’t strain.
Even if you have had back surgery, there will always be some
movements you can do. Be sure to consult your physician before
beginning any new exercise routine.
Breathing techniques and meditation training will teach you how
to relax your body and mind at will and to recover faster from
stress reactions. For beginning meditation, which is done lying
flat so the spine can remain straight without strain, place a
few cushions under your thighs and knees to release any pressure
on your lower back.
By exercising carefully, and by practicing a simple routine of
exercise, breathing, and meditation every day, you can help your
back and neck become as strong and healthy as possible.
A good, regular yoga practice will go far in relieving the
stress and tension that sometimes cause mild back pain, and in
fact, studies have shown that yoga is the number one most
effective exercise for relieving back pain. However, not all
yoga poses relieve back pain, and some can in fact aggravate
existing pain, so it is important to know which poses is the
most helpful in relieving back pain. It is best to do these
exercises under the supervision of a qualified yoga instructor,
and if you encounter any problems with these poses, you should
consult an expert. Even just one or two sessions with a yoga
instructor can help. Here are some of the best yoga poses for
relieving back pain. Each pose should be held from five to ten
seconds, depending upon your level of comfort, and should be
done on a mat or other soft, supportive surface.
SABASANA (CORPSE): Lie flat on your
back in a relaxed position, arms resting at your sides, palms
facing up, and legs lying naturally with one feet distance
between both legs and knees turned out slightly. If it hurts
your back to have your knees turned outward, do this pose with
knees bent, feet flat on the floor. Breathe in and out for a few
seconds while allowing any tension to leave the body.
BALASANA (CAT STRETCH): Start out
on your hands and knees with a flat back. Your hands should be
directly under your shoulders with fingers spread. Knees should
be directly under the hips. Head is held loosely so that you are
looking at the floor between your hands. Inhale, and as you
exhale, arch your back toward the ceiling, tuck your chin in to
your chest so that you are looking at your navel, and tuck your
tailbone underneath. Hold, then release back into your original
PAWANMUKTASANA (WIND-RELEASING POSE) :
Lie flat on your back as in Corpse pose. As you inhale, bend
your knee, place your hands right below the knee, and draw your
leg towards your chest. Your left leg should remain flat on the
floor. Exhale and bring your forehead up to touch your knee.
Inhale, and then as you exhale, return to your original
position. Repeat with the other leg and again do it with both
BAKRASANA (TWISTING POSE) : Warning
for this pose—it involves twisting your back, so you should take
particular care not to twist too far aggravating any existing
back pain. This should be a gentle stretch; twist just as far as
is comfortable. Sit on the floor with both legs out in front of
you. Bend your right knee, lift your right leg over your left,
and place your right foot on the floor next to your left knee.
Sitting with spine straight, place your left elbow on the right
side of your right knee. Bend your left arm so that your left
fingertips are touching your right hip, while at the same time,
twisting to look over your right shoulder. This is where you
need to be careful not to twist too far. Hold for a few seconds,
release, and repeat on the opposite side.
TADASANA (TREE POSE) : Stand with
feet facing forward, arms at your sides, weight distributed
evenly on both feet. Raise both arms over your head, interlock
your fingers, and turn your hands so that your palms are facing
upward. Next, place your palms on your head and turn your head
so that you are looking slightly upward. Stretch your arms
upwards, and at the same time, come up onto your toes if you can
do so without pain. Stretch your entire body upward and hold, if
you can. Some people have difficulty balancing during this pose,
so just do the stretching part if you need to.
MATSYASANA (FISH POSE): Lie on your
back with knees bent and arms at your side. Arch your back as
far as you comfortably can and raise it off the ground by
pushing the floor with your elbows. If you can, tilt your head
backwards and rest the crown of your head on the floor. Breathe
deeply from the diaphragm and hold pose for one minute if you
In recent years, researchers have become interested in studying
the effects of yoga on treating disease, and studies are
encouraging that yoga can be a useful part of the treatment plan
for many medical conditions as varied as heart disease, carpal
tunnel syndrome, epilepsy, asthma, addiction, and many neck and
Although no one treatment works for everyone, many aspects of
yoga make it ideal for treating back pain and neck pain. For
example, studies have shown that those who practice yoga for as
little as twice a week for 8 weeks make significant gains in
strength, flexibility, and endurance, which is a basic goal of
most rehabilitation programs for back pain or neck pain.
In addition, the breathing and meditation aspects of yoga induce
a "relaxation response" that has been found in many studies to
assist people in decreasing their pain. Yoga has also been found
to be helpful in the treatment of depression and anxiety that
often accompany pain problems.