Backache: The Long & Short Of It

Words: Dr Rajgopal NIDAMBOOR

Backache [back pain] is as common as the common cold. It affects five out of six people, some time in their life.

While most cases of backache do not have any underlying ‘factors,’ the disorder attracts a huge annual cost, running into several million rupees — from absence at work to low productivity.

The onset of backache is related to a host of causes. It may be caused by a muscle strain, muscular complaints, back injury, overuse, pressure on a nerve root, including poor posture, among other things.

A typical symptom of backache is often felt in the lower back. This may manifest itself from the spine, muscle, nerve, or other structures in the back. Sometimes, the pain may also radiate from your mid- or upper-back. 

Backache is most often felt when you —

  • Lift a heavy object
  • Move suddenly, or hastily
  • Sit in a particular position for long hours
  • Suffer an injury — a fall, or an accident.

Backache is one of the leading causes of missed workdays for people under age 45.

The good news is 98 per cent of backache patients get better with medical treatment and physiotherapy. The bad news is two per cent of backache cases may require surgery. 

  • A sedentary lifestyle, bad posture, stress and overdependence on technology, or utility gadgets, could leave you with ‘constant’ backache
  • A variety of symptoms may present when your back hurts. Symptoms, in general, may be: tingling, or burning sensation, accompanied by a dull, aching and/or sharp pain. This may be accompanied by weakness in the legs, or feet. A simple movement gone wrong suddenly can also lead to backache
  • Many back-related injuries happen at work; it is, therefore, better to be prepared, and change the ‘tide’ when your back aches. More so, because there are as many things you can do to lower your chances of getting backache as there are ready-to-make-and-eat foods at the mall
  • Your job could be one of the determining factors — of positions that require heavy lifting, bending and twisting, or car/truck/lorry/bus driving [whole body vibration], for long hours, may cause backache. There are other causative factors too, viz., bad posture, and pregnancy, or if you are over age 30, or smoke and/or are obese.
  • The chances of backache increase, if you don’t exercise.

Medical conditions may also cause low backache — viz., arthritis [bone joint disease], bladder infection, kidney stone, ovarian cyst, or cancer, and twisted [torsion] testicles. People with a low pain threshold and/or individuals who are stressed, or depressed, also present with backache.

Self-Help

Keep moving to ease lower back pain. Exercise is one of the most important activities you can do to help ease your back pain. ‘Go’ walking, swimming, cycling, yoga, or gentle workouts in the gym [under professional guidance]. Exercise is good for your mind too — to keep negativity out.

Lose weight. The first thing is to lose weight, if you are overweight, as this exerts excess pressure on your body, leading to aches and pains — where your muscles can’t cope with the workload.

Increase core muscle strength. This refers to your core muscles, viz., the abdominal, back, pelvic and chest muscles. Useful exercises are push-ups, knee-fold tucks, oblique crunches, and sleeping better.

Lift carefully. Most people injure their lower backs while lifting heavy objects. Never bend from the hips to pick something up, but always bend your knees first. This way you use your whole back and your leg muscles to lift rather than just your upper body.

Sit well. Right posture holds the key. Make sure you take regular breaks to ease the pressure on your back and try sitting back a little. Not slouching, but leaning back into the chair back to allow it to support your weight. Make sure there is ‘spine support’ in the lower-back part of the chair — place a small cushion, or rolled up towel, if necessary.

Yoga. Research shows that regular yoga sessions can help ease the symptoms of lower back pain more quickly than other exercises, such as walking.

Handbag. Clear that heavy stuff inside, because your handbag could be putting your spine into an awkward position causing backache.

Deal with stress. We all have stressors in life; the key is how you respond to them and treat the symptoms. Try meditation, listening to soft, soulful music, or learning a musical instrument. A study shows that 74 per cent of people who opted to swim daily found it helped ‘purge’ their stress, tension, and depression.

Treatment

Ayurveda

Low back pain [LBP] affects approximately 60–85 per cent of adults during some point in their lives. Lifestyle changes in diet and habits of individuals have also made katigraha a common illness now-a-days. In most cases, people are not able to manage the back ache with modern medicine and/or quitting their skewed diet and other habits, or changing their lifestyle. So, keeping such points in mind, an attempt was made with sapthasaram kashayam [internal] and kottam chukkadi taila [external application] mentioned in Sahasrayoga.

20 subjects diagnosed with katigraha and who fulfilled the inclusion criteria were randomly selected. Sapthasaram kashayam was given in two divided doses of 50ml each; morning and evening, one hour before food, and kottam chukkadi taila applied at kati region, twice daily for 30 days.

Results showed that there was relief in pain [27.3 per cent], stiffness [39.9 per cent], tenderness [44.7 per cent] and difficulty in walking [23.8 per cent], Schober’s test [20 per cent], VAS [24.3 per cent] and Oswestry test [17.2 per cent] was also statistically significant. [p<0.001].

To conclude, patients, in the study, showed improvement in most of the assessment criteria of katigraha. Sapthasaram kashaya and kottam chukkadi taila can be opted for all types of katigraha.

  • Pooja Sharada, et al, “Sapthasaram Kashayam and Kottam Chukkadi Taila in the Management of Katigraha [Lumbar Spondylosis] — A Clinical Trial,” Ayurpharm Int J Ayur Alli Sci, Vol 7, # 6 [2018], pp 92-100. 

Homeopathy 

Homeopathy is best prescribed when the individual with backache is able to describe the exact location, the precise nature of pain, sensation, if any, pattern, or distribution of pain, or what makes it better, or worse.

The more details one gives, or explains, the easier it will be for the professional homeopathic physician in finding out the most suitable homeopathic remedy that accurately ‘fits’ the person’s unique symptom-picture.

There are other factors too that the individual should report for better treatment outcomes. These are sometimes changes the person has experienced since backache first began. They also correspond to changes in body temperature — whether they feel cold, or warm — including thirst and sleep, psychological and emotional patterns.

All the same, the irony is, backache is not as simple as it appears to be. It’s, therefore, imperative for one to seek specialised treatment from a professional homeopathic physician.

In a controlled, randomised, prospective study, a group of people suffering from chronic low backache were treated for two months, either by homeopathy, or standardised physiotherapy. The assessment, based on initial and final clinical investigations, Oswestry questionnaire [pain scale], and visual analogue scale, found that homeopathy was useful for low backache [Source: Z Orthop Ihre Grenzgeb, Sep-Oct; 2002;140[5]:503-8:10.1055/s-2002-34004].

NB: It would also be most useful for the individual having backache to communicate what makes the pain worse, rather than better, since most homeopathic remedies have it in their action profile more ‘worse’ than ‘better’ symptoms. When your homeopathic doctor chooses a remedy that suitably matches with one’s distinctive symptoms of backache, or any other cue, whether acute [backache with sudden onset], or chronic [long-standing backache], it stimulates the body’s healing processes — with much better treatment outcomes.

Nutrition

Objective. This study was aimed to investigate the effects of vitamin D3, vitamin C, vitamin E and zinc supplements on pain and functional capacity in chronic low back pain [CLBP]. 

Methods. 20 patients [female/male:10/10] with CLBLP, aged between 28 and 57 years [mean age: 41.25±9.12], participated in the study. McGill Pain Questionnaire [MPQ] was used to measure the state of pain. Pain-related functional capacity was evaluated through Roland Morris Disability Questionnaire [RMDQ]. Fear-Avoidance Beliefs Questionnaire [FABQ] was used to assess fear-avoiding beliefs based on physical activity and the effects of work in chronic low back pain. The Finger Floor Test [FFT] was used to assess the flexibility of trunk flexion. Evaluations were performed before and after treatment.

Result. Before treatment: the mean of MPQ was 50,55±6,03, the mean of FFT was 5,5±2,35cm, the mean of RMDQ was 14,9±2,38, and the mean of FABQ was 50,7±5,68. After treatment: the mean of MPQ was 23,45±5,35, the mean of FFT was 2,45±0,89cm, the mean of RMDQ was 6,95±1,70, and the mean of FABQ was 22,5±5,73. The results were statistically significant with difference between before and after assessment scores [p<0.05].

Conclusion. Vitamin D, C, E and zinc have been found to be effective in the treatment of patients with chronic low back pain.

  • Mehmet U, Gonul G E, Ahmet S B, Muammer K, “The Effects of Vitamın D, C, E and Zinc Supplementation in Chronic Non-Specific Low Back Pain.” Open J Pain Med 2021, 5[1]: 008-011. DOI: 10.17352/ojpm.000024.

Recent research has highlighted the potential role of vitamin B complex — defined in the literature as 1mg of vitamin B-12, 50-100mg of vitamin B1 and 50-100mg of vitamin B6 — as an adjunct to NSAID therapy in patients otherwise uncontrolled on their current therapeutic regimens and who may require intensification.

The DOLOR study, a randomised, double-blind study, assessed the efficacy and safety of twice-daily oral administration of either vitamin B complex combination therapy [group DB; 50mg diclofenac + 50mg vitamin B1, 50mg vitamin B6 and 1mg vitamin B12], or diclofenac monotherapy, [group D; 50mg diclofenac].  After 3 days of treatment, a statistically significantly higher proportion of subjects in group DB [n = 87; 46.5 per cent] than in group D [n = 55; 29 per cent] terminated the study due to treatment success [χ2: 12.06; p = 0.0005].

According to the study authors, the combination therapy yielded superior results in pain reduction, improvement of mobility and functionality as assessed by the Visual Analog Pain Scale [VAS].

  • M Mibielli et al. “Diclofenac Plus B Vitamins versus Diclofenac Monotherapy in Lumbago: The DOLOR Study.” Curr Med Res Opin 2009;25[11]:258.
Dr RAJGOPAL NIDAMBOOR, PhD, is a wellness physician-writer-editor, independent researcher, critic, columnist, author and publisher. His published work includes hundreds of newspaper, magazine, web articles, essays, meditations, columns, and critiques on a host of subjects, eight books on natural health, two coffee table tomes and an encyclopaedic treatise on Indian philosophy. He is Chief Wellness Officer, Docco360 — a mobile health application/platform connecting patients with Ayurveda, homeopathic and Unani physicians, and nutrition therapists, among others, from the comfort of their home — and, Editor-in-Chief, ThinkWellness360.

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