Everything You Should Know About Lower Back Pain

Back pain is pain felt in the back that usually originates from the muscles, nerves, bones, joints or other structures in the spine. Back pain may have a sudden onset or can be chronic pain, it can be constant or intermittent, stay in one place or radiate to other areas. It may be a dull ache, or a sharp or piercing or burning sensation.

Causes Of Lower Back Pain:

• Strain due to muscles and ligaments in the back
• Intervertebral disc injuries, like disc herniation, prolapse, extrusion etc
• Sciatica
• Spinal stenosis
• Abnormal spine curvatures (Scoliosis/ kyphosis/ lordosis)
• Arthritis
• Fibromyalgia
• Spondylosis
• Uterine fibroids
• Cancer

Classification Of Lower Back Pain:

1. Anatomy related:

• Upper backache
• Middle backache
• Lower backache

2. Duration related:

• Acute (Up to 12 weeks)
• Chronic (more than 12 weeks)
• Subacute (6-12 weeks)

3. Etiology related:

• Mechanical or Non-specific
• Secondary back pain

Symptoms Of Lower Back Pain:

• Pain over the back area
• It can be a dull ache, sharp or piercing or burning type of pain.
• According to the underlying pathology, symptoms can be added like weakness of lower legs, numbness over lower legs, burning sensation over legs

Diagnosis:

• Clinical evaluation
• Radiological evaluation (X-ray, MRI, CT-scan)

Management:

Aim: To achieve a maximal reduction in pain intensity as rapidly as possible.

To restore the individual’s ability to function in everyday activities.

• Hot and cold compressions
• NSAID
• The surgical method used in conditions like Disc herniation etc
• Exercises
• Physiotherapy

 

AYURVEDIC WAY OF APPROACH TO LOWER BACK PAIN:

The back pain can be upper back, middle back or lower back. According to Ayurveda texts, the Low backache is mentioned in more detail because it is the site that is more prone to get pain.

In Ayurveda, low back pain is termed as Katisulam.

Katisula is clearly explained by different Ayurvedia Acharyas and are mentioned their nidana( Causes), lakshana (signs and symptoms), samprapthi (pathogenesis), chikitsa (treatment) with explanation.

Nidana (Causes):

The causative factors for Katisula is explained elaborately under the Vatavyadhi (Vatika Diseases).

• Ahara factors like spicy, dry, astringent etc
• Vata generating food items like: Potato, Dal, deep fried food etc
• Excess work
• Weight lifting
• Trauma (accidents, fall)
• Improper sleeping posture etc

Lakshana (Symptoms):

• Kati pradesha sula (Back ache)
• Kati graham (low back stiffness)
• Supthi (Numbness)
• Daha (burning sensation) ( due to compression of the nerve, these symptoms appear)

Samprapthi (Pathogenesis):

Shoola in kati pradesha is the main lakshana of katisula. The shoola may be of various types, which occurs by provoked Vata dosha. In a typical case, pain is confined to the Kati pradesha or the lumbo sacral and sacroiliac region only.the pain arises due to the vitiated vyana vata, which dries up the shleshaka kapha in the joints creating friction. When the Vitiated vata get localized in the Kati pradesha, the shleshaka kapha get dries up and joint friction get increased. And the condition manifested as pain over low back and stiffness in the kati pradesha.

 

Ayurvedic Management:

{Ayurvedic management mainly aims to arrest the process of degeneration and helps in the regeneration of soft tissue damages.}

The main management for katisula is executed with Panchakarma.

The Ayurvedic approach to maintain a healthy condition and to reduce the progression.

It includes:

• Internal and external snehana (Oleation)
• Swedanam (Fomentation)
• Sodhana (Virechana– Purgative therapy)

Basthi (Medicated Enema)

 

Snehana:

• It can be adopted in kati shula, except in conditions of Ama,Amavata, Ajeerna (indigestion).
• In the case of associated Ama or Kapha dosha , langhana and pachana (Carminative) line of treatment has to be executed to make Nirama avastha.
• Internally we can use Ghritha or Oil which is medicated in Arohana Krama (Increasing dosage)
• Externally oleation can be done with Abhyanga-like therapies.

Swedana:

• Swedana therapy is very much effective in back pain-relieving and also in improving range of movement.
• It can be done in the entire body or in the affected part of the body like low back, upper back
• We can choose different Sweda procedures like: Avagaha, Pinda or potali sweda, ushmasweda etc.

Sodhana:

Among the sodhana procedures, Virechana and Vasthi are the most used procedure in