( By Dr. S. R. Jindal )

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Back Pain (Lumbago & Lumbar Spondylosis)

Back Pain (Lumbago & Lumbar Spondylosis)

The low back area is highly strained as it has to bear the weight of the whole upper body. Discs situated between the vertebrae are made of a jelly-like substance and are strong structures. Degenerative changes occur gradually an naturally as you get older. Everyone over the age of 50 has changes of natural wear and tear, changes in the spine and discs become thinner and less flexible. These changes are irreversible. Back pain is generally due to inflammation of the joints, faulty posture and spinal diseases such as Osteoarthritis, prolapsed intervertebral discs, Spondylosis, Spondylolisthesis and renal stones. Prevention / Treatment

  1. REST - allows the body to heal itself, the mind and emotions to calm down, the muscles to relax and to some degree allows the inflammation in the tissues to subside.
  2. RELAXATION - eases tension in the body muscles, quietens the mind and allows mind and the body to heal. Meditation is best.
  3. HEAT - causes the small blood vessels and capillaries to dilate thus increasing the flow of blood (circulation of blood). Muscles respond best to this treatment, as the application of heat improves the flow of blood, relieves the pain /spasm and relaxes the muscles. A hot bath,sauna or a hot water shower on the aching area can relax spasm and muscle pain. You can also use a hot water bottle or an electric heat pad or infra-red lamps on the area of pain for 10-15 minutes. You can also utilise your own body heat by wrapping a scarf around the neck and a piece of woollen cloth around the waist to ease the ache.

    Heat should be applied generally at least twice a day; four times a day would be more preferable. Deep heat treatment is also provided by microwave diathermy and ultrasound therapy which are safe, and very effective, but should be taken under expert guidance. Hot and cold contrast treatment is the best pain reliever - apply a towel squeezed in hot water for two minutes ; then immediately another towel squeezed in chilled water for half a minute - each application four times,and finally end with the hot towel for one minute. Ice pack is useful immediately after an injury, such as a bruise or an over-stretched ligament, blow or a fall to prevent too much inflammation and swelling. It must be applied for 2 to 3 minutes only.

  4. MASSAGE - removes muscular tension and spasm, relieves pain, breaks down the stringent inelastic muscular fibres, stimulates the larger nerve fibres in muscles which travel to the spinal cord and soothes the mind and emotions.Massage also helps relax the skeletal muscles of the human body.
  5. APPLICATION - of irritant rubs, heat creams that stimulate the nerves, also irritant poultices such a mustard poultice helps greatly. Pain killers like aspirin can help temporarily and should be taken only if the pain is severe and unbearable.
  6. REDUCTION OF WEIGHT - The heavier you are, the more work the back has to do. Since the excess weight is carried in the front of the stomach area, it places additional strain on the low back, as it pulls forward, making your muscles work hard to keep you upright.
  7. POSTURE - Correct posture is vital for the prevention of back and neck pain. Self-assessment of poor and imbalanced posture involving the tight muscles in the low back and neck can be done while sitting, standing, lying down, lifting etc. Sleep on a hard bed with a firm but comfortable mattress. The correct pillow is important. The spine should be straight from the head to the pelvic region (no bend).

    Sit upright and use some support, if necessary,such as a cushion in the low back and neck.Strong abdominal muscles keep the stomach from sagging forward. Sagging imposes dangerous stress on the lower or lumbar region of the spine. Weakness of abdominal muscles is one of the most common causes of back pain. While sleeping there should not be much body movement like twisting and turning. No support should be given to the lower back thus allowing maintenance of the normal hollow in the low back. A special pillow should be used to support the head, so that it does not drop below the shoulder. For those suffering from backache, the prone or ‘on the stomach’ sleeping position is not recommended, since it tends to extend and strain the back.

  8. OCCUPATIONAL HAZARDS - People with sedentary habits must realise the adverse effects of just sitting, lack of exercises, tension /stress, etc. and cultivate the habit of moving about, stretching the neck, shoulders, walking briskly/playing games /doing lot of exercises like Yoga. Avoid standing for long and bending forward with a jerk or lifting weight. As you get older, keep your spine mobile through changing postures, regular exercises, warmth and massage. You may also use neck collar and sacroiliac belt in case of severe pain of cervical and lumbar spondylosis and in the low back area. We pay a high price for sedentary living both in terms of back pain (commonly caused by inadequate musculature) and overall health.
  9. TRACTION - Stretches the spine along its length and moves the vertebrae thus taking pressure off the discs. Traction can be mechanical, i.e. with the help of equipments or manual, i.e. while lying down, the other person holds both ankles, pulling lengthwise,moderately and slightly upwards ( 30 seconds of pulling and 30 seconds of remaining idle -repeat 10 times). Or , fix a rod or a piece of strong 30 mm diameter pipe on your door frame, hold in your hands and hang, stretching the whole body and spine downward ( with weight hanging on the arms). Do this 3 to 6 times, for 30 seconds each time every day.
  10. MANIPULATION - This treatment should be taken only from qualified and trained Osteopaths and Chiropractors to avoid severe damages.
  11. INJECTIONS - are not of any help, though many doctors claim to achieve a variety of effects through their use.
  12. ACCUPUNCTURE - does help in some cases of back and neck pain, specially when used to relieve spasms of back muscle; if you believe in it, you can consider consulting a trained acupuncturist.
  13. MAGNETIC BELT - may be used for 30-60 minutes intermittently, though it provides only symptomatic relief.

This is, in fact, the most important factor to control and cure any disease. Avoid, or reduce sugar,white flour, fried, refined or processed food, additives such as colouring, flavouring, preservatives and vinegar, alcohol, salt, coffee, cola, chocolate, cakes, biscuits, ice cream, canned fruit or juice, citrus fruits,butter milk etc. Eat plenty of vegetable salads, fresh fruits, whole grain cereals, beans, brown rice, yoghurt, skimmed milk, baked potato, banana, apple, dates, fig, garlic, sesame seeds, fenugreek. Low-fat, high-fibre and low-protein diet would be the best. Vitamin B complex and Vitamin C are recommended. Drink a lot of water , say 8 to 10 glasses a day, and sleep 7 to 8 hours daily. Have enema or do Shankprakshalan intermittently to avoid constipation. Have a three-day detoxification course every month.Maintain a strict diet control and do daily exercises with strong WILL POWER.

Uric Acid and Gouty Arthritis

Rise in uric acid levels can result in Gouty arthritis. Diet is very important. One should avoid fruits like grapes, citrus fruits, white sugar, cakes, biscuits, all meat items, alcohol, whiteflour, canned fruit /juices, sweets, ice cream, almonds, all nuts, aerated water, tomatoes, potatoes, green chillies, brinjal, lady’s finger and arvi to reduce uric acid. During an attack of gout, it is advisable also to avoid beans, cauliflower, green peas, mushrooms, chikoo and seetafal (custard apple). On the other hand, skimmed milk and curds, in reasonable quantity, are recommended.

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