Why my UPPER BACK hurts whole day?

"Whenever I look at my phone, read books, work in kitchen or on my laptop the neck feels stiff and upper back hurts. Any stress be it a mental or a physical one causes flare up in my pain. I can't keep having medicines everyday. I just don't wake up good, it hurts. I feel its endless and pain has become a part of my life."

Do you also feel the same when your upper back hurts? That constant pain almost convinces you to live with it and suffering becomes part of your everyday life. Even when you try managing your pain you end up in frustration because either the pain doesn't change or the relief is very temporary.

Everyone is so keen on diagnosing the problem through investigations such as X-RAYs or MRI Scans showing the blind belief on something so incomplete. Most of the problems depicted by these tests are normal after a certain age and on the other side the results can be totally negative inspite of a bad pain you are complaining off.

Do we really know what is going wrong with the body?

Are we catering to the problem in the best way possible?

Do you really think the solution to the problem does not exist?

Wait!!! This blog may have answer to your problem. Well, we have to break down the problem by looking into the root cause of upper back and neck pain.

What ! what did I just say? ROOT CAUSE...

"Neck and head sits on rest of the spine"

The upper back behaves like a root of the tree for your neck. A healthy strong root is necessary for the tree to survive better. Also mechanically the 7 bones of the neck (Vertebraes C1-C7) moves along with upto 4 bones of your upper back (T1-T4). And they  further get support from rest of the spine.

Consider spine like a group of blocks piled up on top of each other and any misbehaviour by one block can affect the other at a different location. A physiotherapist trained in manual therapy can assess and treat such problems by techniques using hands or mobility drills and exercises or a combination of all.

Scary bones can't move alone

Bones never move on their own, they need muscles to move your scary skeleton. Muscles can get tight in response to pain or your inactive lifestyle which may limit the movement and can get weak leading to poor concious control in the spine. Bad movement around spine surely creates trouble because nerves originate from spine which carry sensation of pain.

Manipulating your tight  muscles to loosen up their grip on stiff spine or self myofascial releases  done at home or exercises specific to the problem or a combination of all can be really helpful in managing pain and restoring spine health.

Deep is the real sleep

Sleep like a child. Sleeping enough is almost like system reset for the brain and the body as it consumes one third of your life duration. When people do not sleep enough, the body cannot recover from the stress given on the previous day. Moreover, sleeping in wrong posture doesn't allow muscles to rest enough and you may get pain as soon as you wakeup. Some of you might have experienced early morning flare ups in upper back and neck pain.

Pillows are nice sleeping fellows

A good pillow support is necessary to make the muscles and joints well supported. Pillow must provide support under the neck more than your head. Pillows are always about hit and trial, so how high or low the pillow should be, is a matter of personal choice.

"Block in mind is a block in the body"

Stress affects far more strongly when you do not realize it is a problem in the first place. When the mind gets blocked with disturbing thoughts consciously or subconsciously, it affects your physical health and also how you perceive pain. 

A friend in need is a friend in deed. Truly said, sometimes you need to open up about your problems rather facing alone. You need someone who won't judge any wrong doing against you, by you or around you. This confidence in someone melts you down, you share and take a step towards solution. Trust me at times this is it, your pain dissolves mentally and physically both.

This is just one example of many sufferings the body goes through due to our changing lifestyle, reduced physical activities and gadgets. I think pain is far different from how it is being approached based only on investigations. A lot more things can be picked up and treated using good clinical skills.

This is not a medical advice but generic suggestion on how you can self educate to bring some change in your daily suffering. Kindly feel free to comment here or contact on the details below in case of any doubt or help required.

Dr. Kunal Vashist, PT

MPT (Ortho), Manual Therapy

Dry Needling Practitioner

Movement Specialist (USA)

Email: kvashist.physio@gmail.com

Contact No. 9968302757

Doctors are MIS-Treating the BACK PAIN....

YES !!! YOU READ IT CORRECTLY.

MIS treating the back pain here means using M- Medicines, I- Injections and S- Surgeries. Studies have shown that back pain is an outcome of poor physical activities, mental stress and sleep disorders. None of it needs medicine if the pain is not acute. Moreover in chronic stage injections and surgeries have almost failed to show promising results so far. 

Why medicine and surgery doesn't help in long term back pain? The answer lies in what causes a long term back pain or chronic back pain.

From last one Decade I have been raising my voice against managing LOW BACK PAIN through surgeries and injections. No! This doesn't mean they are not required but definitely not at a scale at which surgeons and hospitals are performing it. 

Yes surgeons do not immediately operate on every patient who complains back pain. But what you want them to do when every time you enter their office saying no relief and high suffering. Most people who undergo operations for back pain have not done enough but only tried  medication with no exercises or lifestyle change before opting for their surgeon's advice.

"BACKPAIN SURGERY IS NOT A SOLUTION BUT AN OPTION"

Long term back pains are non-specific (80%) in nature which means the pain is caused by tight muscles, stiff joints, lack of physical activities, Stressed life or Sleep difficulties. Some backpains are specific meaning they have a disease involved like Disc bulge, sciatica, spondylosis and spondylo-listhesis etc. There is a very thin line between non-specific and specific back pain because above 40 years of age it is very common to find damage in spine structures even if someone's back is pain free. In fact studies have shown, after 40 years of age chances of having one or more disc bulges increase with every decade of life with or without a back pain.

So for now it is sure that even if your investigations reveal a structural damage to your spine, your suffering may not be caused by it. A thorough clinical checkup designed to investigate your source of pain is necessary to confirm your diagnosis. Also your check up must involve your muscle flexibility testing, spine and peripheral mobility assement, strength and functional testing. A careful history taking to understand your basic life issues related to mental health, sleep troubles and much more is also needed. This definitely needs excellent clinical skills by your doctor rather than a hybrid XRAY / MRI Machine.

Backpains are funny as they scare the hell out of you giving you worse nightmares but still the reason can be very simple when checked thoroughly. Most back pains doesn't respond well or benefits temporarily with medication. The limited use of medication is only to control some inflammation and give you a good start in your recovery process.

The real nature of our spine is to be strong and functional at the same time. Pain restricts our movements and makes the unused muscles weak. Well this can be other way round also. Reduced physical activities and long hours of sitting (leisure or work related) can make spine weak and stiff resulting in pain.

A proper diagnosis not just based on investigation is required to select which patient needs injection or surgery. In my opinion all patients except emergency situations should work hard on regaining the spine mobility and strength. Rehabilitation or physiotherapy should focus on getting their functional recovery and putting them back to physical activites which they like. 

Reaching out to a physiotherapist can help as they can do a damage assesment as well as bio-mechanical assessment of your whole body including spine. At times we have issues in spine superimposed with stiffness and weakness around it. Physiotherapist will help you in pain education, exercises and way to increase physical activities which is backed by scientific evidence in today's world in dealing even with complex spine disorders.

What your spine doesn't like:

• Prolonged sitting hours
• Prolonged standing hours
• Less physical activities
• Lack of hydration
• Stiffness and poor mobility
• Wrong sitting or standing habits
• Stress in life
• Lack of sleep

What your spine likes:

• Active movements throughout the day
• Good range of motion
• Less physical and mental stress
• Goodnight sleep
• Strong and flexible muscles 
• Cardiovascular health to provide enough oxygen and blood flow

"In BACK PAIN - Our spine is more robust than our mind" - KUNAL VASHIST

In case of any further questions, Feel free to ask for any furhter information but do not use the blog as a medical reference. Your treating doctor knows the best about you compared to a write up which doesnt even know you.

Dr. Kunal Vashist, PT

MPT (Ortho), Manual Therapy

Dry Needling Practitioner

Movement Specialist (usa)

Contact Details:
998302757
kvashist.physio@gmail.com

3 Steps To Stronger You

Everyone likes being active and strong, however most of the people think that they do not have enough time to do anything about it. And I just wish if it is easy to be fit forever without making efforts for it.

When you are growing up the fitness comes from active/athletic childhood,your nutrition and even from your genes (Active parents produce active babies). By the time you reach 30 yrs of age, the body's natural ability to remain fit and strong becomes weak. From thereafter only nutrition and active lifestyle matters.

Strength is the force which you can produce while doing a certain task. You need muscles to produce that force. Muscles are made of protein and if your nutrition lacks it then even the exercise cannot help. The road to fitness comes from high protein diet and exercises. When you workout on muscles, the protein from the food gets synthesized and used up by muscles for their growth.

 Regarding Muscles it says :

 " If you Don't use it, You Loose It"

  BUT

When it comes to getting fit, Can the least be done to gain MAX?

Do you know it takes only few set of only 3 exercises to start your fitness journey?

These exercises can help you save time, grow muscles and burn calories.

I suggest choosing exercises which includes whole body where the resistance is your own body weight. The benefit is time efficient, equipment free and travel friendly workout anywhere anytime. Especially this is for the people who are always short of time and feels they need time friendly workout plan.

Assuming readers to be from different fitness levels, I will start exercises from very basic level

So, lets discuss these exercises, their basic preparation and variations to make it challenging at each level...

PLANKS - Builds your core muscles and learn to gain structural stability of the body.

Planks are good as they target abdominal muscles also as an alternative to the crunches. Compared to crunches they target larger group of muscles involving the whole body. They are safer for the SPINE whereas crunches may damage spinal discs. In fact, I came across few patients who got injured because they overdid crunches with poor techniques. From injury point of view and for gross health benefit I always recommend PLANKS over CRUNCHES.

PUSH-UPS - Helps upper body strength along with core stability

Push-ups is all time favorite and a very popular exercise. But technically they are like moving planks. A basic good planking capacity is required before you start push-ups otherwise it can cause you back pain. So improving on your plank becomes must before you attempt any push-ups on ground.

Most people have rounded shoulder while sitting causing chest muscles to become tight and upper back muscles to become weak. This result in weak scapular control and if push ups are done at this time it can create neck or shoulder pain. The strong scapular control can be trained and must be practiced before attempting to start Push-Ups.

Go for my PRE Push-Up regimen to make your muscles work rightly. Pre Pushup exercise is a memory building exercise for the muscles to be used during push-ups. Once you adapt to these movements it will be easy and safe to do pushups.

SQUATS - This is your entire lower body workout starting from calves, thighs, glutes and lower back. This can simply make you stronger with your legs and can make your daily activities like stair climbing, getting down and up from the floor easier. Before starting to perform free squats on the floor, people who are new to squats must do some basics to improve their form.

NO !! Your leg pain is not just SLIP DISC...

It won't be wrong if I quote that BACK PAIN is second most common condition after common cold which makes people suffer affecting their daily life. Every third person has faced atleast one episode of back pain in their life. Our SPINE encloses and protects spinal cord which carry information from brain to the body via nerves. Without such information the body cannot control, move or feel anything effectively making you senseless and motionless.

"Are you suffering from back pain? 

Or

Do you get a pain travelling down your one or both legs? 

Or

Is it difficult to walk few minutes or few steps without a back or leg pain? 

Or 

Do you know someone who is facing such a complaint?"

Read the article carefully to understand what is going wrong inside your body. Read it as you will get to know things beyond your doctor might have missed to share with you.

You may have a leg pain travelling down along with back pain or sometimes without any back pain. The reason for leg pain can be nerves compressed from the spine or even at your hip. Sometimes muscular pain mimics like a nerve pain in the leg which makes you and your doctor confused. The difference between leg pain due to nerve or muscles is that former causes sharp shooting or electric current like leg radiation whereas the latter creates a continuous dull achiness in the affected leg along with pain in the muscle involved.

If you have seen a human spine, it looks like a curvy snake formed by multiple bones called vertebrae arranged in a manner to give it "S SHAPE " when looked from side view. But from front or back view it looks like a straight vertical spine. Any deviation in these curves can put the spine structures under stress causing lot of muscle imbalances or vice a versa.

When your muscles doesn't support the spine symmetrically it can cause excessive stress between couple of vertebrae causing reduced space for the nerves exiting from the spine. Hence, leading to compressed nerves causing painful radiation in the leg. These imbalances can even create severe muscular spasm putting heavy pressure on your affected nerve and the result is your painful suffering again.

Interestingly, the above mentioned reasons can put the disc under pressure and making it appear like a bulge or on MRI Scan. This should be called as false or pseudo disc prolapse causing nerve irritation and leg pain. This type of bulging can disappear or improve once the pressure between vertebrae goes away.

   

I have come across patients who comes with a dull pain in the hip which also radiates down the leg but does not behave like sharp shooting pain. And the reason is not your spinal disc or nerve but a muscle around the hip known as GLUTES MEDIUS (the HIP Abductor) which may have a TRIGGER POINT - muscle knot causing nerve like pain which people often confuse with sciatica due to nerve compression. 

 A deep muscle of the hip known as PIRIFORMIS (the HIP Rotator) is placed right on top of your sciatic nerve and in some cases this nerve pierces from within the piriformis muscle. If this muscle becomes tight it can cause a similar nerve pain but thankfully then the reason is not your spine. This is more common in people who keep purse in their back pocket and also when people sit with scissored legs (Cross Leg Sitting).

A disc is a doughnut like structure with hard outer shell filled with jelly like material inside. Disc is found between the vertebrae of the spine adding shock absorbing effect. In case there is a sudden trauma or repetitive wrong movement pattern in daily life, the disc wall gets weakened and starts bulging mostly backwards and outwards. If the nerve gets compressed by this bulging disc as it is lying very close to it, you can get a sharp shooting pain radiating down the leg. This condition is popularly known as SLIP DISC OR SCIATICA. The people describe this feeling as painful electric spark travelling down the leg. Your bulging disc or slip disc cannot cause leg pain if it is not pressing on to a nerve.

Bulging discs are very common and not everyone who has a bulging disc go through pain. Infact, after 30 yrs of age, every 10 years increases the chance of finding one or more bulging discs with or without leg pain. So when disc bulge is so common then what is causing your leg pain. Careful examination can reveal whether your nerves are compressed due to muscular imbalance, a mis-alignment in the spine or a disc compression on your nerve.

This information is totally in contrast with MRI reports showing disc prolapse as the possible cause of your pain. Trusting the MRI reports without careful examination can misguide you towards unnecessary treatments not required for your stage of the disease.  If you are better informed then you can reduce your suffering by heading towards the effective treatment for your condition.

The information on this blog is helpful in creating awareness related to different problems which produces similar symptoms and often confuse against reaching better treatment approach. 

Please do not consider this blog as a medical advice and do visit your doctor or physiotherapist whenever you experience such symptoms.

Feel free to explore more information by commenting here anytime.

Regards,

Dr. Kunal Vashist,PT

MPT(Ortho), Manual Therapy

DryNeedling Practitioner

Email ID - kvashist.physio@gmail.com

Contact No. 9968302757

More Than Physio... Clinics                       

Shoulder Pain Is Beyond Arthritis, Tendonitis or Muscle Tear

(Do not blame the name, Understand the game)

Br J Sports Med bjsports-2016-096772 Published Online First: 2 November 2016 doi:10.1136/bjsports-2016-096772

Shoulder is a complex joint as it moves along with other structures. Shoulder can produce a powerful movement almost in every direction making it susceptible to numerous injuries. A lot has been said about diagnosing shoulder pain where the focus is too much on identifying the structural damage. Whereas when it comes to managing pain, it has been seen that the symptoms are produced by multiple factors including posture, mobility and muscular strength in and around shoulder joint.

A shoulder joint (Gleno-Humeral joint) is a ball and socket joint between humerus (arm bone) and scapula (triangular flat bone behind shoulder). The collar Bone (Clavicle) connects to scapula  through Acromio-Clavicular joint and chest bone (Sternum) via Sterno-Clavicular joint. A full shoulder Range of motion is a collective effort of all three joints along with good mobility from thoracic spine and ribs.

The muscles responsible for shoulder functions, like Pectorals, Trapezius,  Deltoid Rotator cuff, lattisimus dorsii etc. are not just limited to the above mentioned joints in shoulder complex but also to ribs and thoracic spine via different muscles. It even includes your core and pelvic stabilizers to form the basis of effective and dynamic movements of shoulder. Lower body strength and balance are equally contributing to generate proper force transmission through ground reaction force during a powerful movement from the shoulder.

If you look at the anatomy and function of shoulder region, the arm is almost hanging to the torso via scapula and various muscles enabling it to do large movements but keeping it also at risk of injuries. No matter if you are a high performance athlete or a sedentary person, a poor posture (static or dynamic) leads to loss of mobility in concerned areas and creates muscular imbalances around spine and shoulder joint.

The scapula (triangular flat bone) behind the upper back plays a crucial role in dynamic motion of the shoulder. During a shoulder movement, scapula stabilizes itself on ribs with some degree of movement to produce a strong dynamic movement of humerus (arm bone). The poor muscle control around scapula changes the movement pattern of humerus which leads to impingement of musculature passing from under the shoulder region.

Some various common diagnosis in shoulder pain are supraspinatus tendonitis, bursitis, labral tears, muscle tears, Painful Arc syndrome, shoulder impingement etc. Why we are so keen on naming these diagnosis? Now we already know that there must be multiple events which has gone biomechanically wrong to create the basis for an injury. The investigations such as MRI or CT scan always direct us towards the local structure which is injured but is not usually the source of pain. The injured structure is only one of the source which is creating trouble during the painful movement.

When there are so many events involved in a painful shoulder, it is not feasible to label it with one diagnosis. Rather we should physically assess for muscular imbalances and biomechanical changes which are the root cause of current injury. We should make a physical diagnosis rather than a diagnosis based on mere investigations. The physical diagnosis helps in planning and implicating conservative management mainly corrective exercises to restore the muscular imbalances. 

There is a very limited role of surgeries in managing shoulder pain considering the cost required and risk involved in shoulder repair. Saltychev M et al said there was moderate evidence that surgical treatment is not more effective than active exercises on reducing pain intensity caused by shoulder impingement.

Neck Pain - Three Things To Think Beyond MEDICINE

In the world of technology, the machines are becoming advanced and addictive up to a level that nearly 70% of your active daily time goes into it. Neck pain is as common as Low back Pain since both of them mainly originates from poor lifestyle and reduced physical activities. I see number of patients suffering from Bad Neck Pain and still keen on wanting an X-RAY or MRI scan because they really wants to see what has gone wrong with them. And the kind of reports which comes out after scans keeps them scared for life.

"So many studies have shown that Xray or MRI changes are normal after a certain stage of life even in people with NO PAIN"

Most people consider X-RAY or MRI Scan reports as their diagnosis further complicated by their doctors because they almost stamp the reports to be true. And you start believing in the terms like Cervical Spondylosis, Degeneration, Reduced disc space, loss of cervical curve etc.

What else can be done in 5 min checkup time with your doctor?

You can only prove me wrong if your doctor has examined you thoroughly and tried looking for reasons beyond what investigations are pointing towards. Remember, your reports always quote in the end " This is not a diagnosis, Please correlate clinically". A thorough checkup easily needs 30 min duration to carefully examine all possible reasons which may cause you pain. Identifying the source of pain is as important as your treatment so that you are not misguided towards ineffective solutions to your neck pain.

If you are wondering what else can cause you pain other than what your investigations had so far revealed, then read further down as this can be an eye-opener article for you.

My First question to you, if you have a NECK PAIN :

HOW bad you are with your sleep?

 

DO you feel stiff and painful with your neck in the morning?

 

DO you find your pain worse on the days when you do not sleep enough?

Your sleep quality is directly linked to pain and stiffness in the neck. Good sleep is almost like a restart to your body system ( including hardware- joints and muscles / software- mind and nervous system). Sleep helps recovering from all day stress which your body and mind has gone through. Minimum 7 hours sleep is the baseline for healthy sleeping time including minimum 2 hours of deep sleep.

My second question to you to observe carefully:

Does your pain aggravates from long hours of prolonged sitting at home or work? 

Do you think your bad posture is responsible for your pain?

Is your pain better on the days when you are active with less sitting?

From years doctors have blamed your poor posture for your neck pain. Blaming your bad posture is overrated as no one can sit in good posture for long as it requires enormous strength from the muscles to keep you upright nonstop.

If you do not move enough then even an upright sitting can trouble you equally.

"Your muscles need more blood to survive better"

Keeping yourself inactive for so long makes your muscles stressful and then it doesn't matter even if you try attaining a good posture. So it is not your posture which makes you suffer with strained NECK. Blame your long hours of sitting which reduces blood flow to the muscles and makes your joints feeling stiff.

My third and the last question you need to think about: 

Do you feel your mind gets stuck with thoughts making you worry constantly about random things?

Do you find increased neck pain on the days when your mind is overworked?

Does your neck pain has started giving you emotional response like crying, tensed, irritated etc?

Stress has started bugging our daily life and it has become almost epidemic. We all try to hide our disturbing thoughts and keep them alive in our mind. Generally we all are forgetting / hiding to share as we are scared of letting people know what we think. This huge collection of disturbing thoughts gives emotional response but also a physical response which we don't believe it can. Your neck pain can be an expression of stressful thoughts running in your mind (oh! sorry stuck in mind because running is still better).

If you have a bad disturbing neck pain even more so if it is chronic; you should consider the following factors which alone or in association of your diagnosis and treatment can help you recover better:

SLEEP, PHYSICAL ACTIVITIES AND STRESS

If you want to find more about your neck pain or looking for a solution to resolve your condition effectively, feel free to comment below or contact me on below mentioned details:

Regards,

Dr. Kunal Vashist, PT

MPT (ORTHO), Manual Therapy

Dry Needling Practitioner

Movement Specialist (USA)

Conservative Pain Management Specialist

Email id : kvashist.physio@gmail.com

Contact Number: 9968302757

More than physio... Clinics

Common Low Back Pain - Are You At RISK ?

"IGNORANCE MAKES YOU SUFFER"

While starting to write this topic on risk assessment for low back pain, today I simply searched on google the statistics related to low back pain. It was really shocking to read nearly 80% of population suffer from low back pain at least once in lifetime. You know what it means that leaving just one or two in our family, we all suffer from low back pain. 

Isn't it very disturbing that pain has become such a closest partner for us to live with? Something is seriously going wrong with our bodies. How can it be so fragile that all of us are not so comfortable and pain free to live with. Moreover it makes us less productive and creative as we can't think or move without pain. 

I have categorized different expressions given by your back under pain. If you know the level of severity then you can easily take decision on what action your back pain needs at that moment. Remember it is the ignorance which makes you suffer.

Self Limiting Back Pain

For most people low back pain starts with a dull ache or a tiring sensation around the lower back which comes with physical exertion and goes away with rest. Normally this is a hint by the body that you have done something beyond your body can handle. This kind of pain is usually self limiting and goes away in couple of days or when your exertion days are over.

Acute Back Pain

The issue comes when you keep ignoring this discomfort and the pain becomes stronger or acute which also last longer even with rest. But again just being conscious of basic do's and don'ts things can be managed by adding self management like rest,  ice or hot compress and activity modification. This is an alert by the body to kind of look into your daily routine and work on changing the lifestyle. Mainly look into your daily activities somewhere you might be abusing your body by over exertion or just being too sedentary. Get your nutrition sorted because you become what you eat. Have you been  sleeping enough? Or is it difficult get a good deep sleep?

If at all your discomfort or pain is not getting over in 2 weeks, there is a need to see your physician or physiotherapist who can do a basic examination and rule out anything major. 

Acute Back and Leg Pain (Yellow Alert)

Sometimes the back pain is very disabling and doesn't allow you to work or do any activity. It can also radiate a sharp pain in your leg usually in one leg upto the ankle. This is the time when you should definitely seek a specialist help like an orthopaedic doctor or a specialized physiotherapist. They can diagnose the problem and start your treatment soon. Usually, the leg pain is coming due to compression of a nerve root from the spine primarily on the right or the left side. The nerve can get pinched because of a Bulging Disc, a small bony growth (osteophytes), a stiff or locked vertebral movement or a bad muscular spasm etc. Here I would say follow your doctor's advice rather thinking to self manage as things can get worse if you ignore.

Back Pain Emergency (RED ALERT)

There are certain emergency situations in back pain. In case you feel a sudden numbness or weakness in your leg or gives you a feeling of "dead Leg" or you can't control passing of urine or stool; this is the time where you should rush to the hospital and get emergency checkup done. Our spinal cord and spinal nerves is the only connection between Brain and the Body which helps us regulating sensation and movement control. Without such connection the body can go in paralytic mode where you may loose any conscious control over your body movements.


Year Long (Chronic) Back Pain



I see many patients coming with year long back pain along with an MRI or X-RAY in their hands. They want me to see what their report says about them. And like always my answer is I want to see what your muscles and joints want to tell me regarding you. As with chronic back pain investigations can be MIS-LEADING where we might treat what is even not bothering in the first place. Most chronic back pain is coming from poor body functioning along with contribution from mental health, nutrition, level of physical activities and Tolerance.

Having a Low Back Pain is not always about a pathology, a spinal disease or an injury to the content of Low Back. It can just be a predictor of your general health, your physical activity status or your fitness. Low back pain is very vast when it comes to diagnosing a problem there ranging from Muscular Spasm, Disc Prolapse, Sciatica, Lumbar stenosis, Spondylosis, Spondylo-listhesis, Vertebrae Fractures, Infections and Tumors. Without making you too much scared the biggest relief is most of these issues are rare. But yes majority of back pains are just a poor physical or mental health.

Just keep in mind that if your back pain is associated with:

• fever and chills

• constant back pain not linked to your movements

• continuous pain especially at nights 

• sudden abnormal weight loss along with back pain

Please contact your general practitioner as not all back pains are just physical.

Carefully assessing the low back problems and their timely management can give full recovery. Let me just put certain evidence based facts which we know today about back pain:

• Recovery rate for a back pain case is as high as 99%.
• Investigations have a low value as most back pains are due to poor function where early X-RAY or MRI doesn't give much information to help the treatment.
• Your pain has no relation to how bad or good is your disease. Each one of us has different pain threshold. To some people needle feels like a sword while others can take lot of pain easily.
• 80 - 90 % of low back pain sufferers can get better with lifestyle modification, optimal physical activities and rehabilitation (Exercises).
• Your mental stress is a major contributor to your back pain especially in chronic back pain.
• Conservative treatment with Active Physiotherapy has to be the number one choice of treatment. 
• People who do not recover in due course of time may need Injections or Surgery as per their doctor's advice but there is no other choice but to EXERCISE.

This article is an effort to create awareness regarding back pain in general public. Always talk to your physiotherapist and seek specific advice as every condition is as unique as you.

Feel free to comment or contact in case you need more information on this topic. 

Regards,

Dr. Kunal vashist,PT

Mpt (Ortho), Manual Therapy 

Dryneedling practitioner

Email ID : kvashist.physio@gmail.com 

Contact no. 9968302757