Hello sir/ma'am, when the pandemic began, I started doing home workout and weight lifting. After few months I felt back pain, I immediately stop exercising but back pain did not vanished even after several treatment. Initially I visited government hospital, and then private orthopaedic clinics as well. All of them suggested me to avoid exercise and told me some physiotherapy exercises to do. Since then regularly or irregularly I have been doing exercises, but I could not get full relief from back pain. Once I stopped exercising back pain comes back. I recently started jogging and again experienced the same back pain. I am stuck in this loop. I don't know what to do and who to refer? Kindly give me suggestion for better approach. Thank you.

Dr. Julie Mercy J DavidPhysiotherapist24yrs exp

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Hi first of all if you have back pain the most important thing would be subside the immediately with the help of ice packs or by doing hot water fermentation. This is mandatory and this is the first and foremost thing you need to do. However exercises and physiotherapy exercises there is no big difference. The only difference is in general exercises you will concentrate more on fitness and you may not prevent moving rigorously your back. But in physiotherapy exercises for the back pain we initially concentrate only on the abdomen strengthening exercises and slowly we will teach you the spinal strengthening exercises which is mandatory. If you want we can help you to learn this from our end by doing a video call. Let us know. And also the general literature I am sharing here for you to have better understanding. However you can go for regular exercises but please avoid jogging and running as your back bone ie. The lower end of the lumbar vertebrae and the sacral vertebrae is inflamed and you need to give rest to that area by applying ice packs, doing hot water fermentation and also by wearing lumbo sacral corset. If you want that we can provide you the same as it definitely helps you to strengthen the abdominal muscles and also the abdominal muscle tone. Back pain / sciatica: back pain can affect people of any age, for different reasonsas people get older, the chance of developing lower back pain increases, due to factors such as previous occupation and degenerative disk disease. Lower back pain may be linked to the bony lumbar spine, discs between the vertebrae, ligaments around the spine and discs, spinal cord and nerves, lower back muscles, abdominal and pelvic internal organs, and the skin around the lumbar area. ?acute pain starts suddenly and lasts for up to 6 weeks. ?chronic or long-term pain develops over a longer period, lasts for over 3 months, and causes ongoing problems. Home advise: ?resting from strenuous activity can help, but moving around will ease stiffness, reduce pain, and prevent muscles from weakening. ?applying heat, ice, ultrasound, and electrical stimulation ? as well as some muscle-release techniques to the back muscles and soft tissues ? may help alleviate pain. ?as the pain improves, the physical therapist may introduce some flexibility and strength exercises for the back and abdominal muscles. Techniques for improving posture may also help. ?the patient will be encouraged to practice the techniques regularly, even after the pain has gone, to prevent back pain recurrence. Regular exercise helps build strength and control body weight. Guided, low-impact aerobic activities can boost heart health without straining or jerking the back. Before starting any exercise program, talk to a health care professional. There are two main types of exercise that people can do to reduce the risk of back pain: ?core-strengthening exercises work the abdominal and back muscles, helping to strengthen muscles that protect the back. ?flexibility training aims at improving core flexibility, including the spine, hips, and upper legs. We suggest you to wear lumbosacral corset (belt) which is available at our clinic. If you want you can buy from us, if you are far away from chennai we can send you by courier. The reason why we are conveying you to buy from us is we can demonstrate over the videocall (using whatsapp) and also we can monitor you throughout when to wear it and how long to wear it. And also if you find any difficulty wearing the brace you can also revert back to us for few more suggestions and we can propose you good solution how to go about it. Uses of lumbosacral corset (belt) a lumbosacral corset adds pressure to the intra-abdominal area. This adds stability to the spine. It is prescribed to people suffering from moderate to severe pain. Other benefits of using a lumbar spine belt are: 1.helps in a certain degree of immobilization of facet joints. 2.reduces pain to allow continuation of normal activities. 3.speeds up the healing process. 4.the pressure exerted by a lumbar spine belt helps in stretching the erector spine muscles. 5.this belt can also be used to support the lower back while exercising. Ohelps prevent rolling oprovides stability to lumbar and sacral regions of the back ocan be used when performing actions like lifting and handling heavy items ocan also be used when playing sports orestricts back movement to aid treatment of back problems do?s and don?ts sitting do: ? sit as little as possible and then only for short periods. ? place a supportive towel roll at the belt line of the back especially when sitting in a car. ? when getting up from sitting, keep the normal curves in your back. Move to the front of the seat and stand up by straightening your legs. Avoid bending forward at the waist. ? try to keep the normal curves in your back at all times. Don?t: ? do not sit on a low soft couch with a deep seat. It will force you to sit with your hips lower than your knees and will round your back. You will loose the normal curve in your back. ? do not place your legs straight out in front of you while sitting (e.g. Sitting in the bath tub). Standing do: ? if you must stand for a long period of time, keep one leg up on a foot stool. ? adapt work heights. Don?t: ? avoid half bent positions. Lifting avoid lifting if you can. Do: ? use the correct lifting technique. Keep your back straight when lifting. Never stoop or bend forward. Stand close to the load, have a firm footing and wide stance. Kneel on one knee, keeping the back straight. Have a secure grip on the load and lift by straightening your knees. Do a steady lift. Shift your feet to turn and do not twist your back. Don?t: ? do not jerk when you lift. ? do not bend over the object you are lifting. Lying do: ? sleep on a good firm surface. ? if your bed sags, use slats or plywood supports between the mattress and base to firm it. You also can place the mattress on the floor, a simple but temporary solution. ? you may be more comfortable at night when you use a pillow for support. Don?t: ? do not sleep on your stomach unless advised to do so by your doctor or physical therapist. Bending forward do: ? keep the natural curves of your back when doing these and other activities: making a bed, vacuuming, sweeping or mopping the floor, weeding the garden or raking leaves. Coughing and sneezing do: ? bend backwards to increase the curve of your back while you cough or sneeze. Driving a car do: ? drive the car as little as possible. It is better to be a passenger than to drive yourself. ? move the seat forward to the steering wheel. Your seat must be close enough to the wheel to keep the natural curves of your back. If your hips are lower than your knees in this position, raise yourself by sitting on a pillow. Exercises for low back pain safety guidelines ? an increase in your low back pain can be expected with these exercises. This is acceptable as long as your leg symptoms are not increasing. ? if while doing these exercises, your pain worsens or you have new pain or symptoms, stop the exercises and discuss your symptoms with your doctor or physical therapist. ? stop exercising and let your doctor or physical therapist know right away if you have any change in your bowel or bladder control or any increase in weakness in your leg or foot. Exercises ? ?press-ups: keep your back and buttocks relaxed and use your arms to press up. Concentrate on keeping your hips down and push up your upper body as high as possible. ?double knee to chest: grasp both your knees with your hands and pull toward your shoulders. Hold the stretch for 1 second. Let your knees return, but keep them bent at arms length. ? ?lumbar spine stretches: lie on your back. Bring your knees towards your chest. Rotate your knees towards the pain. ?side-lying position: lie on your side and face forward. Have both arms straight in front and bend your knees. Turn your head as you move your top arm across your body as far as you can. Keep your arm in place and turn your head back to the starting position. Look back again and turn your head farther if you can. Bring your head and arm back to the starting position. Relax and repeat 10 times on each side. ?hamstring stretch: lie on your back with your legs out straight. Raise your leg up and put your hands around the upper leg for support. Slowly straighten the raised knee until you feel a stretch in the back of the upper leg. Hold, then relax and repeat 10 times on each leg. ?standing arch: stand with your feet apart and hands on the small of your back with fingers pointing backwards. Bend backwards at the waist, supporting the trunk with your hands. Keep your knees straight. Hold for 5 seconds. Repeat 3 to 5 times. Side glides: stand at a right angle to the wall about 2 feet o eliminate your pain? improve your muscular endurance and strength? attain better posture, balance, body awareness and co-ordination? improve your balance and flexibility? learn to lift properly.? posture when standing: make sure you have a neutral pelvic position. Stand upright, head facing forward, back straight, and balance your weight evenly on both feet. Keep your legs straight and your head in line with your spine. Posture when sitting: a good seat for working should have good back support, arm rests and a swivel base. When sitting, try to keep your knees and hips level and keep your feet flat on the floor, or use a footstool. You should ideally be able to sit upright with support in the small of your back. If you are using a keyboard, make sure your elbows are at right-angles and that your forearms are horizontal. Shoes: flat shoes place less of a strain on the back. Driving: it is important to have proper support for your back. Make sure the wing mirrors are properly positioned so you do not need to twist. The pedals should be squarely in front of your feet. If you are on a long journey, have plenty of breaks. Get out of the car and walk around. Bed: you should have a mattress that keeps your spine straight, while at the same time supporting the weight of your shoulders and buttocks. Use a pillow, but not one that forces your neck into a steep angle. Posture supportspoor sitting posture is a common cause of sciatica. To assist the support of your lower back many simple and effective products have been developed over time. These include: ?lumbar d-roll ?bassett frame ?kinesiology lumbar tape please ask your physiotherapist for their advice in what will help you most. Exercise sciatic nerve pain 1. Reclining pigeon posepigeon pose is a common yoga pose. It works to open the hips. There are multiple versions of this stretch. The first is a starting version known as the reclining pigeon pose. If you are just starting your treatment, you should try the reclining pose first. 1.While on your back, bring your right leg up to a right angle. Clasp both hands behind the thigh, locking your fingers. 2.Lift your left leg and place your right on top of the left knee. 3.Hold the position for a moment. This helps stretch the tiny piriformis muscle, which sometimes becomes inflamed and presses against the sciatic nerve, causing pain. 4.Do the same exercise with the other leg. Once you can do the reclining version without pain, work with your physical therapist on the sitting and forward versions of pigeon pose. 2. Sitting pigeon pose 1.Sit on the floor with your legs stretched out straight in front of you. 2.Bend your right leg, putting your right ankle on top of the left knee. 3.Lean forward and allow your upper body to reach toward your thigh. 4.Hold for 15 to 30 seconds. This stretches the glutes and lower back. 5.Repeat on the other side. 3. Forward pigeon pose 1.Kneel on the floor on all fours. 2.Pick up your right leg and move it forward on the ground in front of your body. Your lower leg should be on the ground, horizontal to the body. Your right foot should be in front of your right knee while your right knee stays to the right. 3.Stretch the left leg out all the way behind you on the floor, with the top of the foot on the ground and toes pointing back. 4.Shift your body weight gradually from your arms to your legs so that your legs are supporting your weight. Sit up straight with your hands on either side of your legs. 5.Take a deep breath. While exhaling, lean your upper body forward over your front leg. Support your weight with your arms as much as possible. 6.Repeat on the other side. 7.4. Knee to opposite shoulder this simple stretch helps relieve sciatica pain by loosening your gluteal and piriformis muscles, which can become inflamed and press against the sciatic nerve. 1.Lie on your back with your legs extended and your feet flexed upward. 2.Bend your right leg and clasp your hands around the knee. 3.Gently pull your right leg ac 4.5.6.7.Ross your body toward your left shoulder. Hold it there for 30 seconds. Remember to pull your knee only as far as it will comfortably go. You should feel a relieving stretch in your muscle, not pain. 8.Push your knee so your leg returns to its starting position. 9.Repeat for a total of 3 reps, and then switch legs. 5.sitting spinal stretch sciatica pain is triggered when vertebrae in the spine compress. This stretch helps create space in the spine to relieve pressure on the sciatic nerve. 1.Sit on the ground with your legs extended straight out with your feet flexed upward. 2.Bend your right knee and place your foot flat on the floor on the outside of your opposite knee. 3.Place your left elbow on the outside of your right knee to help you gently turn your body toward the right. 4.Hold for 30 seconds and repeat three times, then switch sides. 6. Standing hamstring stretch this stretch can help ease pain and tightness in the hamstring caused by sciatica. 1.Place your right foot on an elevated surface at or below your hip level. This could be a chair, ottoman, or step on a staircase. Flex your foot so your toes and leg are straight. If your knee tends to hyperextend, keep a slight bend in it. 2.Bend your body forward slightly toward your foot. The further you go, the deeper the stretch. Do not push so far that you feel pain. 3.Release the hip of your raised leg downward as opposed to lifting it up. If you need help easing your hip down, loop a yoga strap or long exercise band over your right thigh and under your left foot. 4.Hold for at least 30 seconds, and then repeat on the other sideif you have low back pain and sciatica you can undergo intermittent pelvic traction where in your half of your body weight will be added in the electronic traction so that that would help you to reduce the pain, along with interferential therapy stimulations which would help you to get relieved from the radiating pain. Apply ice for the pain to get subsided immediately. If you cannot go immediately for the physiotherapy treatment. Ice can be kept in the low back where you have back pain. It is suggestible to wear lumbo sacral belt which would help you to build the abdominal muscle tone which itself would make you feel better. You can also wear mcr chappals which would help you to have less weight falling in the painful back. U have to take vitamin d rich foods. Likemilk,cheese, yogurt,brocoli, spinach.u need calcium consumption for increase the bone density. Lackof bone and bones crush inside the body this might be due to low calcium or vitamin d which has more impact on the bone density and also it makes one to feel that there is lack of bone strength or in a way the bones are brittle and almost breaking and they feel it is crushed in a way there are many bones breaking at the same time. You have to take vitamin d rich foods. Likemilk,cheese, yogurt, brocoli, spinach.u need calcium consumption for increase the bone density. ?vitamin d intake via supplements or exposure to low levels of sunlight. Vitamin d is used to absorb calcium in the bone and regulate calcium in the blood.  

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