Rehabilitation Medicine

Overview :Rehabilitation Medicine                          
Back pain has many possible causes. It is often related to problems with muscles and ligaments of the back. It may also be related to problems with the nerves, discs, or bones of the back. Moving, lifting, standing, sitting, or sleeping in an awkward way can strain the back. Sometimes you don’t notice the injury until later. Arthritis is another common cause of back pain.
Although it may hurt a lot, back pain usually improves on its own within several weeks. Most people recover in 12 weeks or less. Using good home treatment and being careful not to stress your back can help you feel better sooner.

What causes back pain?
Back pain is often caused by overuse, strain, or injury. For example, people often hurt their backs playing sports or working in the yard, being jolted in a car accident, or lifting something too heavy.
Aging plays a part too. Your bones and muscles tend to lose strength as you age, which makes injury more likely. The spongy discs between the bones of the spine (vertebrae) may suffer from wear and tear and no longer provide enough cushion between the bones. A disc that bulges or breaks open (herniated disc) can press on nerves, causing back pain.
In some people, back pain is the result of arthritis, broken vertebrae caused by bone loss (osteoporosis), illness, or a spine problem.
Although most people have back pain at one time or another, there are steps you can take to make it less likely.

How can you have a healthy back?
Reduce stress on your back through good posture
Slumping or slouching alone may not cause low back pain. But after the back has been strained or injured, bad posture can make pain worse.
•Sleep in a position that maintains your back’s normal curves and on a mattress that feels comfortable. Sleep on your side with a pillow between your knees, or sleep on your back with a pillow under your knees. These positions can reduce strain on your back.
•Stand and sit up straight. “Good posture” generally means your ears, shoulders, and hips are in a straight line.
•If you must stand for a long time, put one foot on a stool, ledge, or box. Switch feet every now and then.
•Sit in a chair that is low enough to let you place both feet flat on the floor with both knees nearly level with your hips. If your chair or desk is too high, use a footrest to raise your knees. Place a small pillow, a rolled-up towel, or a lumbar roll in the curve of your back if you need extra support.
•Try a kneeling chair, which helps tilt your hips forward. This takes pressure off your lower back.
•Try sitting on an exercise ball. It can rock from side to side, which helps keep your back loose.
•When driving, keep your knees nearly level with your hips. Sit straight, and drive with both hands on the steering wheel. Your arms should be in a slightly bent position.
Reduce stress on your back through careful lifting
•Squat down, bending at the hips and knees only. If you need to, put one knee to the floor and extend your other knee in front of you, bent at a right angle (half kneeling).
•Press your chest straight forward. This helps keep your upper back straight while keeping a slight arch in your low back.
•Hold the load as close to your body as possible, at the level of your belly button (navel).
•Use your feet to change direction, taking small steps.
•Lead with your hips as you change direction. Keep your shoulders in line with your hips as you move.
•Set down your load carefully, squatting with your knees and hips only.
Exercise and stretch your back
•Do some exercise on most days of the week, if your doctor says it is okay. You can walk, run, swim, or cycle.
•Stretch your back muscles. Here are a few exercises to try:
  Lie on your back, and gently pull one bent knee to your chest. Put that foot back on the floor, and then pull the other knee to your chest.
  Do pelvic tilts. Lie on your back with your knees bent. Tighten your stomach muscles. Pull your belly button (navel) in and up toward your ribs. You should feel like your back is pressing to the floor and your hips and pelvis are slightly lifting off the floor. Hold for 6 seconds while breathing smoothly.
  Sit with your back flat against a wall.
•Keep your core muscles strong. The muscles of your back, belly (abdomen), and buttocks support your spine.
  Pull in your belly and imagine pulling your navel toward your spine. Hold this for 6 seconds, then relax. Remember to keep breathing normally as you tense your muscles.
  Do curl-ups. Always do them with your knees bent. Keep your low back on the floor, and curl your shoulders toward your knees using a smooth, slow motion. Keep your arms folded across your chest. If this bothers your neck, try putting your hands behind your neck (not your head), with your elbows spread apart.
  Lie on your back with your knees bent and your feet flat on the floor. Tighten your belly muscles, and then push with your feet and raise your buttocks up a few inches. Hold this position 6 seconds as you continue to breathe normally, then lower yourself slowly to the floor. Repeat 8 to 12 times.
  If you like group exercise, try Pilates or yoga. These classes have poses that strengthen the core muscles.
Lead a healthy lifestyle
•Stay at a healthy weight to avoid strain on your back.
•Do not smoke. Smoking increases the risk of osteoporosis, which weakens the spine. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.

How can you care for back pain?
•Sit or lie in positions that are most comfortable and reduce your pain. Try one of these positions when you lie down:
  Lie on your back with your knees bent and supported by large pillows.
  Lie on the floor with your legs on the seat of a sofa or chair.
  Lie on your side with your knees and hips bent and a pillow between your legs.
  Lie on your stomach if it does not make pain worse.
•Do not sit up in bed, and avoid soft couches and twisted positions. Bed rest can help relieve pain at first, but it delays healing. Avoid bed rest after the first day of back pain.
•Change positions every 30 minutes. If you must sit for long periods of time, take breaks from sitting. Get up and walk around, or lie in a comfortable position.
•Try using a heating pad on a low or medium setting for 15 to 20 minutes every 2 or 3 hours. Try a warm shower in place of one session with the heating pad.
•You can also try an ice pack for 10 to 15 minutes every 2 to 3 hours. Put a thin cloth between the ice pack and your skin.
•Take pain medicines exactly as directed.
  If the doctor gave you a prescription medicine for pain, take it as prescribed.
  If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
•Take short walks several times a day. You can start with 5 to 10 minutes, 3 or 4 times a day, and work up to longer walks. Walk on level surfaces and avoid hills and stairs until your back is better.
•Return to work and other activities as soon as you can. Continued rest without activity is usually not good for your back.
•To prevent future back pain, do exercises to stretch and strengthen your back and stomach. Learn how to use good posture, safe lifting techniques, and proper body mechanics.