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Low back pain

Lower Back Pain Symptoms, Diagnosis, and Treatment

Low back pain (LBP) is a common disorder involving the muscles, nerves, and bones of the back. Pain can vary from a dull constant ache to a sudden sharp feeling. Low back pain may be classified by duration as acute (pain lasting less than 6 weeks), sub-chronic (6 to 12 weeks), or chronic (more than 12 weeks). The condition may be further classified by the underlying cause as either mechanical, non-mechanical, or referred pain. The symptoms of low back pain usually improve within a few weeks from the time they start, with 40-90% of people completely better by six weeks.

In most episodes of low back pain, a specific underlying cause is not identified or even looked for, with the pain believed to be due to mechanical problems such as muscle or joint strain. If the pain does not go away with conservative treatment or if it is accompanied by “red flags” such as unexplained weight loss, fever, or significant problems with feeling or movement, further testing may be needed to look for a serious underlying problem. In most cases, imaging tools such as X-ray computed tomography are not useful and carry their own risks. Despite this, the use of imaging in low back pain has increased. Some low back pain is caused by damaged inter vertebral discs, and the straight leg raise test is useful to identify this cause. In those with chronic pain, the pain processing system may malfunction, causing large amounts of pain in response to non-serious events.

Symptoms

In the common presentation of acute low back pain, pain develops after movements that involve lifting, twisting, or forward-bending. The symptoms may start soon after the movements or upon waking up the following morning. The description of the symptoms may range from tenderness at a particular point to diffuse pain. It may or may not worsen with certain movements, such as raising a leg, or positions, such as sitting or standing. Pain radiating down the legs (known as sciatica) may be present. The first experience of acute low back pain is typically between the ages of 20 and 40. This is often a person’s first reason to see a medical professional as an adult. Recurrent episodes occur in more than half of people with the repeated episodes being generally more painful than the first.

Other problems may occur along with low back pain. Chronic low back pain is associated with sleep problems, including a greater amount of time needed to fall asleep, disturbances during sleep, a shorter duration of sleep, and less satisfaction with sleep. In addition, a majority of those with chronic low back pain show symptoms of depression or anxiety.

Causes

Low back pain is not a specific disease but rather a complaint that may be caused by a large number of underlying problems of varying levels of seriousness. The majority of LBP does not have a clear cause but is believed to be the result of non-serious muscle or skeletal issues such as sprains or strains. Obesity, smoking, weight gain during pregnancy, stress, poor physical condition, poor posture and poor sleeping position may also contribute to low back pain. A full list of possible causes includes many less common conditions. Physical causes may include osteoarthritis, degeneration of the discs between the vertebrae or a spinal disc herniation, broken vertebra(e) (such as from osteoporosis) or, rarely, an infection or tumor of the spine.

Women may have acute low back pain from medical conditions affecting the female reproductive system, including endometriosis, ovarian cysts, ovarian cancer, or uterine fibroids. Nearly half of all pregnant women report pain in the lower back or sacral area during pregnancy, due to changes in their posture and center of gravity causing muscle and ligament strain.

Low back pain can be broadly classified into four main categories:

  • Musculoskeletal – mechanical (including muscle strain, muscle spasm, or osteoarthritis); herniated nucleus pulposus, herniated disk; spinal stenosis; or compression fracture
  • Inflammatory – HLA-B27 associated arthritis including ankylosing spondylitis, reactive arthritis, psoriatic arthritis, and inflammatory bowel disease
  • Malignancy – bone metastasis from lung, breast, prostate, thyroid, among others
  • Infectious – osteomyelitis; abscess

Treatment

Which Ayurvedic Therapies Are Commonly Used For Back Pain Relief?

Abhyangam: A full body massage (Head to Toe) done with Ayurvedic oils. It relieves pains and aches in the joints by lubricating the same, improves blood circulation and channelizes nerve ending.

Kati Basti: In Kati Basti, specially prepared warm herbal oil is poured over the lower back and retained inside a well created using black gram paste or whole wheat flour. It is helpful in lower back conditions like lumbar spondylosis, inter-vertebral disc prolepses, lumbago (a low backache), and sciatica.

Pizhichil: Pizhichil is the squeezing of warm medicated oil onto the body of the patient from a piece of cloth that is periodically soaked in a vessel containing the medicated oil. Pizhichil literally means squeezing. It helps improve muscle tone and strengthen them thereby providing the much-needed support.

Kizhi: Kizhi uses powders, herbs, rice, and tied in a muslin cloth to make small satchels. These powders, herbs, rice or sand sacks are then heated and lightly pounded over the body or specific parts of the body as needed. This massage provides dry heat for aggravated Vata and Vata Kapha conditions. The heat generated in Kizhi helps to pacify the aggravated vata thus relieving the associated pain immediately

Sneha Basti: Sneha Basti involves enema using medicated oil. It is used to treat lower backache, gout and rheumatism.

Kashaya Basti: Kashaya Basti involves enema using medicated decoction. It is used to treat lower backache, gout and rheumatism.
Get effective and safe Ayurvedic Treatment for low back pain

Prevention

Exercise appears to be useful for preventing low back pain. Exercise is also probably effective in preventing recurrences in those with pain that has lasted more than six weeks. Medium-firm mattresses are more beneficial for chronic pain than firm mattresses. There is little to no evidence that back belts are any more helpful in preventing low back pain than education about proper lifting techniques. Shoe insoles do not help prevent low back pain