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Title: Strengthening Low Back Pain Exercise Yoga improves Range of


1
Strengthening Low Back PainExercise
  • Yoga improves
  • Range of Motion, Mobility, Strength
  • results in pain reduction
  • As well as gives
  • ease to sore stiff muscles

2
Pathophysiology of back pain
  • Pathology, broadly speaking, is the "study of the
    nature and cause of disease or the results of
    disease in the body.
  • Physiology is the study of normal, healthy bodily
    function (as opposed to anatomy, which is the
    study of normal structure).
  • When something disrupts normal physiological
    processes, it enters the realm of
    pathophysiology.
  • Pathophysiology looks at the detailed
    malfunctioning that comes from or - alternately -
    causes disease.

3
Anatomy of Lower spinal
  • The important parts of the lumbar spine include
  • bones and joints
  • nerves
  • connective tissues
  • muscles
  • spinal segments
  • Bones and Joints
  • The human spine is made up of 24 spinal bones,
    called vertebrae. Vertebrae are stacked on top of
    one another to form the spinal column.
  • The spinal column is the body's main upright
    support.
  • The lumbar spine is made up of the lower five
    vertebrae. These vertebrae referred as L1 to L5.
  • The lowest vertebra of the lumbar spine, L5,
    connects to the top of the sacrum, a triangular
    bone at the base of the spine that fits between
    the two pelvic bones.

4
Anatomy of lower back
  • Each vertebra is formed by a round block bone,
    called a vertebral body
  • A bony ring attaches to the back of each
    vertebral body. This ring has two parts.
  • Two pedicle bones connect directly to the back of
    the vertebral body.
  • Two lamina bones join the pedicles to complete
    the ring.
  • The lamina bones form the outer rim of the bony
    ring. When the vertebrae are stacked on top of
    each other, the bony rings form a hollow tube
    that surrounds the spinal cord and nerves.
  • The laminae provide a protective roof over these
    nerve tissues.

5
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6
Anatomy of Lower back
  • The facet joints are located on the back of the
    spinal column. There are two facet joints between
    each pair of vertebrae, one on each side of the
    spine.
  • A facet joint is made of small, bony knobs that
    line up along the back of the spine. Where these
    knobs meet, they form a joint that connects the
    two vertebrae. The alignment of the facet joints
    of the lumbar spine allows freedom of movement as
    you bend forward and back.
  • The surfaces of the facet joints are covered by
    articular cartilage.
  • Articular cartilage is a smooth, rubbery material
    that covers the ends of most joints. It allows
    the ends of bones to move against each other
    smoothly, without friction.
  • On the left and right side of each vertebra is a
    small tunnel called a neural foramen. (Foramina
    is the plural term.)
  • The two nerves that leave the spine at each
    vertebra go through the foramina, one on the left
    and one on the right
  • A facet joint sits in back of the foramen
  • The intervertebral disc (described later) sits
    directly in front of the opening.

7
Low back pain
  • There are many causes of pain in the back.
    Symptoms in the low back can be a result of
    problems in
  • Bony lumbar spine,
  • Discs between the vertebrae,
  • ligaments around the spine and discs,
  • spinal cord and nerves,
  • muscles of the low back,
  • internal organs of the pelvis and abdomen,
  • and the skin covering the lumbar area.
  • Bone spurs that form on the facet joint can
    project into the tunnel, narrowing the hole and
    pinching the nerve

8
Cause of Back pain
  • Ruptured DiscA ruptured intervertebral disc,
    also called a herniated disc, is another common
    cause of back pain. How to treat the back pain
    from a herniated disc depends on the particular
    individual and situation.
  • Discogenic Back PainDiscogenic back pain is the
    result of damage to the intervertabral disc, but
    without disc herniation. Diagnosis of discogenic
    back pain may require the use of a discogram.
  • A bulged or herniated disc can narrow the opening
    and put pressure on the nerve

9
Cause of Back pain
  • Lumbar Muscle StrainMuscle strains are the most
    common cause of low back pain. Patients may or
    may not remember the initial event that triggered
    their muscle spasm, but the good news is that
    most episodes of back pain from muscle strains
    resolve completely within a few weeks

10
Cause of Back pain
  • Spinal StenosisAs we age, the spinal canal can
    become constricted, due in part to arthritis and
    other conditions. If the spinal canal becomes too
    tight, back pain can be the result.
  • Lumbar Spine ArthritisArthritis most commonly
    affects joints such as the knees and fingers.
    However, arthritis can affect any joint in the
    body, including the small joints of the spine.
    Arthritis of the spine can cause back pain with
    movement.

11
Cause of Back pain
  • OsteoporosisOsteoporosis can cause a number of
    orthopedic problems and generalized discomfort.
    Back pain from osteoporosis is most commonly
    related to compression fractures of the vertebra.
    Osteoporosis causes weak bones and can lead to
    these fractures.
  • SpondylolisthesisSpondylolisthesis causes back
    pain because adjacent vertebra become unstable
    and begin to "slip." The most common cause of
    spondylolisthesis is due to degenerative changes
    causing loss of the normal stabilizing structures
    of the spinal column. If the spine becomes
    unstable enough, back pain can become a problem.

12
Sign Symptoms
  • Have significant back pain lasting more than 3
    weeks
  • Have back pain that becomes worse when you rest,
    or wakes you up at night
  • Get numbness or weakness in legs while walking
  • Low back pain extended down to leg
  • Leg pain increase if you lift knee to your chest
    or bend over
  • If so, there is a good chance a disc is
    irritating a nerve.
  • Have persistent bladder or bowel problems

13
Back Pain Treatment
  • Do not alleviate back pain
  • Avoid strain to the spine
  • Often help from ice and heat theraphy
  • Physical Therapy Back exercises, aquatherapy,
    ultrasound, electrical stimulation.
  • Epidural Steroid Injections
  • Anti-inflammatory medications
  • Muscle Relaxers
  • Spine Surgery

14
Safety Yoga
  • Yoga is for fun
  • Listen to your body
  • Feel freedom, Feel Relax
  • Do not hurt yourself
  • Keep breathing
  • Tune in relax rhythm of breathing
  • Yoga is not just posture
  • It is more than posture- Steady breathing
    steady mind
  • Throw all negative feelings and stress

15
Safety Yoga
  • Always warm up before Yoga
  • Yoga should not cause pain, mild discomfort is
    acceptable.
  • Never bounce or havr jerky motion
  • Never lock joints arm/leg while doing yoga
  • Do not compete
  • Happy thought, smiley face, thus relax your body
    and cortex
  • Do each stretch 3 to 5 times
  • Hold stretch for 5 to 30 seconds

16
Yoga remedies Three sessions
  • Perform Yoga exercise in sequence
  • Warming up
  • Yoga for back pain
  • Relaxation
  • Do no compromise with Warming up and Relaxation
    due to lack of time
  • Cut down on number of yoga postures
  • Do not cut down on time of yoga posture
  • Progress gradually in your Yoga exercise

17
Warming up
  • Side Bending
  • Backward Bending
  • Forward Bending
  • Pectorals Stretch
  • Trapezoids stretch
  • Neck stretch
  • Arms and Legs

18
Warming up
  • Leg Exercise
  • Hips Exercise
  • Lower back Twist
  • Back twist

19
Warming up
  • Pelvic Tilt
  • Starting Position Lie on your back on a table or
    firm surface. Your feet are flat on the surface
    and the knees are bent.Action Push the small of
    your back into the floor by pulling the lower
    abdominal muscles up and in. Hold your back flat
    while breathing easily in and out. Hold for five
    seconds. Do not hold breath.
  • Pelvic Lift
  • Starting Position Lie on your back on a table or
    flat surface. Your feet are flat on the surface
    and your knees are bent. Keep your legs together
    Cross your arms over your chest.Action Tilt
    your pelvis and push your low back to the floor
    as in the previous exercise, then slowly lift
    your buttocks off the floor as far as possible
    without straining. Maintain this position for 5
    seconds. Lower your buttocks to the floor Do not
    hold breath.

20
Yoga Remedies
  • Bellow posture (Knee to Chest )
  • Starting Position Lie on your back on a table or
    firm surface.Action Clasp your hands behind the
    thigh and pull it towards your chest. Keep the
    opposite leg flat on the surface of the table
    Maintain the position for 30 seconds. Switch legs
    and repeat.
  • Bellow posture (Knee to Chest ) followed by leg
    Raised up.
  • Lie on firm surface. Knees bent and feet flat on
    the table. Flatten your back to the floor by
    pulling your abdominal muscles up and in.Action
  • Bring one knee toward your chest. Hold this
    position
  • Raise your leg keeping your knee straight. Hold
    for ____ seconds. Slowly lower the leg to the
    floor. Repeat on the opposite leg.

21
Yoga Remedies
  • Hip Rolling (8 variation)
  • Starting Position Lie on your back on a table or
    firm surface. Both knees bent, feet flat on the
    table.Action Cross your arms over your chest.
    Turn your head (trunk) to the right as you turn
    both knees to the left. Allow your knees to relax
    and go down without forcing. Bring knees back up,
    head to center. reverse directions.

22
Yoga Remedies
  • Boat posture (3 variation)
  • Starting Position Lie on your back on a table or
    flat surface. Your feet are flat on the surface
    and your knees are bent. Maintain your pelvic
    tilt for the curl up exercises.Action
  • Slowly reach your arms in front of you as much as
    possible, curling your trunk. Slowly keep the
    neck muscles relaxed. Breathe normally. Slowly
    return to the starting position. Do Not Cause
    Pain.
  • Fold your arms on your chest. Tuck your chin to
    your chest and slowly reach your elbows to your
    knees, curling your trunk. Keep neck muscles
    relaxed and breathe normally Return to the
    starting position.
  • With your hands behind your head, slowly curl
    your head to your chest and then your trunk.
    Relax, breathe and then slowly return to the
    starting position.

23
Yoga Remedies
  • Child pose Cobra pose
  • TV pose
  • Baby cobra
  • Full cobra
  • Locust
  • Plank
  • Dog and Cat
  • Threading needle
  • Tail wagging Neck wagging
  • Balancing box

24
Relaxation
  • Bhamri (Buzzing bee) pranayam
  • Relaxation

25
Diet recommendation
  • Eat fresh cooked food
  • Hot herbal (ginger) tea with Honey
  • Sleep before mid night
  • Avoid
  • Cold foods
  • White sugar sweet
  • Cooling fruits like banana, mango.

26
Life style and other tools
  • Sun bathe technique
  • Message with sesame oil
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