Back pain. Back pain is second only to common cold in the ailments patients most frequently see their doctor for.

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1 Back pain Back pain (also known as dorsalgia) is pain felt in the back that usually originates from the muscles, nerves, bones joints or other structures in the spine. The pain can often be divided into neck pain, upper back pain, lower back pain or tailbone pain. It may have a sudden onset or can be a chronic pain, it can be constant or intermittent, stay in one place or radiate to other areas. It may be a dull ache, or a sharp or piercing or burning sensation. The pain may radiate into the arm and hand), in the upper back, or in the low back, (and might radiate into the leg or foot), and may include symptoms other than pain, such as weakness, numbness or tingling. Back pain is one of humanity s most frequent complaints. About nine out of ten adults experience back pain at some point in their life, and five out of ten working adults have back pain every year. The spine is a complex interconnecting network of nerves, joins, muscles, tendons and ligaments, and all are capable of producing pain. Large nerves that originate in the spine and go to the legs and arms can make pain radiate to the extremities. Back pain is a common problem which everybody tends to have at some time or other in their life, irrespective of age and sex. Since the back supports a large portion of the body s weight and is used for lifting, sitting, and just about every other physical activity, it is susceptible to intermittent pain and injury. Back pain is second only to common cold in the ailments patients most frequently see their doctor for. The backbone is generally referred to as the vertebral column. The vertebral or spinal column is a flexible structure formed by a number of bones called vertebrae. Between each vertebral, the column is supplemented by pads of fiber cartilage. There are 33 bones in the vertebral column, named according to the region they occupy.

2 7 Cervical vertebrae forming the neck or cervical region. 12 Thoracic vertebrae from the back of the thorax or chest. To this the ribs are attached. 5 Lumbar vertebrae form the lumbar region or lions. 5 Sacral vertebrae from the sacrum 4 Coccygeal vertebrae from coccyx or tail The vertebras in the upper region remain separate and are called movable vertebra. The 2 lower one sacral and coccygeal are united to form 2 bones, and called fixed vertebrae. All the movable vertebrae are of similar characteristics except the first 2 cervical vertebrae. The bodies are small and oblong in shape from side to side. The seventh cervical vertebra forms a distinct projection in the neck and is called the vertebra prominens. The Thoracic vertebrae are larger than the cervical and they increase in size as they extend downwards. They are connected with the ribs. The Lumbar vertebrae are the largest. The forth lumbar vertebra articulates with the sacrum at the lumbosacral joint.

3 The sacrum is a triangular bone situated at the lower part of the vertebral column. The apex of the sacrum articulates with the coccyx. The coccyx is composed of 4 rudimentary vertebrae fused to form one bone. The vertebral column is S-shaped, the Cervical is concave, Thoracic is convex, Lumbar is concave and Sacral is convex. This shape enables the vertebral column to give stability and mobility to our body. It acts as a firm support to the body and at the same time enables the bending process. They absorb shock when moving the weight of the body as in running and jumping and thus the brain and spinal cord are protected from shocks and jerks. The 5 lumbar vertebrae normally carry the weight and have almost all the movements of a spring. The 4 th and 5 th lumbar vertebrae are the major trouble spots. The basic causes of back pain are Sedentary living habits Weak abdominal or back muscles Poor posture Muscular tension Straining of the joints Arthritis Prolonged sitting or standing in one position Prolonged stooping Improper lifting of weights Wearing high heels Lack of exercise. Classification Back pain can be divided anatomically: Neck pain, upper back pain, lower back pain or tailbone pain.

4 Low Back Pain Neck pain By its duration: acute (less than 4 weeks), sub acute (4-12 weeks), chronic (greater than 12 weeks). By its cause: Musculoskeletal (MSK), infectious, cancer etc. Back pain is classified according to etiology in mechanical or non specific back pain and secondary pack pain. Approximately 98% of back pain patients are diagnosed with nonspecific acute back pain which has not serious underlying pathology. However, secondary back pain which is caused by an underlying condition accounts for nearly 2% of the cases. Underlying pathology in these cases may include metastatic cancer, spinal osteomyelitis and epidural abscess which account for 1% of the patients. Also herniated disc is the most common neuologic impairment which is associated with this condition, from which 95% of disc herniations occur at the lowest two lumbar intervertebral levels. Associated conditions: Back pain can be a sign of a serious medical problem, although this is not most frequently the underlying cause. Surgery Surgery may sometimes be appropriate for patients with:

5 Lumbar disc herniation or degenerative disc disease Lumbar spinal stenosis from lumbar disc herniation, degenerative joint disease, or spondylolisthesis Scoliosis Compression fracture Minimally invasive surgical procedures are often a solution for many symptoms and causes of back pain. These types of procedures offer many benefits over traditional spine surgery, such as more accurate diagnoses and shorter recovery times. Surgery is usually the last resort in the treatment of back pain. It is normally recommended only if all other treatment options have been tried or if the situation is an emergency. A 2009 systematic review of back surgery studies found that, for certain diagnoses, surgery is moderately better than other common treatments, but the benefits of surgery often decline in the long term. ACUPRESSURE AND ACUPUNCTURE POINTS Acupuncture for back pain and slipped disc Slipped disc or any other problem in the lumbar region is treated by reducing the yin humidity or increasing the yin wind. The following points are used for treatment. Sp-6 LIv-1 P -7 Lu-8 This tonification or sedation is done according to the pulse diagnosis. Low Back Pain Treatment is given in the yang coldness meridian for any pain the lower back. Treatment is given either in the system level or in the subsystem level. B-66 St-36 Gb-34 Tw-2

6 Heat therapy is useful for back spasms or other conditions. A Meta analysis of studies by the Cochrane Collaboration concluded that heat therapy can reduce symptoms of acute and sub acute low back pain. Some patients find that moist heat works best (e.g. a hot bath or whirlpool) or continuous low level heat (e.g. a heat wrap that stays warm for 4 to 6 hours). Cold compression therapy (e.g. ice or cold pack application) may be effective at relieving back pain in some cases. Massage therapy, especially from an experienced therapist, can provide short term relief. Acupressure or pressure point massage may be more beneficial than classic (Swedish) massage. All Figures :Courtesy INTERNET (used for illustration)

7 ACUPRESSURE CLUB KNEE PAIN TREATMENT CAMP REGISTRATION FORM Name Date of Birth Address Telephone / Mobile Please answer all these questions a. How long you have been having back pain? < 6 months < 1 year >1year b. Please describe the treatment undertaken so far? c. Do you have slipped disc.? If, please attach the diagnostic test details d. Do you have osteoarthritis? If, please attach the diagnostic test details e. Do you have rheumatoid?

8 If, please attach the diagnostic test details f. Are you on pain killers? If, give details on the medicines taken per day. g. Is there inflammation anywhere on the back of the body? If, you can approximately mention the region viz neck, upper back, lower back, tail bone region etc. h. Do you get stiffness anywhere in the back of the body? If, how long it lasts? i. How long can you walk now at a stretch < 0.5 km < 1 km <2 km j. Does walk increase your pain kl. Have you taken any X-ray or MRI If yes, attach the diagnostic details. l. What is your pain intensity now in a scale of 10 which represent the maximum knee pain you expeirnced 0 10

9 Camp Record Name : Telephone. Date of Joining the camp: Aug 2011 Pain Intensity 0 10 Swelling Stiffness Flexibility Distance walking without pain