Lower back pain is not a disease in itself. It is a symptom that can arise from poor body posture, the incorrect use of the body or from some underlying disease.
Low back pain is the most common health complaint in 35-50 year olds, in both men and women. Above 50, it is associated with several other diseases. It is usually characterized by dull or sharp aching pain in the lower part of the back.
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Mechanical reasons top the list of causes of low back pain. We can point the blame on our modern lifestyle.
Fast track life, lack of physical exercise, inadequate nutrition, improper diet, weight gain, eating on the go, and long hours in front of the screen, all contribute to poor posture and health. Prolonged upright positions and long drives can also cause lower back pain.
Lack of physical activity and exercises also contribute to low back pain.
Sitting for a long duration, bending and lifting incorrectly, and poor sleeping postures, directly and adversely impact the spine. Embedded sensitive nerves result in lower back pain.
Irrespective of gender and age, these mechanical causes of low back pain can affect anyone.
Pregnancy is yet another mechanical reason and a major cause of low back pain.
Pregnant women who are carrying the baby weight often have a disturbed posture. They may find comfort in lying on a particular side.
Similarly, obese patients who have abnormal body weight are quite prone to back pain. In fact, most people with back pain-related issues are overweight or, do a lot of activities involving bending and lifting.
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Lower back pain also results from underlying diseases as well. Symptoms will show up according to the cause. Sometimes, lower back pain is due to compression of the nerves. This is known as sciatica.
Sciatic nerves pass through the vertebral column. They get pressed by the vertebrae and this causes severe pain. People experiencing sciatica complain about the pain not being limited to the waist but also being carried down to one of the legs, all the way to the toes.
Symptoms of low back pain are created according to the causative factor.
If someone has back pain due to tuberculosis, they will also experience other symptoms like weight loss, decreased appetite, and rise in body temperature in the evening.
Similarly in rheumatism, inflamed joints with pain in different body parts and problems in the digestive system are also experienced. If there are degenerative changes then back pain will be associated with pain in other body parts like the knees. Degenerative changes happen everywhere simultaneously.
Low back pain is also associated with uterine disorders, urinary tract infections, and renal diseases.
Lower backache can be a prodromal symptom in fistula in ano, sciatica, gouty arthritis, hernia, and emaciation disorders. Pain is confined to the lower part of the spine, especially the lumbar region or lumbosacral region. In cases of secondary pain, there is usually a history of injury or fall associated with the lower back.
First, have your doctor check all your objective and subjective parameters: CT scan, X-ray, MRI, and blood tests.
If there is no such underlying cause, then there is a saying in Ayurveda that fits. If there is pain, the reason is Vata dosha.
Modern lifestyles and habits disturb Vata in the body. Wherever air accumulates, the pain will be created.
So if this is the situation even after consulting a doctor and no diagnosis has been ascertained, then make an attempt to control the accumulated Vayu or air. We’ll explain.
According to Ayurvedic medicine, certain unconscious habits make you more susceptible to pain because they aggravate Vata.
Holding your breath, chronically tensing your muscles, suppressing your emotions, eating over-processed refined foods, ingesting too much caffeine and drinking, not enough water can all aggravate Vata.
Again, Vata dosha is the dosha involved when there is pain.
If you can step back and observe which of your activities and habits contribute to the problem, you can start to undo your pain naturally.
In Ayurveda, lower back pain is called katishool, kati graha or pristha graha.
Kati shool and kati graha fall under Vata vyadhi or a Vata dosha imbalance disorder.
Vatananatmaja vyadhi can be correlated to neurological or neuromuscular disorders. The causes and pathogenesis of diseases caused by vitiation of Vata dosha in general are the exclusive cause and pathogenesis of kati graha.
The Charaka Samhita, Astanga Samgraha and Sushruta Samhita mention the root cause of Vata vyadhi as either dhatu kshaya (degeneration) or margaavaran (obstruction).1
Consult a qualified Ayurvedic practitioner for assistance.
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Exposure to mild but continuous trauma to the lumbar region is a major cause of low back pain. Improper sitting or lying down, forward bending, lifting heavy weight, traveling, carrying heavy loads and digging may all create continuous trauma.
Suppressing the urge to urinate or defecate, improperly treated pelvic disease, a fall or injury can also be responsible for accumulation of Vata in the lumbar region.
The ancient Ayurvedic sage Charaka states that the vitiated or aggravated Vata settles in riktanisrotamsi, the channels depleted of nutrients) and causes Vata diseases in the body.
The symptoms of Vata vyadhi may not manifest immediately. After coming into contact with an aggravating factor the symptoms may manifest. Vata dosha can get aggravated due to diet and lifestyle.
Additionally, it may be due to trauma or injury which leads to bone depletion and which in turn aggravates Vata.
The provoked Vata dosha may directly affect asthi and majja dhatu to produce the symptoms of katishool. Sometimes Kapha gets involved with Vata producing symptoms of indigestion, drowsiness, nausea, anorexia, heaviness of the legs, and freezing sensation of the lower limbs. Here Kapha is the associated dosha.
So based on dosha imbalance, lower back pain is of two types, vataj katishool or vataj kaphaj katishool.
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Other causes of lower back pain include the following.
When there is no apparent cause of low back pain, Vata is the culprit. Vata pacifying measures should be taken to counter the degenerative changes. Let us explain.
Too much of anything is never a good thing. If you have a desk job and you have to sit continuously for as long as eight to nine hours, then take good care of yourself. Take regular breaks and do stretching at intervals.
The flexion posture in which you sit while bending forward is a major cause of back pain. Be careful about your posture while sitting and try to keep your back and spine straight. You cannot quit your job of course. But do ensure you practice some stretching exercises like bhujang asana, surya namaskar, and salabh asana daily.
In between, work take short walks, do some free hand stretching exercises, head and neck exercises, and do self oil massage (abhyanga) before taking a bath.
The general principles of treatment for Vata dosha are followed for conditions of kati shool, and low back pain. Avoid all Vata aggravating factors, including a Vata aggravating diet and lifestyle.
Also recommended are snehan (oil application or abhyanga), swedan (hot fomentation or steam), and basti. A diet having an amla (sour) and lavana (salty) taste, snigdha (unctuousness), ushna (hot) properties treat Vatavyadhi, Vata imbalance.2
In the ancient Sushruta Samhita text, sneh abhyanga (oil massage), upanah swed (fomentation using a thick paste of herbal powders), mardan (massage), raktamokshana (bloodletting), and agnikarma (use of heat at specific marma points using a metal rod) is mentioned.
If there is an accumulation of Vata in the lower abdomen a lower backache may be aggravated. A mild laxative using oils like castor oil and basti chikitsa or herbal enema is recommended.3
Always consult a qualified Ayurvedic practitioner before self-administering any herbs or therapies. Even natural treatments may have side effects or adverse reactions if not properly used.
Since lower back pain is a disease of Vata origin, the general line of treatment for Vata can be applied to it. Basti or enema is considered the treatment of choice in classical Ayurveda.
Ayurveda also offers a body treatment for alleviation of lower back pain.
Kati basti is a method of unctuous fomentation that is externally applied to alleviate localized Vata and provide nourishment to the place of pathology, the lumbo-sacral region.
Other forms of sedation or medicated steaming such as avagaha sweda (tub bath) may be recommended.
Pizhichil, the pouring of warm oil over the body, nadi swedana (tube fomentation), pinda sweda (fomentation with medicated boluses), mridu samshodhana (mild purgation), and medicated enema (basti) are utilized in Ayurvedic medicine for low back ache.
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References
1. Sushruta Samhita, nidana sthana.
2. Agnivesha Charaka Samhita, e-samhita Chikitsa Sthana 28/13, National Institute of Indian Medical Heritage.
3. Sushruta Samhita, e-samhita, Chikitsa Sthana 4/5, 7. National Institute of Indian Medical Heritage, www.niimh.ap.nic.in.
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