Low Back Pain

Low Back Pain treatment in Gurgaon | Physiotherapy for Lower Back Pain

Low back pain (LBP) is the most common condition which nearly 80% of population faces at least once in their lifetime. This can be classified into 3 stages according to their duration of pain: acute, sub-acute, and chronic.

  • Acute pain usually remains for an episode and last not more than 6 weeks.
  • Sub-acute pain remains for longer duration i.e. 6-12 weeks and is quite discomfort.
  • Chronic pain is very troublesome and may present with or without leg pain. It may be localised or can also refer pain to any other area. Any pain which remains for more than 3 months is a chronic pain.

We are DynaFisio provide the Low Back Pain treatment in Gurgaon, Here we are told about  Low Back Pain Causes, Symptoms & Treatment. If you have any contact us for  Low Back Pain treatment. Our Doctors give Best physiotherapy for Low Back Pain

Low Back Pain Causes

Common causes contributing 80% of LBP are:-

  • Mechanical cause i.e. Muscle Strain or sprain, Poor posture
  • Prolapsed intervertebral disc herniation (PIVD)
  • Obesity; weak abdominal muscles causes undue strain on back muscles
  • Arthritis; especially in old age group due to their repetitive bending and twisting activities
  • Occupational causes
  • Sedentary lifestyle

Other causes contributing 20% of LBP are:-

  • Congenital causes – Scoliosis, Spondylolisthesis, Spondylolysis, etc
  • Infective conditions – Tb spine
  • Traumatic causes – Fractures, injuries, PIVD
  • Degenerative causes – OA
  • Metabolic causes – Osteoporosis, Osteomalacia
  • Inflammatory causes – Rheumatoid Arthritis, Ankylosing Spondylitis
    Neoplastic causes (very rare)

Low Back Pain Symptoms

They can vary according to different conditions, but some common features of LBP are:

  • Spasm, can be seen in the paravertebral muscles in acute stage
  • Painful restricted movements; forward or backward bending may be affected according to the conditions
  • Swelling; localised (in the form of cold abscess) or generalised (due to inflammatory response)
  • Tenderness; over spinous process, muscles, PSIS, etc.
  • Postural deformities can be seen due to compensation of any underlying cause like, scoliosis, lordosis, kyphosis or pelvic tilt.
  • Pain may or may not radiate to buttock, thigh or leg
  • Pain may aggravate either due to rest or activity due to AS or PIVD respectively.

Ways to Investigate

  • X-Ray; can show vertebral spaces, degeneration or fracture
  • MRI; reveals disc bulge, muscle tear, lesion, etc.
  • CT Scan
  • Blood test; for finding of any specific marker like HLA B27 in AS or any bacterial infection in Tb
  • NCV test for neurological purposes
  • Physical Examinations

Differential Diagnosis

  • Mechanical Back Pain – This pain usually last for 4-6 weeks and can be resolved by only conservative and physiotherapy treatment. This pain is generally localised to your affected part or muscle and is less often radiated.
  • PIVD - This can radiate your pain to your buttocks, thigh or leg. Pain usually gets worsen while walking and relieved by rest. This usually restricts forward bending as pain may get increased after that. It can be differentiated physically by SLR Test or Lasegue Test and also be differentiated through clinical findings like MRI.
  • Arthritis – It is common in old age group due to wear and tear of the bone and is characterised by dull aching pain. It is clinically found through X-ray findings which shows narrowing of vertebral spaces and degenerations of margins of the vertebral body
  • Scoliosis, Kyphosis, Lordosis – It is generalised, dull aching pain which may be present throughout your back and is revealed best in X-Ray findings.
  • Spondylolisthesis and Spondylolysis – Scottish dog appearance wearing a collar is a clinical feature in X-Ray and MRI for Spondylolysis. Similarly, head elongated from neck of the dog is a characteristic feature of listhesis. Spondylolisthesis also shows Step up deformity on physical examination. It usually restricts backward bending as the body may further slip on bending.
  • TB Spine or Pott’s Spine – Pain is usually localised associated with other Tb features. Localised swelling can be seen physically and through MRI which is the cold abscess, characteristic feature of Tb.
  • Ankylosing Spondylitis –X-Ray findings show squaring of vertebra and straightening of spine which can be seen physically also. HLA B27 is its marker can be tested in blood smear. This pain is usually worse in morning and after rest and is relieved by walking or doing any activities
  • Osteomalacia – Decreased bone density and lack of vitamin D
  • SI joint pain - can be differentiated through bilateral SLR test, FABER’s test.


  • Conservative management – Absolute bed rest except in AS, Traction, Use of lumbar belts
  • Medical treatment – Epidural steroids, NSAIDs, muscle relaxant, etc.
  • Surgical treatment It is done for severe cases only. However, in case of neurological deficits it becomes an emergency option. Surgeries like;
  • Micro discectomy, Laminectomy, Foraminectomy, Lumbar spinal fusion, are done according to their indications.
  • Physiotherapy Treatment

Physiotherapy Treatment For Low Back Pain

  • Bed rest – Acute LBP can be treated with some positions of bed rest foe short period of time as in discal pain it get increases with sitting and standing. Supine lying with pillows under your knees, side lying with knees and hip flexed are some suggestive positions.
  • Cryotherapy – Cold pack are best advised in acute LBP for initial 2 days as they decrease your spasm and inflammation better than heat.
  • Thermotherapy – It also reduces pain, inflammation and muscular spasm by increasing your circulation but in later stages or in chronic conditions. Moist heat packs or whirlpool can be used for about 20 minutes to relieve back pain.
  • Electrotherapy modalities – US, TENS, IFT, Infrared rays or Ultraviolet rays can also be used for deep heat or penetrations to your muscles or nerve ending to reduce your pain in both acute and chronic conditions. LASER treatment is also kept reserved for later stages of pain.
  • Traction – Manual and mechanical Traction for various conditions prove to be very effective treatment used for stretching spinal muscles and thus decreasing pressure, distracting the vertebral bodies and for straightning the spinal curve. It is used in conditions like; Disc protrusion, Spondylolisthesis, Scoliosis, Lumbar Spondylosis, etc.
  • Lumbar belt or braces – It is also advised to patients for additional support, to recover the mobility of spine, to maintain the curvature of spine as in scoliosis, or to maintain the faulty posture and relieve pain.
  • Spinal manipulations – It can be done once in a while to correct the malalligned vertebral segments and can be done by various techniques. It is completely contraindicated in severe osteoporosis, malignancy or fractures.
  • IASTM or STM – Soft tissue manipulation is also done either manually or instrument assisted to relax the spasm muscle or to increase blood circulation in the desired area.
  • Proper postural habits or back ergonomics for work environment and proper use of chair is also taught.

Exercises for LBP

There are different type of exercises like flexion, extension or rotation exercises and every exercise is not advised in all conditions so they are done and advised very precautiously. Each exercise is done with 5 repetition once or twice daily.

1. Flexion Exercises – Done in cases like anterolisthesis, increased lumbar lordosis, AS, or if the patient feels pain while standing, walking or backward bending. Some of the flexion exercises are:-

  • Partial sit ups in lying position with legs straight
  • Partial sit ups in lying position with both knees bent
  • Partial curl ups
  • One knee to chest stretch
  • Both knee to chest stretch
  • Toe touch in long sitting position
  • Back press in lying position
  • Cat n cow stretch
  • Lion stretch
  • Bilateral Straight leg raise
  • Single straight leg raise

2.  Extension Exercises – These exercises are prescribed in cases like PIVD, Retrolisthesis, to maintain or decrease lumbar lordosis, to maintain mobility of spine, AS, to decrease pressure on Sciatic nerve. Some of the extension exercises are:-

  • Prone on hands or prone on elbows
  • Straight leg raise in prone lying
  • Hand and leg raise in prone lying
  • Superman pose in quadripod position
  • Pelvic bridging
  • Plank or knee plank
  • Side plank
  • Swiss ball exercises

All these exercises are progressed according to the patient.

3. Rotation exercises – These exercises help in relieving the overall side muscles and stretch or strengthen the oblique muscles of your abdominals, like;

  • Partial diagonal curl ups
  • Trunk rotations with both the knees bent
  • Side crawling in lion’s pose
  • Mobility Exercises – It also induces relaxation on overall spinal muscles and increase the mobility of your spine, like;
  • Pelvic rotations in lying and sitting
  • Chest roll on either side
  • Dead bugs, they can be done in various forms

4. Stretching exercises – To relieve the contracted or spastic muscles;

  • Gluteal stretch
  • Piriformis stretch
  • Hamstring Stretch
  • Quadriceps Stretch
  • QL stretch
  • Paraspinal muscle stretch
  • Iliopsoas stretch
  • IT Band stretch
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