The term ‘back pain’ is known to be a common phenomenon in every household. Earlier back pain was a sign of old age setting in. Be it young or old, these days the lower back pain doesn’t distinguish between age groups and can affect anyone. As per some statistics, one in every seven people are affected by this phenomenon and the growth rate of this problem is high and will continue to be so till proper precaution and remedial measures are not taken.(1)
Individuals suffering from severe back pain find it difficult to bend forward, sit down, do the normal chores of the day, lie down or participate in sporting activities etc. This results into a changed pattern of behavior. They get restless, panicky, mood swings set in; patients are irritable, frustrated, angry and fearful at times. Let us know as to what can cause back pain when bending forward.
What Can Cause Back Pain When Bending Forward?
Bending downwards with your legs straight creates pressure on the back muscles, joints and ligaments of your lower back. It also causes the discs between the vertebrae to be stressed leading to pain in the area. The tight muscles in the front of the spine make the back area tensed. Any bending tasks can be done without applying pressure and this care must be taken at the initial stage itself lest it worsens the condition. The common reason that increases the risk of back pain when bending forward includes:
- Obesity: Obese people are more likely to be affected with back pain when bending forward as their weight puts enormous pressure on their back that results into a back pain when bending forward.(2)
- Pregnancy: During pregnancy, the excess load borne by the lower back leads to a back pain. This back pain increases more when bending forward as the muscle needs to sustain the entire weight which is stressful.(3)
- Back Pain When Bending Forward Caused Due to Paravertebral Muscle Spasms: Paravertebral muscles support lumbar vertebral segment. There are several bilateral paravertebral muscles. Muscle spasm is one of the most common cause of back pain when bending forward. Paravertebral muscle spasms can be caused due to undiagnosed scoliosis, tear or sprain of ligaments, prolonged sitting or standing in improper position while travelling or working in front of computer or at desk, frequent long distance driving, sleeping on hard mattress, tear or sprain of paravertebral muscles, pregnancy, obesity, Manual work – lifting and carrying heavy object, sciatica, stress – physical or emotional, myofascial muscle disease, and Fibromyalgia.
- Non-Traumatic Causes of Back Pain When Bending Forward: Disc bulge or disc herniation, facet Joint arthropathy, spinal hematoma, epidural hematoma, spinal tumor, spinal abscess can cause back pain when bending forward.
- Infections: Discitis, facet joint arthritis, and osteomyelitis can also cause back pain when bending forward.
- Traumatic Causes of Back Pain When Bending Forward: Trauma due to auto accident or work accident can cause skeletal or soft tissue damage resulting in Posttraumatic epidural or spinal abscess, tear or sprain of ligaments, disk herniation or disk bulge, fracture or traumatic degenerative disk, facet joint subluxation or injury, subluxation of lumbar vertebrae, epidural or spinal hematoma which in turn can cause back pain when bending forward.
- Bone Disease that Can Cause Back Pain When Bending Forward: Medical conditions like osteoporosis, scoliosis, spondylolisthesis, rheumatoid arthritis, osteoarthritis, ankylosing spondylitis and spinal stenosis can cause chronic back pain.
- Degenerative Arthritis: The wear and tear of the muscle tissues happen because of age, injury and genetic composition. These muscle wear and tear increases the chances of back pain particularly when bending forward.
- Systemic Disease that Can Cause Back Pain When Bending Forward: One can have acute or chronic back pain if they have endometriosis, kidney disease, fibromyalgia, chronic fatigue syndrome and muscle pain.
- Failed Back Syndrome: Pain in the back when bending forward or with any activities may persist after back surgery secondary to following causes recurrent disc herniation, surgical injuries to facet joint, facet joint hyper mobility, facet joint instability, muscular deconditioning, fibrotic scar tissue of surrounding nerves, ligaments, muscles and joint.
- Fracture: Fracture of vertebrae, facet joint, lamina, transverse process or spinous process causes back pain. Tear and sprain of synovial membrane, ligaments and muscles can result in back pain when bending forward.
Treatment & Management of Back Pain When Bending Forward
Depending on the cause of back pain while bending forward, the treatment or management would vary. The various modes of back pain treatment include:
- Non-invasive Treatments for Back Pain when Bending Forward: These methods include-
- Medications: Non-steroidal anti-inflammatory drugs like Tylenol, Motrin; antidepressants like Elavil; and Antiepileptic analgesics such as Neurontin can help relieve pain in the back.
- Manual Therapy: These include massage, spa, chiropractic therapy, exercise and physical therapy. Manual therapy can be quite effective in getting rid of back pain when bending forward.
- Invasive Treatments for Back Pain with Bending Forward: The invasive therapies mostly include on-site injections like epidural steroid injections, facet joint injections, trigger point injections and selective nerve root injections.
- Surgical Treatments for Back Pain When Bending Forward: When the above mentioned invasive and non-invasive treatment methods don’t help much in reducing the pain in the back, then the patient needs to undergo a surgical correction of the problem causing back pain when bending forward. Surgical treatments include-
- Spinal Fusion
- Removal of tumor
- Removal of hematoma or abscess
- Spinal cord stimulator
- Introducing intrathecal pump or catheter to inject intrathecal pain medicines.
- Alternative Treatments for Back Pain When Bending Forward: Certain alternative treatments could also help in treating back pain which occurs when bending forward. These treatment methods include-
- TENS (Transcutaneous Electrical Nerve Stimulation)
- Magnetic Therapy
- Ayurvedic Treatment
- Mind-body Therapies
- Energy Manipulation Therapies
- Nutrition Therapies.
Home Remedies to Relieve Back Pain When Bending Forward
A number of quick measures can help you get relief from the back pain when bending forward. These measures include:
- Sleep Position to Relieve Back Pain when Bending Forward: While sleeping, prefer to lie down on the sides rather than your back. Insert a small pillow between your legs which will support your lower back. Using a very soft mattress will not only make you uncomfortable but will also increase back pain problems for you. A medium-firm mattress should suffice.
- Improving Your Posture Can Help Relieve Back Pain When Bending Forward: Sometimes unknowingly we tend to slouch or walk with a bend. Proper posture supports and distributes the body weight evenly. Sitting straight relaxes your back muscles a bit. However, long sitting hours without proper support to the back and feet will increase the back pain especially with activities like bending; hence, it is best to alter the height of your chair and be comfortable and after every one hour it is ideal to take a 5 min break. Move around a bit, do some simple stretches and then you can restart your work.
- Over-the-counter Medicine: One tablet that helps in relieving pain much faster is Aspirin. This can be taken if the pain in the back hasn’t subsided after trying out other options for cure or if the back pain is severe and an instant relief is needed. It is a proven drug that helps in reducing pain. Anti-inflammatory drugs will also help but it is advised to seek help from a medical practitioner in this case.
- Ice Pack: Ice packs are a good and suitable method to dull the pain and ease the back muscles. You can also use an ice-towel. For this place a wet, folded towel in a plastic bag and keep it in the freezer for around half an hour. After that, simply place it on the lower back area to feel the relief within sometime.
- Slush Pack: Another option is to mix 3 cups of water and 1 cup of denatured alcohol. Put the mixture into a freezer bag. Once the slush forms remove it and press it over the lower back region.
- Heat Therapy: Just like the cold therapy mentioned above, heat can also work well in easing the back pain when bending forward. An all day heat wrap can be purchased. This will help in reducing the pain to a great extent. Placing hot water bag on the affected area will also bring a lot of relief. Alternatively, if nothing else is available, you can tell your family members to rub their hands against each other to produce heat. Place the warm hands on the affected area for quick relief.
- Massage and Acupuncture to get Relief from Back Pain when Bending Forward: These are one of the best known solutions that heal the sufferer of back pain. Take advice from your doctor regarding the type of massages that you can go in for. Acupuncture uses needles and pressure points on certain parts of the body to relieve pain. The results are worth the pricking pain you would experience.
- De-Stress: Unwanted stress can create more back pain. A stressful mind can make the muscles of the body tensed thus creating more harm. Hence, take some initiative to de-stress yourself with meditation or relaxation therapies.
- Managing Weight: If you are overweight, implementing some dietary measures to lose weight will surely help in getting rid of the back pain that you experience when bending forward.
A quick tip would be not to directly bend down as the back cannot withstand the strain on it. In order to pick up a fallen thing or do some task, go down on your knees to finish the activity.
Exercises for Back Pain when Bending Forward
- Shoulder and Neck Stretch: Bend your head down in such a way that the chin touches your chest and you feel a pull at the lower back. Slowly move your head and let it rest on your shoulder like your ear touching your shoulder. Do it around 10 times.
- Hamstring Stretch: Sit on the floor and bend your one leg bringing it as near to the body as possible. Now lean forward with your chest without bending your back. Gradually try to touch your toes. This will help in reducing the pain.
- Two Knee Twist: Lie down on your back and stretch your hands to the sides and place it at the shoulder level. Slowly bring your knees towards your chest. Now twist to the side and place your leg at the side to give a twist to your spine. Repeat on the other side and try it for around 5 minutes every day.
- Legs up the wall: Lie down on your back on a mat and try putting your legs on the plain wall in such a way that your buttocks touch the wall and your legs also stick to the wall and are perpendicular to it.
- Standing back Extension Exercise: Place your hands on your hips and slowly bend backwards. Stay for two to three seconds and come back to the normal position. Continue doing this everyday for at least 5 minutes and see the difference within few days. After sitting for a long time in one place this is the best exercise that one must try out. It is easy to do and effective as well.
Back pain when bending forward is a common problem faced by almost everyone at some point of time or the other. However, it can be prevented with simple postural corrections and can also be cured if it has already set in by making certain lifestyle changes, incorporating exercise and some home remedies. It isn’t a major problem in itself but can cause one if left unattended.