Low back pain is a universal symptom, and almost every individual suffers from it at some time in life. Chronic and recurrent low-back pain is also very common, and almost sixty percent or more of the general population complains of this problem, usually while approaching middle age. The causes for this condition are multiple, and usually relate to the bony lumbar spine, muscles and ligaments in the lower back, the nerves emerging from the lower part of the spinal cord, internal organs of the lower abdomen, and the skin covering the lower back. Treatment for chronic low back pain therefore, depends upon the known cause for this condition.
The Ayurvedic management of chronic or recurrent low back pain is similarly based on treating or removing the diagnosed or suspected cause of the condition in individuals presenting with this condition. An acute low back sprain is usually treated with rest, local application, hot fomentation, and medications to reduce pain and inflammation. Medicated oils like Vish-Gargha-Oil and Maha-Narayan-Oil are used to reduce pain and muscular spasm. The beneficial effect of local applications can be reinforced with hot fomentations using hot water bottles, electric heating pads, or medicated steam of decoctions of medicines like Nirgundi (Vitex negundo) or Dashmool (Ten herbal roots). Pain, spasm and inflammation can be reduced using medicines like Triphala Guggulu, Trayodashang Guggulu, Maharasnadi Guggulu, Vat-Gajankush-Ras, Vat-Vidhvans-Ras, and Vish-Tinduk-Vati.
Recurrent low back pain is usually because of a faulty working posture, a contributory working environment, poor muscular tone, obesity, and lack of regular exercise. A detailed history of the affected individual is necessary in order to identify and help remove or minimise the known cause. Health life-styles need to be inculcated in order to reduce weight and exercise regularly and sensibly. Relaxation techniques and yogic asanas help considerably in reducing this condition. The appropriate medical investigations need to be done in order to rule out organic causes of the condition.
The commonest cause of severe, intractable, chronic low back pain is usually irritation of the lower back nerves due to bulging, degenerated, herniated or fractured spinal discs or overgrowth of the spinal vertebral bone. Aggressive and long-term treatment, ranging from three to six months, is usually required to bring relief from pain. The medicines which can be used in this condition include Trayodashang Guggulu, Laxadi Guggulu, Maharasnadi Guggulu, Panchtikta-Ghrut Guggulu, Tapyadi-Loh, Ekangveer-Ras, Vish-Tinduk-Vati, Vat-Gajankush-Ras, Trivang-Bhasma, Mukta Bhasma, Praval-Panchamrut, Shrung-Bhasma, Godanti-Bhasma, Ashwagandha (Withania somnifera), Haridra (Curcuma longa), Asthishrunkhla (Cissus quadrangularis), Guduchi (Tinospora cordifolia), Amalaki (Emblica rotus). The patient has to be strongly advised against physician-shopping, in search of a quick remedy.
Regular and moderate exercise and a well-balanced diet provide excellent protection against low back pain. Trunk-rotating exercises and all exercises which bring about an extension of the back muscles are beneficial in this condition. Qualified supervision and advice is however, necessary in order to obtain the maximum possible benefit, while avoiding adverse consequences.