Q: I had sprained my back during trekking. It affected the top right part of my back. But the next day I had pain running down my right knee and ankle. After some days I had a stiff back. I went for physiotherapy and though the pain reduced considerably, it still continues. What should i do?

A:Your problem is a common one. Usually back pain is chronic and recurring, and you have to get rid of it once and for all. This needs a lot of compliance from your side. Backache after any unusual activity or sprain, occurs because of muscle contraction and sometimes nerve root involvement. Since you don't have pain when you first start walking or standing is usually adequate to rule out any mechanical cause of pain or vertebral fracture. The pain is usually inflammatory in origin and sets up a vicious cycle. The radiating pain right upto your ankle suggests neural involvement. You need to do the following things: - Take anti-inflammatory medicines with muscle relaxants for 2 to 3 weeks.
- These are available in india as Myospaz forte, or Dan MR. take 1 tab. 3 times a day.
- Don't massage with oil. It can aggravate muscle contraction.
- You can continue hot fomentation.
- Apply gel like voveran emulgel in the affected area. Just apply, dont massage.
- Modify your posture, like avoid sitting in a relaxing chair or driving car for long distances. Try to sleep on a firm bed instead of a very soft one. Avoid bending, twisting, or lifting weights.
- Exercises are indeed helpful and you should continue them, but do not do any physical activity which can aggravate pain. You can do abdominal muscle strengthing exercises, back extension exercises and gradual stretching, ideally under supervision. Continue this even after the pain stops, to prevent any recurring problem. Avoid long walks for the time being.
- If the problem continues after this, you can have diathermy or some other modality of physiotherapy, but try out this basic treatment plan first. This can solve the problem in many patients.