Spondylosis-vs-Spondylitis-showed by the physiotherapist

Understanding Spondylosis VS Spondylitis

After back pain, neck pain is the second most common musculoskeletal complaint reported by patients. Resultantly, we hear the terms Spondylosis and Spondylitis most often from our patients as the cause of their back pain and neck pain. Sometimes people even use spondylitis and spondylosis interchangeably without understanding the difference and thereby the treatment involved to manage these spine conditions.

In this article, the spine Physiotherapists from ReLiva attempt to help you understand Spondylosis and Spondylitis, the difference between the two in terms of the symptoms, causes and treatment.

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पीठ दर्द – कारण और घरेलू व्यायाम (Back Pain : gharelu upay)

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पीठ दर्द - कारण और घरेलू व्यायाम

मूल लेख यहाँ पढ़ें

पीठ दर्द - कारण और घरेलू व्यायाम हम में से 80 प्रतिशत लोग अपने जीवन में किसी न किसी समय पर पीठ दर्द का अनुभव करेंगे। सब दर्दों में पीठ दर्द सिरदर्द के बाद दूसरे स्थान पर है, और कार्यस्थल की चोटों की सूची में सबसे ऊपर है, जिससे किसी अन्य कार्यस्थल की चोट से अधिक समय, विकलांगता और धन का नुकसान हो जाता है। हमारी पीठ हड्डियों, टेंडन, अस्थिबंधन और नसों का एक सावधानीपूर्वक इंजीनियर नेटवर्क है जो हमारे शरीर के वजन और भार को संतुलित करने में मदद करती है। इस नाजुक प्रणाली के लिए कोई मामूली क्षति या असंतुलन मांसपेशियों और जोड़ों पर दबाव डाल सकता है, जिससे दर्द और चोट लग सकती है। खराब मुद्रा में काम करने, उठाने, झुकने और उठाने, और कमर से घूमकर करने वाली गतिविधियाँ धीरे-धीरे आपकी पीठ की सहायक संरचनाओं को कमजोर कर सकती है और साथ ही दर्द और चोट का कारण बन सकती है।

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Plantar Fasciitis Heel Pain

Plantar Fasciitis? Its a pain in the Heel

Plantar Fasciitis

Things you must know about Heel Pain

Heel pain is a common foot condition. One may experience intense pain while you place weight on your heel. The pain usually builds up gradually and gets worse over time. Walking usually improves the pain, but it often gets bad again after walking or standing for a long time.

This type of pain could be due to the overuse of a tissue known as Plantar Fascia. Plantar Fascia is a broad, thick band of tissue that runs from under the heel to the front of the foot, helping to maintain the arch of the foot. In Plantar Fasciitis, the pain is felt under the heel and usually on the inside, and sometimes along the arch, mostly on walking and running.plantar fasciitis treatment

Things You Must Know About Plantar Fasciitis

  • People who run or jog regularly, and older adults who are 40-60 years of age, are the two main groups affected by heel pain.
  • Overweight individuals are also more at risk.
  • Correct diagnosis is important: Heel pain could be caused due to different reasons. Let a qualified doctor diagnose the correct reason.
  • Rest your heel: This may not be easy. But avoiding walking long distances and standing for long periods will surely help.
  • Pain relief: Techniques such as icing, massage, ultrasound or electrical muscle stimulation can help to reduce the pain.
  • Stretching the calf muscles and the plantar fascia and strengthening of the intrinsic foot muscles can improve the foot mechanics and relieve the stress on the fascia.
  • Foot mobilizations and supportive taping is also known to have worked well.
  • Use of well fitting, appropriate shoes/orthotics: Use of well fitting, appropriate shoes/orthotics.

Read more about Plantar Fasciitis 

buttock pain wallet

Buttock Pain? Is your heavy wallet to blame

Buttock Pain

Is your heavy wallet to blame?

Do you experience a sharp pain right at the centre of your buttock; especially when you sit? Do you get a sharp shooting pain radiating down your legs?

Well, this could be because of your big fat wallet. When it comes to wallet, size matters !

Carrying a big wallet in your back pocket can cause a major trouble to your back & buttocks. Your wallet may be a one stop locale for keeping your cards, cash, bills & coins. But sitting with heavy wallets in your back pocket can put a lot of stress on your buttocks, back and hip. The problem starts when your nerve in the buttock, known as SCIATIC NERVE gets pinched between your wallet & buttock. It causes pain in your hip and/or buttock. It can also cause pain all the way from your buttock down your leg.

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home remedy for neck pain

Neck Pain: Managing at Home

neck pain and stiffness  I neck pain treatment  I  neck pain causes  I  neck pain home treatment  I  physiotherapy for neck

Neck pain or a stiff neck is a common problem and usually nothing to worry about, except that it may be far more troubling.

Neck pain or a stiff neck are extremely common and can affect your life in so many different ways.  Whether it is sharp neck pain, dull muscular aches, headache, or an inability to fully move your head, a sore neck, it can be very frustrating yet it’s simple to fix in the majority of cases.Read More

office stretch for pain relief

5 minute Office Exercises: Back, Neck pain

Make time for Office stretches and improve your productivity.

Taking the time to stretch throughout the day anywhere – in office or at home, can have numerous health benefits. Stretching can improve flexibility and is an important activity to warm up or cool down after exercise. Stretching can also be a fun and healthy break from your computer screen during the work day. These stretches along with correct sitting posture at workplace, also helps you to keep all those pain in the back and neck away.

This Office Stretch Sheet provides you with 6 simple and effective stretches that you can complete whilst sitting at your work station. The newly developed Standing Stretch Sheet is perfect to do before a lunchtime walk, and for those who have standing roles.

Try The Banana,  The Emu,  Reach for the Sky, The Rock, The Twister and The Yes & No today.

We recommend you repeat each stretch twice, and hold each time for 20 seconds.

Print a copy and pin it up next to your workstation to remind you and your colleagues – Have you stretched today?


5minute ReLiva office stretching exercises while Sitting at your desk in office


Related Reading:

Ergonomics Programme for Corporate Employees

Working long on Computer : Carpal Tunnel Syndrome

Ergonomics: Does it matter in your workplace

Neck Pain : Managing at Home

Physiotherapy, a sustainable solution for workplace Health & Wellness


sacroiliac joint pain

SI Joint / Pelvic Pain – Do’s & Don’ts

Sacroiliac (SI) Joint Dysfunction can cause significant discomfort and pain in sitting and lying down. The Hip joint seems to have got locked and does not allow smooth transition from one position to another. Following are few techniques that can help significantly to ease such restricted movement and pain.

1. Rolling Over in Bed:

To roll over from your back to your side, bend one knee, placing your foot on the bed.  Push the heel down, slightly lifting your buttocks and turn towards the side on which the leg is still extended straight. The top arm helps the turning motion.

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workplace health and wellness

Physiotherapy, a sustainable solution for workplace Health & Wellness

Author: Subodh Gupta
As India grows increasingly important in the World economy, more and more Indians are getting into white collared jobs. Information Technology or IT/ITES sector, alone forms the largest employer in the organized private sector of our country. And when over 50 % of these IT professionals in India report musculoskeletal problems like back pain, neck pain etc, one cannot ignore the mounting size of the issue.

A high prevalence of musculoskeletal (orthopedic) problems has been seen amongst IT workforce. Studies have found that over 50% of the IT professionals in India report these issues. Office for National Statistics in UK has found that back, neck and muscle pain accounted for more absences than any other ailment.

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DISC Prolapse

Last Updated: 25 August, 2018

Slip disc is such a commonly heard term among the back pain sufferers. Already about 70% of Indian Population is reported to have suffered from back pain atleast once during their lifetime. Slip disc or disc protrusion or PIVD makes the largest chunk among the possible cause for this LBP.

As we age the discs that are present in our vertebral column, become less flexible and begin to harden, making them more prone to tears. A herniated disc can be caused by a single excessive strain or injury. However, as degeneration of the discs progresses with age, some people may suffer herniated discs from more minor exertions or twists.

Slip Disc

First line of treatment, if you have recently had a slip disc

Immediately after having an episode of PIVD, care should be taken to:

  • Stop the offending /painful movements and activities
  • Lying on your back with feet on a chair & knees at 90 degree angle can sometime be quite comfortable for the back.
  • Apply a cold pack atleast 4-5 times a day for 10 minutes at time
  • See a health care provider (Physiotherapist/orthopedic) to assess the causes and undertand your pain clinically


What are the treatment options for Prolapsed disc?

Treatment of a PIVD depends on the level of severity and discomfort you are facing and how far the disc has slipped out of its place. Usually the line of treatment includes:

  1. Local pain relief: Muscle relaxants or analgesics or non-steroidal anti inflammatory drugs under the ortho’s prescription can be useful.
  2. Physiotherapy – Once the initial inflammation has settled, an appropriate physiotherapy program can relieve the pain. A Physiotherapist will also prescribe an exercise program that strengthens the core and other involved structures.
  3. Surgery - Severe nerve entrapments may require minor surgeries like microdiscectomy.

Tips to manage Prolapsed disc at home

Inspite of the line of treatment you choose for slipped disc, you still need to consider the following tips to manage PIVD better:

  • Sit for only short period of time

    - Your back wants movement and sitting in a chair for an extended period of time puts your back into a loaded flexed position, which your spine will not like. Try to change positions every 30-40 minutes by standing up, going for a little walk, or grabbing a glass of water. While you are sitting for short periods, you want to make sure you sit with good posture and proper lumbar (lower back) support.

  • Apply heat to the affected area

    By using heat you are helping to decrease muscle spasm and improve blood flow through the body. Try using a hot water bottle for 10 minutes or as often as required. Just be sure to place something between your skin and the heat pack to prevent any skin burns.

In case there is swelling or localized warmth, use ice pack for 10 minutes. Read more about using heat and ice.

RICE protocol for Ankle Sprain

  • Find a comfortable sleeping position

    It is important to sleep with proper support so if you like to sleep on your side, place a pillow between your legs to take off any extra pressure through your hips and lower back. If you prefer sleeping on your back, place a pillow or rolled up towel underneath your knees so they are propped up allowing your lumbar spine to relax in a neutral position. These small modifications can help ease any pressure on your spine

  • Healthy exercise lifestyle

     Most importantly, continue your exercise program as a part of maintenance and do regular follow ups with your physiotherapist.

How does Physiotherapy help in treating Prolapsed disc?

Physiotherapy provides a successful treatment for spinal disc prolapse rehabilitation. Typically the treatment includes back pain relief and protection, exercise program for lower abdomen and core stability, restoration of function and preventing a recurrence.

ReLiva Physiotherapy provides Disc prolapse rehabilitation for managing such symptoms at its clinics in Mumbai, Navi Mumbai, Pune and Thane. The treatment phases are described hereunder:

A.Back Pain Relief & Protection:

Our physiotherapists will use an array of treatment tools to reduce your back pain and inflammation. These include: ice, electrotherapy, and unloading taping techniques. Apart from these certain techniques or exercises that unload the inflamed structures are also utilized to provide pain relief and reduce inflammation.

B.Prolapsed Disc Exercises:

  • As your pain and inflammation settles, our physiotherapist will turn their attention to restoring your normal joint alignment and range of motion, muscle length and resting tension, muscle strength and endurance.
  • Our physiotherapist will commence you on a lower abdominal and core stability program to facilitate your important muscles that dynamically control and stabilize your spine.
  • Our physiotherapist may recommend a stretching program to address your tight or shortened muscles.

C.Restoring Full Function:

Depending on your chosen work, sport or activities of daily living, our physiotherapist will aim to restore your function to safely allow you to return to your desired activities. Everyone has different demands for their body that will determine what specific treatment goals you need to achieve. For some it is simply to walk around the block. Others may wish to run a marathon.

Your physiotherapist will tailor your back rehabilitation to help you achieve your own functional goals.

D.Preventing a Recurrence:

Back pain does have a tendency to return. The main reason it is thought to recur is due to insufficient rehabilitation. In particular, poor compliance with deep abdominal and core muscle exercises. You should continue a version of these exercises routinely a few times per week.

What is Prolapsed disc or PIVD?

To understand Prolapsed Intervertebral Disc (PIVD), also known as herniated disc or disc protrusion or disc prolapsed; it is important to understand the central structure of our disc.

A prolapsed /herniated disc means displacement of the content of the disc beyond its boundaries into the intervertebral space. Your disc is made up of 2 layers- thick outer layer called Annulus Fibrosus and the soft gel-like center called Nucleus Pulposus.

You can relate this stricture to a cream biscuit. The biscuits as the tough outer layer annulus and the cream as the central gel like structure nucleus.

These discs act as cushions or shock absorbers between the vertebras.



PIVD is actually an age related problem. But trauma, strains, torsion or heavy lifting can cause disc prolapse/herniatons. It can occur in any disc of the spine but lumbar (lower back) and cervical (neck) disc prolapses are common forms.

What are the causes of Disc Prolapse?

Pain caused due to disc prolapse/ herniation may seem to occur suddenly but it is usually a result of a gradual process accumulating due to many of the following causes:

  • Ageing
  • Being overweight (creating more pressure on the spinal column)
  • Smoking (which can contribute to the degeneration of discs)
  • Incorrect lifting of heavy weights.
  • Repetitive strenuous activity.

Less common causes would be traumatic injuries like a fall or an accident that puts pressure on the disc and causes its displacement.

What are the signs and symptoms of prolapsed disc?

The most common symptom of a herniated disc are:

  • Pain &/or numbness
  • Pain that extends to the arms from your neck OR pain that extends to the legs from the lower back (sciatica pain)
  • Pain worsenig at night while asleep or with certain activities tha defines the pressure on your discs
  • Pain worsening on standing/sitting
  • Pain on walking specific distances
  • Muscle weakness in higher degree of disc involvement
  • Tingling, aching or burning sensation in the affected area

The type of pain or symptoms may vary from person to person depending on the severity of disc involvement.

If problems with bowel or bladder function are experienced this may be a sign of cauda equine syndrome - a rare but serious complication of a herniated disc. Immediate medical attention should be sought if this is suspected.

How much time does it take to recover from prolapsed disc?

Your discs do not have a blood supply (blood is what brings the healing to any damaged structure). This means that your disc doesn’t have any repairing powers of its own and if injured, your spinal disc cannot repair itself.

After a disc injury, your disc would undergo the following 3 stages:

  • Significant dysfunction due to pain
  • Long phase of instability which makes you more prone to back pain episodes
  • Body tries to re-stabilise the segment and you may have lesser episodes of pain.

Either ways, a physiotherapist at ReLiva will plan your treatment based on your assessment and your recovery stage. The time frame of recovery varies based on the severity of structural involvement. But in general your recovery stages would be as follows :

1. Acute inflammatory stage

– in this stage, your pain has just started but is very severe in nature and constantly present. No movement or position helps you relieve the symptom.

2. Acute stage without inflammation

– here the symptoms are intermmittent in nature and usually related to offending activities or movements.

  1. For eg: if you cannot stand longer that 15 min/sit longer than 30 min/walk for more than a mile. Attempting these activities beyond your mechanical limits will aggravate your pain symptoms.

3. Subacute stage

- usually at this stage, certain movement & postures still provoke the pain.

4. Chronic stage

- when this stage is reached, emphasis is placed on returning the highest level of activity that require you to perform repeated movement or we can say repeated loading. For eg: lifting something or playing a sport etc.

What are the complications of a Prolapsed disc?

An untreated slipped disc can manifest in various ways:

  • An untreated, severe slipped disc can lead to permanent nerve damage.
  • In very rare cases, a slipped disc can cut off nerve impulses to the end of the spinal column called as cauda equina in your lower back and legs. If this occurs, you may lose bowel or bladder control.
  • Another long-term complication is known as saddle anesthesia. In this case, the slipped disc compresses nerves and causes you to lose sensation in your inner thighs, the back of your legs, and around your rectum.

While the symptoms of a slipped disc may improve, they also can worsen. If you cannot perform the activities you once could, it’s time to see your doctor.

Frequently asked Questions – FAQs for prolapsed disc

frequently asked questions FAQ

Q Do you have to have surgery for a PIVD?

The treatment of a bulging disc depends on your symptoms. Most patients with a bulging disc do not need surgery. Your symptoms can usually be managed with conservative treatment such as pain medications and physical therapy.

Q What happens if you leave slipped disc untreated?

A lot of times, back pain symptoms are ignored until they do not hamper/restrict your daily activities. An untreated PIVD can lead to permanent nerve damage. In very rare cases, a displaced disc can cut off nerve impulses to the cauda equine (lowest part of the spinal cord) nerves in your lower back and legs. If this occurs, you may lose bowel or bladder control. This could be a debilitating condition.

Q How should I sit with a prolapsed disc?

  1. Keep your back flat against your chair with a pillow/cushion against your backrest mainatining your shoulders tall
  2. Keep your knees at the same level as your hipswhile sitting at your desk
  3. Keep your feet flat on the floor

Q Can exercise help in the recovery of Prolapsed disc?

Exercise is an important component of PIVD treatments. Exercises under the supervision and expert guidance of the physiotherapist will reduce your pain and ensure a long term good health to your spine.

Interesting Facts about PIVD:

  • A bulging disc may be as painful as an herniated disc
  • Prolapsed discs cannot be diagnosed with an x-ray. You need an MRI
  • Many disc pain conditions are misdiagnosed

If I were to gather a group of middle age folks (45 average age) who have NEVER had back pain before and shoot MRIs on them all, here's what we would find:38% would have disc bulges,

  • 37% disc protrusions (aka: contained herniations),
  • 11% disc extrusions (aka: non-contained herniations),
  • 0% disc sequestrations (aka: free fragments) and
  • 4% nerve root compression by the disc herniation.

A more shocking statistic is that 60% of asymptomatic middle aged people would have findings of disc bulge or worse (protrusion, extrusion) on MRI!

In case you have been suffering from prolapsed disc, do not accept you life with pain. You can recover and return to the activities you enjoy.We have seen great success in treating patients with PIVD, LBP, slipped disc and will be happy to help. Contact us at 9920991584 and we will connect you to a physiotherapist near you.

Related Reading:
Exercises for Back Pain
What’s causing your pain? Is it poor posture

Back Pain: cause, Self care, FAQs
Understanding Spondylosis VS Spondylitis

This article is based on the contribution from Dr Anuradha Mandlekar (PT). Dr Anuradha is a senior physiotherapist and heads the clinical team at ReLiva Physiotherapy & Rehab.

We provide Physiotherapy services at our fully equipped clinics in:

Mumbai | Chembur MulundThane  | Kapurbawdi  | Ghodbunder Rd | Kalwa 

Navi Mumbai | Vashi | Nerul | CardiumKharghar | Pune | Kalyani Nagar | Wakad

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