Are sciatica exercises good for back pain or nerve pain?
If you are feeling nerve pain then you should do these sciatica exercises to get relief from back pain.
What Does Sciatica Nerve Pain Feel Like?
The answer to this question is that it is extremely painful and makes you weak. The sciatica is nervous tissues and cells originate from medulla Oblongata and extends to buttocks, hips, and legs. This nerve is the longest and the importance of your body. This nerve directly controls your legs.
The Sciatica Pain Symptoms: If the nerve aggravates then you are in the condition of sciatica. Sciatica is due to an injury or specific area strike on the nerve, this includes vertebrae that are a backbone to the neck. The reasons behind the sciatica are spinal stenosis (spinal canal narrowing), injury and ruptured disk. Mostly the pain is caused due to the disorder in the hips and lower back.
The people between 30 years to 50 years are mostly stung by the Sciatica.
Mindy Marantz (Certified Physical Therapist) says that there many reasons behind Sciatica. She pointed out that “First need to identify the non-moving part in order to reach the solution.
According to a certified conditioning and strength specialist: If you want to minimize or remove the sciatica pain then you need to do some stretching exercise like rotate your hip externally, can provide you with some relief.
Now, you need to perform these six exercises to remove the sciatica pain effect:
- Sitting Pigeon Pose
- Knee To Opposite Shoulder
- Reclining Pigeon Pose
- Forward Pigeon Pose
- Standing Hamstring Stretch
- Sitting Spinal Crunch
1. How To Do The Sitting Yoga Pigeon Pose
- Sit on the Yoga mat or floor and extend your legs as shown in the picture.
- Your right ankle should be on the left knee by leaning the right leg.
- Now, bend forward and try to touch the left toe.
- Keep your body in the same position for about 15 to 30 seconds. This will expand the lower and glutes muscles.
- Repeat this exercise with the right leg.
2. Knee To Opposite Shoulder – Pain Relief Exercise
- This is known as the pain relief exercise by minimizing piriformis and gluteal muscles.
- Lay down flatly on the mat or floor and take up your right to the desired level.
- Close down the leg and grasp with your both hands the area behind the knee.
- Now, remove the hands around the knee area and bring back your right leg.
- Also, perform this exercise with the left leg.
3. Reclining pigeon pose For Back Pain Relief
You perform this exercise in yoga style or pose. This exercise works with your legs and hips. You can do this stretch in various styles. You can start with Reclining Pigeon Pose. This exercise is also known as piriformis syndrome Exercise
- Take up your leg at 90-degree angle, by locking your fingers of both hands back of the thigh.
- Now, take up your left leg up and put right ankle on the left knee top.
- Keep yourself in the same position for a while. It will help you to extend the piriformis muscle and cause pain due to pressing against sciatic pain.
- Repeat this exercise again with another leg.
After this, you need to start the Sitting Pigeon Pose with your trainer or therapist.
4. How Do You Do Forward Pigeon Pose?
- Get down on the Yoga mat or ground with your hands and legs as it is showing the above picture.
- Now, by drawing right leg and move in front just same like as in the above picture.
- Bent down your head by placing both hands palms on the yoga mat or ground and kiss the floor or mat.
- Just need to transfer the body weight on the legs. After bending down sit up again by putting weight on your legs and hands.
- Breathe out while lean forward and put all weight on your hands.
- Again do this exercise with the different leg.
5. Standing Hamstring Stretch
This exercise helps to minimize the level of rigidity in the hamstring and pain due to sciatica.
- Stand yourself in the straight position exactly at 90-degree angle. You should need to place a rectangular box in-front of in order to place your right leg on it, same like as in the picture. Stretch your foot and leg on the box straightly. A slight bend in the knee can be possible if it is hyperextended.
- Now, you need to lean your body in the direction of the foot. If you move further, you will get more the stress.
- Now take down your hip of the right leg (raised leg) instead of lifting more upward. For support, you can bend yoga strap on the right thigh below your left foot.
- Do this exercise for minimum of 30 seconds and then change the side (do it on another side).
6. Sitting Spinal Crunch
The Sciatica Pain can be controlled or minimized by compressing of spinal vertebrae.
- Sit down on the yoga mat or floor and extend your in-front of you while keeping your toes upward.
- Now by bending your right knee and reside your foot smoothly on the ground on the exterior side of the opposing knee.
- Abode your left side elbow on the external side of the right knee support you moderately by turning your body in the direction to the right.
- You need to keep in the same position for at least 30 seconds and do it maximum for 3 times and then change sides.
Do Exercise With Caution
Kovacs highlighted that there is no need to accept that you are stretchy as some exercises preferably call for. Don’t contemplate about Television of YouTube Exercises for which you can become or grow into these postures or positions. He further describes Majority of people who exhibit the exercises have sufficient bendability and performing for years. Where you feel pain, you should need to stop.
The DSMC (Duke Sports Medicine Center) famous therapist and physical trainer named as Corina Martinez says that not every exercise is best fit for the Sciatica pain people. Need to check the different exercise and evaluate which movement or position best suit you. If you feel better in certain position or exercises then this is the best treatment for your Sciatica Pain.
According to my personal experience: if a person in the Sciatica Pain from 1 month then he or she need to check themselves from the certified doctor or therapist. He or she can feel liberation from the best suitable Sciatica Pain exercise at home. Sometimes also known as Sciatica pain treatment at home.
Sciatic Pain Symptoms
Following are the Sciatic Pain Symptoms:
- You are feeling constant or infrequent pain on one side of leg or buttocks.
- Pain alongside the Sciatic Nerve trail, from the backside to the thigh and end at your foot.
- Harsh, assassination or sweltering pain.
- Unresponsiveness, needles, and pins, lower down of energy in foot and leg.
- Difficulty in sitting, walking and standing.
Every time consult with your doctor if you are worried about the discomfort or pain.
Treatment For Sciatica Pain During Pregnancy
During pregnancy, the sciatic pain treatment comprises of chiropractic care, physical therapy, and massage. Sciatic pain self-treatment in pregnancy consists of different exercises like stretching exercises for hips, legs, and buttocks that support to minimize the sciatic nerve pressure. During the pregnancy, swimming is also a useful exercise because it helps you to manage the weight of your child or baby.
Sciatica Exercises During Pregnancy
Sciatica stretches are kinds of exercises you need to perform during your pregnancy.
Here, I am going to discuss before you the 5 best sciatica stretches that can minimize your sciatica pain and anxiety during the pregnancy days.
1. Piriformis Syndrome Exercise – Seated Piriformis Stretch
The Piriformis is deep buttocks muscles. When hard, it may annoy the Sciatic Nerve. This piriformis stretch exercise helps you to decrease the level of hardness in buttock muscles and reduce the sciatic pain. No special kind of equipment needed to perform this pain relief exercise. This exercise especially targets your piriformis muscles. Below is the procedure to perform this exercise:
- Just sit down on the simple chair and smoothly keep your foot on yoga mat or floor.
- If your right is affected, place your right ankle on the left knee.
- Your back should be straight, bend forward while waiting for buttocks stretch.
- Remain in this position for 30 seconds and perform this exercise when you have a time of at least 3 to 5 times in a day.
2. Brings Elasticity In Muscles – Table Stretch
By doing this stretching exercise you feel awesome during the days of pregnancy. During this exercise, you can feel elasticity in buttocks, behind legs and back. It is easy to perform this elastic exercise without expensive and special equipment. You just need a back of a chair or a table. This exercise specially designed for hamstrings muscles, low back and spinal regulators.
- Grasp the upper corner of the table or a chair in the palms of your both hands. You must need to away your body approximately 2 to 3 feet maximum from the table and chair.
- Bend your body in the direction of the table or chair with the support of your hands. Make sure that your arms are still in straight position and back is horizontal.
- Push backward your hips from the chair till you sensation a stretch or elasticity behind your legs.
- You can increase the level stretch by moving your hips from side to side.
- Hold yourself for 30 seconds in this position. Do the same at-least two times in a day.
3. A Big Relief In Pain During Pregnancy – Pigeon Pose
The pigeon pose is a yoga pose exercise that gives you relief in Sciatica Pain during pregnancy. You can do this exercise with small changes while you are in pregnancy. You need a yoga block or rolled up towel to perform this exercise. The flexors and hip turners are the main target muscles in this exercise.
- Put your both knees and hands on the yoga mat or floor.
- Move forward your right knee so it is in the middle of your both hands.
- Move behind your left leg by retaining your foot on the ground.
- Now dwell the yoga block or rolled towel behind the right hip.
- Get on your hands and knees on the floor.
- Slide your right knee forward so it’s between your hands.
- Slide your left leg back, keeping your foot on the floor. This will create ease for expansion of muscles by removing some rigidity and will create a gap for a belly.
- Bow forward above the right leg. Try to move down in the direction of floor or yoga mat, place a pillow below your arms and head for care.
- Remain in this position for 1 minute. Now change the side and do this exercise. Try to perform this exercise several times in a day.
4. For Tight Hip – Flexor Stretch
The hip flexors are the front hip muscles that help to move your leg forward during walking. The rigidity can occur in the hip flexors during pregnancy in females. This can harm the pubic configuration and initiate pain. No need for any equipment for this exercise. This exercise targets your hip flexors muscles.
- Go down with your knees and hands.
- In order to create an angle between your knee and a hip step ahead one foot.
- In order to feel stress in your leg and hips try to transfer your weight frontward.
- 30 seconds are enough to retain you in the same position. Now, change the side and repeat the exercise.
5. Sciatica Massage – Foam Rolling
A glute and hamstrings foam rolling exercise with your both hips. It is a cheap way to reduce the Sciatica pain. It works as a message for the rigid muscles and the related tissues.
Foam Roller is the major and un-expensive you needed to perform this exercise. The glutes, piriformis, hamstrings and calf muscles are the target muscles for this foam roller.
- First, need to set the foam roller at the desired place on the mat or floor.
- Now, sit down on the roller and your hands should be behind yourself for assistance.
- Place your one knee under one foot.
- By finding a tender spot move your body in the front and backward direction slowly but gradually.
- Constantly performing this rolling exercise minimum 30 and maximum for 60 seconds.
Effects of Sciatica Exercise During Pregnancy
Sciatic pain is frustrating and painful during the women pregnancy. The implementation of stretching exercises can minimize your muscles rigidity with the reduction in pain. The stretching exercises create flexibility and extension in your muscles and remove the body tension. So the sciatic pain can become serious if you remain in the same body in a day. So keep moving and change body directions and movement throughout the day.
Now, start listening to your body and cut down on the activities that are the main reasons for the sciatic pain. But it is strongly suggested that before starting any kind of exercise first need to consult or take advice from the concerned specialist. If you have any signs or indications of headaches, bleeding and dizziness then stop stretching and need to get medical treatment first.
Sciatica Pain Treatment Naturally
If your sciatica pain is severe then you first consult with your doctor. Few doctors prescribed steroids, anti-inflammatory drugs and muscle relaxers for the treatment of sciatica pain. But there is also signs and indications that the stretching, physical therapy, and chiropractor adjustments can all make the situation better and improve.
Sciatica Pain Natural Treatment Includes Of The Following:
1. Chiropractor – Physical Exam Test
Doctors first find the problem and then suggest the solution to the problem. The Chiropractor is the type of the physical test or exam conducted by the doctors to determine the harm in the spine. Other tests like MRI (Magnetic Resonance Imaging) and X-rays can also be performed for the exploring of real harm to the spine.
A chiropractor is a spinal adjustment by identifying the pain area. The OJNASS (Official Journal of the North American Spinal Society) revealed that after matching results of one hundred and two adults who underwent the Sciatica Pain, those who treated with spinal adjustments chiropractor have less or no pain in contrast to those who not treated with spinal adjustment chiropractor.
2. Stretching and Yoga Exercises – Best Relief For Sciatica Pain
The certain body movements can help to reduce the pain. By standing or sitting in the same posture can cause sciatica pain.
However, expanding the spine through expansion or stretching, laying down or yoga can help to minimize rigidity, swelling and the last but not least is the pain.
Yoga is the most effective and safe exercise to get rid of sciatica pain. The specific movements in the yoga target your legs, hips, and backs and help you to create softness in the hard areas.
You can perform different kinds of stretching and yoga exercise like sitting crunch, pigeon and much more as already described above. The sciatica Exercises Pictures can help you more to know more about how to perform the exercise.
3. Sciatica Massage Therapy And Acupuncture
Let first determine what is the effect of the sciatica massage on the Sciatic Pain?
The massage therapy is all about the softening of the body tissues and removing the hardness so that they start working.
Massage therapy removes the pain in the following ways:
The hamstrings muscles (lower back muscles) start placing a strain on the nerve. The massage therapy supports to minimize the hardness of the back muscles tissues and thus work as a pain relief by removing irritation and pinching.
A massage boosts the discharge of endorphins (pain fighting hormones). It can help you to minimize the burning or heating feelings in the legs and throbbing in the foot.
What Things Should You Need To Consider For Choosing The Massage Therapist?
You can find a lot of massage therapists near to your area by the Google search or internet search. So here the question arises in the mind How to find the right massage therapist?
You should need to consider the following points before the selector of the sciatica massager.
1. Recognition Of Your Objectives
First of all, you need to figure out your achievement (what you want to achieve). For example, if your objective is to remove the legs pain then find the person who is a specialist in legs removing pain. The desired person should have experience in handling the sciatica patients in legs pain. If you are looking to boost endorphin levels then the treatment of Swedish massage from the local spa will be enough for you.
2. Ask Your Doctor For Advice
You can take advice from your doctor that what is the best massager on a specific issue near to your area? This advice can save your internet or Google search time.
3. Check With Certified Institutions
The AMTA (American Massage Therapy Association) is responsible for the delivering of the licensed and authentic massage therapists near to your area. However, the data is not full but in contrast with internet search, it displays the persons who can’t practice legally.
Alternatives To Sciatica Massage Therapists
If there is no availability of the massage therapists near to your home or flat then you can attain the alternatives to sciatica massage therapists. However, it is true that professional therapists are good for your sciatica massage but if it is hard to visit them then other alternatives for the sciatica pain removing exists in the market:
1. Sciatica Massage Chairs
Different kinds and quality massage chairs you can find. But the copycat’s massage chair can boost your back stability and deliver you relief from sciatic pain.
2. Sciatic Tennis Balls Massage
With Tennis Balls and Duct Tape, massage yourself in the office or home floor. For less disturbance set and fix the ball on the chair. You can soften the rigidity of the lower back muscles by this tennis ball massage.
Acupuncture is related to tiny needles. However, what is your familiarity about acupuncture or what do you know about acupuncture?
Acupuncture is the term originated from China, It is a Customary Chinese Remedy or medications and the basic objective of these medications is to achieve the body health by removing the sciatic pain. The medication technique comprises of tiny but pain-free needles that inject on the specific body areas. The medication treatment is also officially accepted and permitted by the FDA. This medication is especially targeted for your back pain, sciatic pain and also minimizes the other chronic pains.
The other non-surgical techniques for sciatic pain are Rolfing and Massage Therapy. Both help to enhance energy in the body, soften the tissues and muscles, maximize the flow of blood, back pain removing and release of the hormones to reduce pain.
4. Avoid Standing & Sitting For a Long Time
If you are working on the computer for many hours or you are playing a game or watching a video on YouTube for a long time then it can cause back pain and bulging discs. So, you need more treatments for swollen or irritated area movements.
The inclusion of isometric exercises with some stretches in your daily routine can lower down the legs and spine pain. These exercises not only protect you from pain but also create stability in your body parts. The exercises are the best Sciatica pain treatment at home and there is no need to visit the doctor clinic. You can perform these exercises easily and with comfort at home.
If you are watching a movie on your laptop in a sitting posture then you can also lie down to watch a movie. So keep changes your body movement. If you are working on the computer then keep your neck moving after some minutes. You can also perform some neck exercises while sitting on the chair in the office or your working place.
5. Inexpensive Way To Remove Pain- Heating Pads
The Sciatic Nerve pain can be minimized or lower down by the use of the heating pads. Heating pads are the cheap treatment for nerve pain lower down.
You can set it on the back lower part at medium or low setting range and remain fixing just for 15-20 minutes in a day. However, you can use heating pads number of times in a day, after every 2 or 3 hours you can use it. Whether you are at home or at work, you can easily benefit from the pain remove from heating pads.
The hot water bathtubs are also good for pain lowering. Heat helps to soften the muscles tissues and increase blood movement in the body. You can buy used heating pads for painful areas. If you joined a gym, after exercises the steam area and heat area also helpful for your body to reduce the sciatica pain.
Heat and cold ice are two opposite items. Both work as a paint remover. By placing a small amount of ice on your back or in the pain area can reduce pain. Just 10-15 minutes can do the trick for you. However, some doctors prescribed painkiller pills when the situation goes too bad.
6. Reduce Irritation Or Inflammation
An observation reveals that approximately 5 to 10 % of back pain patients have sciatica pain. However, there were also a few cases of nerve pain due to the occupational and personal risk factors. The reasons behind these never pain cases are obesity, older age, mental stress, vibration effects, smoking, standing or sitting for a long period. The vibration effects are mostly faced by the taxi, bus or truck drivers.
These factors can cause irritation or swelling (inflammation) and it is difficult to come out of the pain and injuries. To overcome nerve pain, it is better to sleep well, stop smoking and eating of a reasonable diet.
Weight Training Sciatica
Due to sciatic nerve irritation or swelling causes sciatic pain that travels through to your lower back to the legs. Different factors are responsible for inflammation and swelling and can be trifling to closely incapacitating in nature. If you are doing weight lifting exercises then full needs to care for you because don’t want to further irritate your nerve Sciatic.
Composition And Functioning
Most of the exercises are safe for the sciatic nerve and pain. The Cleveland clinic experts indicated that the main of nerve pain is a herniated disk because it put stress on the nerve root. The piriformis muscle in the buttocks also becomes tight and put hassle on the sciatic nerve.
The spinal stenosis is another problem which also strains the nerves. When two vertebral disks slip from the line then the condition is known as spondylolisthesis also cause sciatic pain.
Thoughts And Effects
The weightlifting exercises can be more dangerous for the sciatic pain. The therapy massage and stretching exercise often result in reducing your sciatica pain. The core muscles strengthen exercises must need to perform carefully because it can damage your back. Nerve pressure creates sciatic chronic pain. Sciatic nerve injury can weaken your muscles.
Exercises To Do And Avoid
The abdominal exercises are for strengthening the abdomen muscles and mitigate the stress for the back muscles. Avoid performing legs exercises like sit-ups that worsen the back pain. When the pain exacerbates you can start adding or lifting the weight.
However, it all depends on you and your body condition if you are feeling that you can manage more weights then you can otherwise carry on with the normal exercises. You know better what sciatica exercises to avoid or what not.
What Sciatica Exercises To Avoid Are:
Rowing with bent and pulling of weight is harmful to your back. Also, avoid from shoulder press or overhead press because it involves lifting weight above the head. These exercises put pressure on the spine that is harmful to a herniated disk.
Sciatica Stretches – Herniated Disc Treatment Exercises
To tackle or control the herniated disc pain you need to do some Herniated Disc Treatment Exercises. Below are three Herniated Disc Treatment Exercises, if these exercises are not good to perform, for example, you can feel sudden pain or you feel that it can cause again sciatica pain then quit the exercise.
1. Herniated Disc Treatment Exercise – Seated Chair Stretch
If you have hamstrings or limited mobility then this exercise is the best suit for you. You can perform this sciatic stretching in the following way:
- By placing a small table or chair in front of you sit on a chair.
- Grab the chair from both sides with your both hands.
- Now, place your left leg on the front table or chair while keeping one right leg on the floor.
- Sit in such a way so that your back at a 90-degree angle with the chair bent in the direction of the stretched leg.
- When you feel the strain in the rear thigh then try to remain in this position maximum for 30 seconds and minimum for 15 seconds.
- Now do this again with the alternate leg.
2. Sciatica Stretching With Towel Hamstring
All about your preferences: If you like to do exercise while laying down then the towel hamstring is the unique stretch for you.
- Lay down straightly, smoothly and flatly
- Bring the left leg up and wrapping it with a belt or towel and push down with your hands so that you start flaring pressure and in this position remain for 15-30 seconds maximum.
- Now bring the right leg and demonstrate this exercise again.
You can demonstrate this stretch also on mat and carpet or on a foam therapy table.
3. Sciatic Stretching – Wall Hamstring
An alternative exercise to towel hamstring is wall hamstring. In contrast to towel hamstring, the wall hamstring is easy to demonstrate. Without any assistance, you can bring up your leg around the wall. How to perform this exercise with the door jamb or the wall is as:
- Lie down on the carpet or mat near to the door jamb or a wall.
- Now try to put the left leg on the wall the same like as shown in the picture and keep the other leg flat on the carpet.
- Now overextended your leg with the wall so that you feel stress and keep your leg in the same posture approximately for 30 seconds.
- Repeat 2 to3 times wall hamstring with the same leg and then change the leg.
Stretch your body to the desired extent; please stop overextending your body when you feel any pain. If pain starts due overextending then ask your doctor for the advice. Not all kind or overextending exercises are suitable for sciatica pain or nerve pain.
Usually, it is realistic to cogitate surgery by keeping in mind the following reasons:
- Harsh leg pain that has continued for 5 to 7 weeks or further.
- Pain that is not minimized after an intensive struggle or by the use of manual manipulation, Injections, physical therapy, steroids and anti-inflammatory (Non-Steroidal).
- Patient’s ability and participation in the ordinary activities.
The surgery can be urgent due to cauda equina syndrome; the patient feels continuous weakness in the legs or unexpected loss on controlling the bladder or bowel.
The sciatica surgery depends on the duration and cause of the sciatic pain, below two surgeries is mentioned:
- A lumbar laminectomy
- A microdiscectomy
1. Type Of Sciatica Surgery – Lumber Laminectomy
When the lumbar spinal stenosis is the main for sciatica pain then lumber laminectomy is mostly suggested by doctors. During the surgery process, the small portion of disc or bone is cut down because it has been pilfering the nerve core.
When the patient tolerance is fall to the intolerable level due to spinal stenosis then the laminectomy is suggested. The surgery also depends on the patient’s general health level.
A wide-ranging analysis of laminectomy patients collective with discectomy had 78% success rate.
2. Type of Sciatica Surgery – Microdiscectomy
When lumber disc herniation is the main cause for the sciatica pain then microdiscectomy is strongly offered to the patient. It is the surgery by the common approach known as magnification. The disturbing portion to the nerve of the herniated disc is removed during the surgery and remaining portions left without any damage.
If the non-surgical sources are not helpful to reduce this sciatica pain then after 4 to 6 weeks the microdiscectomy is highly suggested. The surgery can be done before 4 to 6 weeks due to patient disability and pain.
Roughly 90% of patients feel liberation from the pain after the microdiscectomy surgery.
Surgery Revolves Around Patient’s Choice
Surgery is the choice of the patient whether the doctor advises him for laminectomy or microdiscectomy. The decision making lies with a patient in both the conditions.
The patient choice about surgery is based on the pain duration and intensity level of pain. The doctor judgment about surgery is also based on patient health.
Sciatic Surgery Supplementary Considerations
You must consider the following supplementary considerations to decide for your surgery.
Nonsurgical Treatments And Their Usefulness
Some people rest with nonsurgical treatment and try to remedy the sciatica pain. For example, if a person starts flaring the sciatica pain may plan for stretching exercise, some bed rest and steroid injections can lower down the pain.
Fast Pain Liberation Need
Few patients due to their lifestyle or personal preference want to get the advantage of the fast pain liberation surgery. For example, a patient who is a businessman and have no time for non-surgical treatment because he most of the time remains busy in the office tasks and also have some family obligations.
A medical and non-medical analysis reveals that the outcomes of both the treatments are the same after 1 year. However, some studies suggested the use of medical treatment provides more speedy relief than non-surgical perimeters.
According to one study span over 8 years analysis about sciatica patients found that more progress in the pain liberation is due to the surgical treatment.
The main point is here that the patient is independent in the decision for the surgery and non-surgery treatment. The doctor can just provide you with the best solution for the sciatica pain relief treatment.
Spinal Stenosis Sciatica
Sciatica is a symptom need to be diagnosis medically or naturally.
If the spinal stenosis is responsible for the sciatica symptoms then the backstretch can lessen the pain.
Spinal Stenosis Sciatica Exercise – Back Flexion Stretch
You should need to wait for a green signal from your doctor before starting of any kind of exercise. You should need to start back flexion stretch after the permission from your doctor. The following directions you need to follow for the flexion stretch:
- Lay down flatly on carpet or mat.
- Take your knees in the direction of your chest.
- Now grasp you knees area and wrench toward the chest. You can enjoy a relaxed stretch. Keep yourself position for 30 seconds and repeat it 3 times.
Demonstrate The Exercise In Proper Form
Try to perform the exercise in the right way because properly demonstration is more effective for your back stretch and sciatica pain. The improper form can cause more trouble for you by increasing your back pain.
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