Solutions for Back Pain

  • 13 Mar 2009
  • Reading time 11 mins
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Up to 80% of us will suffer with the misery of back pain at some point in our life. Understanding why it occurs – and how you can keep your back in good shape – can help to reduce your risk of suffering. Osteopath Clive Lathey from The Putney Clinic explains:

 

Q: How widespread is back pain?

A: Back pain is the second highest cause for seeking medical advice in the UK, falling just behind the common cold. GPs receive some 7 million visits from sufferers each year, with 80% of back problems recurring. What’s more, the NHS spends more than £2 billion every year on back-pain-related costs including GP consultations, hospital fees and physical therapy. And in the private healthcare sector, a further £5.5 million is spent annually trying to treat this condition. Factor in the five million working days lost each year, and the charity BackCare estimates that back pain costs the UK around £5 billion every year.

Q: What’s the main cause of back problems?

A: The leading cause is sedentary living. In the Western and developed world, sedentary life is on the increase, particularly in the workplace. We spend long periods of time sitting at desks and computers, driving vehicles, flying and generally being less active. This has contributed to the dramatic increase in back pain in recent times. The human spine is a complex piece of engineering which is designed to be active. Prolonged sitting places our spinal discs under strain. The discs are like shock absorbers between our vertebrae and have a ‘jelly-like’ substance inside them. A slumped sitting posture, which reverses the natural curve of the lower back, can increase disc pressure by as much as 190%. This gradually weakens the tough spinal ligaments and outer layer of the disc, and subsequently can lead to the development of disc bulging (also known as a ‘slipped disc’).

Q: What about decreasing fitness levels?

A: If you live an inactive life with a sedentary job, it goes without saying that your overall body function will suffer. For example, in a typical day an average person may spend 30 minutes walking to and from public transport to their workplace and home again (and even less if they drive to work). The rest of the day, for the majority of people, will be spent inactive sitting at a desk. This may easily mean seven-to-ten hours of very little movement. Mechanically, you will develop generally less flexible muscles and poor muscle tone, alongside increased joint stiffness. The spinal muscles will not only shorten and tighten, but also waste, which is known as muscle atrophy. The result of this is less ability to control and maintain body position, co-ordinate movements and maintain the natural ‘S’ shape of the spine. All these factors increase the likelihood of injury to your spine.

Q: Does our posture play a big role?

A: The way you hold your body is probably the most important factor in determining the health of your back. Poor posture will gradually weaken your back and result in pain. Good posture is achieved by maintaining the S shape of the spine, both in a sitting or standing position [see exercises below to help you achieve this.] When the spine is in the S-shaped position, the centre of gravity is located in the mid-line or neutral location. In other words, the weight of your body is distributed equally along the length of the spine. In this position, the muscles in the front and back of the body are well toned, but relaxed. A poor slumped or ‘C’ shaped posture (particularly in sitting), will weaken the spinal discs, stretch ligaments and joints, tighten muscles and eventually cause pain.

Q: Does any section of society appear to suffer more?

A: The overweight and obese are more likely to suffer with joint pain. Excess body weight not only leads to an increase in loading of many of the body’s joints – which can contribute to early wear and tear, ie arthritis – but also puts a tremendous strain on the back and neck. The spine – with all its discs, muscles and ligaments – and the pelvis, has to support the rest of the body. So, if there is extra weight, which generally pulls the body forward, all the components of the spine have to work very hard to maintain an upright posture. This means there is a much greater risk of a slipped disc, muscle tears and ligament sprains. Overweight patients often complain of low back, knee, hip, ankle and foot pain. The body requires optimal health in order for damaged tissue to repair quickly and permanently. However if, as is often the case with obese patients, the body is not in a healthy state, then these tissues can become chronically damaged resulting in long-term pain and reduced quality of life.

Q: What about those with congenital conditions?

A: A number of patients who complain of hip, back and neck pain have a spinal scoliosis which may be the root cause, or at least a contributory cause, of the pain. The scoliosis may be due to other factors such as leg length difference or pelvic torsion and so the spine is trying to accommodate these asymmetries by twisting and rotating. In some patients, the scoliosis may have occurred at birth, or later in life through a traumatic incident or long-term postural anomalies. The consequences of a scoliotic spine will be uneven stresses and strains being placed upon the vertebral joints, discs, ligaments and muscles, resulting in damage and discomfort of varying degrees. As an osteopath, I assess the type and degree of scoliosis and the causes and contributory factors. With this information, I can perform manual treatment with the intention of minimising the scoliosis and/or assisting the patient’s body to adapt to the strains and thus reduce the pain. Postural advice and exercise regimes can also help in a rehabilitative and preventative manner. <......

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