Back to Basics

No doubt all of us at some point or another have felt aches and pains in our backs, and write them off as a temporary nuisance or put up with them as a fact of life- something to be accepted when getting older. Indeed, my patients often say that they’ve suffered from back pain for years and they just get on with it. At first, these aches and pains may appear minor and relatively short lasting, but what happens when the back pain alarm is ignored? The answer, for the large majority of people, is that the alarm starts going off more frequently and more loudly.

Why does back pain occur?

As we know, lifestyle can be a major predictor of back pain. Generally speaking, the more sedentary a person is, the more likely he or she is to develop problems. This is especially relevant when considering postures such as sitting for long periods in slouched positions or in unergonomic workspaces.

In such cases the core muscles that are not being used become weak and stop supporting the spine. Consequently more pressure is placed on important structures (discs/joints/nerves) of the the back, which over time start to complain and give rise to pain.

Other factors that often contribute to back pain include being overweight, lifting incorrectly, overstretching or repetitive movements, which lead to overuse injuries.

What structures may be at fault?

Perhaps the question I am most often asked by my patients is whether they have suffered a “slipped disc”, known medically as a disc herniation. This indicates that there is a problem with the rubbery material that sits between each bone of the spine, and which act as small shock absorbers. If too much stress is placed through the discs, over time they can develop small cracks, which can eventually lead to some of the rubbery material inside escaping. This material may start to place pressure on adjacent nerves, which produce pain.

Another common problem arises from the joints that run down either side of the spine and connect one bone to another. If these joints are kept in one position for too long, over time they can become stiff and

What if I already have back pain?

Well, the first thing is to do something about it. The problem is only likely to get worse when it is ignored. Back pain which has persisted for over twelve weeks is classed as chronic and is often much harder to treat effectively.

If you already have pain, think about what things may be aggravating the symptoms. Is the pain worse when you are lying in a certain position in bed, when you are lifting, or after you have been sitting at work for an hour? If you can identify a pattern between your daily activities and the symptoms, try changing these factors as a first-line treatment. If you are sitting for long hours during the day, improving your sitting posture will greatly reduce the stress you are placing on your back. If you are unsure how to make these changes, your company may even provide an ergonomic assessment.

Begin by taking small measures such as walking over to talk to a colleague rather than sending an email, taking a short walk at lunch instead of eating at your desk, or climbing the two flights of stairs to your apartment instead of catching the lift.

Performing exercises two or three times a day can prove extremely beneficial in breaking up the static positions that we adopt at work and home. Every hour try standing up at the desk and performing some basic stretching exercises to replenish the muscles and reduce stiffness. At home, perform exercises after getting up. When you get home from work, and before you go to bed.

Why does my back pain keep returning, even after treatment?

The vast majority of my patients that reappear in the clinic are there because they fail to maintain their lifestyle changes. It is all too easy for patients like Mr. X to slip back into old habits and stop focusing on their posture and exercises. I often say to patients that back exercises should be as habitual as brushing your teeth.

Final Word

Back pain does not have to rule your life. Be proactive and begin your journey towards a healthy back today.