How To Prevent Back Pain. In 5 Easy Steps…
May 19-25th is Spinal Health Week.
So Who Has Back Pain?
Research tells us that more than 80% of us, at some point, will have significant back pain.
So why do we get back pain, and what are some easy strategies to try and prevent our chances of getting this affliction?
How Does The Back Work?
There are may structures in the lower back which can cause pain and problems.
The way the spine works is:
- Vertebrae bones in back
- In between are discs which act as shock absorbers
- The spinal cord runs down the middle branching off nerves to supply different parts of the body
- Joints on the side called facet joints – allow movement of vertebrae on each other
- There are also ligaments which hold the bones together, and tendons holding muscles to bones
- Another structure which causes low back pain is the pelvic joints the sacroiliac joints.
Are The Discs Causing My Pain?
Let’s concentrate on one particular structure in the back for a moment- the disc.
The disc is the most commonly injured structure in the back and can be very disabling.
The disc is very interesting because of its nerve supply we don’t always get pain when we are doing damage to our backs. So lack of pain is not a good guide to follow that you are not damaging your back.
A healthy disc looks a bit like a jam donut – the inside of the disc the nucleus pulposus is the jam and the surrounding dough is the annulus fibrosus. Yum!
Sitting, especially while slumped or bending, places a huge amount of force on the discs and the spine. Interestingly labouring work involving heavy lifting can put just as much strain on the spine as sitting.
An “Unhappy disc” looks like this jam donut, where the jam has leaked out of the dough so to speak. A prolapsed disc or disc bulge can vary in severity from just causing a low back ache to being severe enough to need surgery.
Depending on how bad it is the “jam” can then start to squash the nerves in the spinal cord which can cause symptoms such as pins and needles or pain down the leg, muscle weakness, or even loss of bladder or bowel control.
It’s Not Just Discs
Let’s leave the discs for a moment.
Different positions place pressure on different structures in the lower back.
For example, bending backwards and twisting place more force on the facet joints, like the golfer ‘s positon in this picture.
With regard to treatment and performing exercises it is very important to know which structures in your back have been injured as the correct exercises and treatment will vary according to the problem.
Our Top Tips For Preventing Back Pain
Tip 1. Pacing
At home you don’t have to finish things all at once.
Spread the big gardening job over a few weekends, invite your friends over and have a garden party.
You don’t have to vacuum the whole house all in one day. Mix up some vacuuming with some dusting or surface cleaning.
Change activities. If you sit a lot at work don’t come home and sit all night- do some exercise, go for a walk or watch television whilst lying down. If you have had a busy week sitting at work, maybe that is not the weekend to move all the furniture around in the house.
It’s surprising how uneventful the incident that “broke the camel’s back” can be. It can be as simple as bending over to dry your toes in the morning, getting up after sitting on the couch, or picking up the cat.
Tip 2. Pause
At work – don’t sit for more than 30 minutes without a break.
You don’t have to go for a 10 min walk every 30 mins but you just need to stand up and then sit down. This can relieve the pressure on the spine.
Practical ways to help this include setting a screen saver on your computer, setting an alarm on your mobile. Have “Microbreaks” – Have a cup of tea and a rest in between housework.
Don’t be obsessed with getting it all done at once.
Tip 3. Position
Think more about the type of positions you are getting your spine into every day and try to minimise bending and twisting.
Sit with your back supported, looking straight ahead.
If at a desk, your mouse should be easy to reach.
Avoid laptops if possible, otherwise get a lap top stand. Get an ergonomic assessment at work it can make all the difference.
Carry smaller loads, place basket on a stand or table instead of bending all the time.
Extend the height of the vacuum. Lunge rather than bend. Same goes with mopping – use smaller amount of water in buckets.
Use a kneeling stool.
Squat instead of bending.
Use the hose instead of a bucket.
Keep loads close to your body.
Bend your knees.
Get a helper if you can.
Tip 4. Perform Exercise
Regular cardiovascular exercise can help to reduce back pain and reduce your chances of getting it.
This just needs to be something that gets you puffing – get your heart rate and respiratory rate up to the point you are lightly sweating.
Top 5 Back Pain Prevention Exercises
Over time our joints get stiff if we don’t regularly take them through their full movements.
With less available movement in our spine we will reach the end of our available movement more easily and be more predisposed to injury.
If you perform regular range of movement exercises these will help maintain your movements. Please note these are preventative exercises, they may not be suitable if you are currently experiencing back pain.
Our first exercise is to maintain extension, the arching back movement in the spine.
Extension exercises performed in standing or lying take the spine into the opposite direction and can help to take pressure off structures like the discs in the spine. This is a great exercise to slip into your day especially performed after sitting , bending or lifting activities.
Great for opening up the facet joints, can be performed with both knees bent or 1 knee bent.
Glutes are the big muscles in your butt – they often tend to get tight if we sit on them a lot.
They attach around the spine so keeping them flexible will keep your spine more flexible.
Hip Flexor Stretches
Another big muscle which attaches into the spine are the hip flexors.
Once again keeping these muscles flexible will assist your spinal movement.
If you have a sore knee, then use a pillow to prevent aggravation of your knee.
Abdominal Muscle Activation
The “Transverse Abdominus” is a deep abdominal muscle which runs across the belly and attaches into the spine.
Research has shown this muscle stops working properly if we experience low back pain and if we don’t correctly rehabilitate this muscle it can be a cause of ongoing back pain.
Getting specific advice about activating this muscle correctly (using real time ultrasound) is essential to help prevent or treat back pain.
Tip 5. Support Your Spine
Support your spine in multiple ways:
A good supportive chair at work, support spine with a cushion on the lounge or softer seating, lumbar rolls
With Strong Muscles
Support your spine with strong muscles – as just mentioned core stabilising muscles like transverse abdominus and pelvic floor help to support your spine.
Pilates classes can be a great way to exercise your core muscles and also keep your spine flexible.
My Back Hurts – What Should I Do?
If you do experience low back pain or stiffness, the good news is that Physiotherapy can help.
The most important thing is to have your spine correctly assessed and diagnosed to find out what is causing your problem.
Don’t take advice from your next door neighbour (unless they are a physio!) or your gym instructor or local butcher!
Physios are specifically trained to be able to give you a diagnosis and therefore an appropriate treatment plan for your problem.
We can refer you for x-rays or recommend you see your doctor for other investigations like CT scans or blood tests if necessary.
Physios can advise you on the best way to manage your back problem, things you can do at home to help it recover more quickly, things you may need to avoid while it settles, and they will suggest the type of physio treatment to assist your spine to recover pain free movement.
We will often give you specific exercises and a rehabilitation program to ensure you make a full recovery.
Leading Edge Physios will make sure you do the right exercises at the right time in your recovery- if you do some exercises too early they may make you worse.