Although back pain is common, when you are the one who has it, it may seem that no-one else can truly understand your suffering. It can influence your sleeping habits, and your ability to work and function normally.
The back is composed of a complex arrangement of muscles, ligaments, bones, joints and nerves. The lower spine supports 70% of our body weight. When any one of these structures becomes worn, injured or inflammed, pain can occur. The spine is actually a stacked column of bones called ‘vertebrae’. The vertebrae are connected to each other by joints which allow the spine to bend forwards, backwards, and side to side.
One of the many structures thought to be responsible for back pain is the disc structure. The disc provides a flexible space between each vertebra, acting like a cushion, helping to absorb pressure and load throughout the spine. It is made up of a centre called the ‘nucleus pulposus’ and an outer region called ‘annulus fibrosis’.
As we age the disc can stretch or bulge and the annulus may tear causing pain and inflammation. This is known as ‘degenerative disc disease’ (DDD). Unfortunately this is a result of the normal ageing process, just like grey hair and wrinkles, it is not really a ‘disease’. Most people once they are over the big ’30’ have some degenerative changes in their discs! Those who have played strenuous sport or engaged in strenuous work may develop DDD at an earlier age. The key conditions for a disc injury involve compression, bending twisting, quick movements, and a combination of all, rather than in isolation, increases the chance of injury to the disc.
Although the disc can be a source of back pain in some cases it does not necessarily cause the symptoms of pain. In addition to bulging and stretching, discs can rupture or herniate causing material to protrude and press against a spinal nerve, nearby ligament or nerve root. The irritated nerve or structure can then cause pain and sometimes weakness in the area of the body connected to the nerve. A good example of this is pressure of the sciatic nerve root resulting in pain, weakness or numbness in the leg or foot. These symptoms are commonly called ‘sciatica’.
Joints in the back can cause problems like any other joint in the body. Minor injuries, excessive movement and arthritis can all cause joints to become inflammed, tender and painful. Other structures such as muscles, tendons, ligaments and bone can also be sources of back pain.
Faulty alignment can add stress and strain to your soft tissues, contributing to pain. Posture is how you hold and how you move, it is unique to each one of you and can be influenced by your mood, culture and environment. Your posture is balanced when your head, spine and pelvis are maintained in its natural alignment with optimum muscle effort. Habits, such as leg crossing and arm folding, are what come easiest and strongest to you, you may not be aware of them or realise the harm that they are doing to you, and it is difficult to break a habit.
Many of you sit infront of your computers all day which is equivalent to driving to Scotland and back every day! It is no wonder you may end up with back ache unless you are very careful how you sit and how you support your back. It is important when sitting at your work station that you sit well back in your chair and your low back curve is supported, your feet are flat on the floor or on a foot rest, and your computers are straight infront of you at eye level. The common thing that happens at the end of the day is that you end up slouching and your chin poking forward. This will put a great strain on the neck and shoulders and may go on to cause pain down the arms, and what is commonly known as RSI or work related upper limb disorder (WRULD).
The type of work and other activities that trigger RSI are:
- REPETITION – performing repeated movements with the same body part
- POSTURE – holding a joint towards its extreme
- FORCE – performing an activity with excessive muscular exertion
- STATIC EXERTION – holding part of the body still
- CONTACT STRESS – direct pressure on nerves or tendons
Your attitude to your job can also affect your chances of contracting RSI. Things to be aware of are:
- Little job satisfaction
- Infrequent or inflexible breaks
- Monotonous work (low activity, little variety and fast pace)
- Limited autonomy (lack of control)
- Perception of intensified workload and work
- Pressure (deadlines, monitoring, bad management)
It is important to manage this carefully and avoid problems by exercising 3 times a week and keep moving frequently at work. A healthy musculoskeletal system:
- Boosts energy levels
- Decreases pain and discomfort, inturn increasing mental agility and concentration
- Strengthens the immune system to fight infection and disease
- Stimulates the circulation and heart and lung function
- Reduces stress, tiredness and the effects of chronic illness
Any signs or symptoms require an inter-disciplinary approach. The problem cannot be resolved until the cause is found and eliminated. This may include medical screening, physiotherapy, ergonomic intervention and specialist equipment.
So, be aware, look after your back, don’t get into those bad habits and keep moving.