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.
Lifting, bending, slouching and even sneezing can cause pain. Whether it is a sudden pain that seems to cripple you like sciatica, immobilise you like migraine, nag and sap your energy like a frozen shoulder or facial pain, or is one that is constant like arthritis, the physiotherapists at The Wyndham Centres are trained to find the root of the problem and treat the condition.
If the pain is due to bad posture or tension, we will help you with certain exercises to improve your posture by working on your core stability. If it is due to mouse twitching, key tapping or other repetitive minor movements we can stretch your muscles, correct your posture and show you exercises to help. If it is due to spinal problems we can mobilise, manipulate and massage your way back to pain relief.
Physiotherapists will treat any sports injury, tennis and golfers’ elbows, runners’ and skiers’ knees, rugby necks and footballers legs, and we can show you with the right warm up and stretching exercises how to prevent further injury.
It’s that time of year again when we all hope to hit sun drenched tennis courts. Unfortunately it also means that it’s the time of year for tennis related injuries.
One of the most common is tennis elbow (lateral epicondylitis), a pain on the outside of the elbow, which can radiate down into the forearm. This involves a sprain of the tendons of the forearm where they attach onto the bony ridge on the outside of the elbow. It can cause the local tendon tissue to degenerate and may have an inflammatory reaction. This can be a stubborn problem resulting in long lasting symptoms, which are resistant to treatment and, it can be brought on by any activity involving gripping, digging, hammering or even carrying a heavy case.
New research may have discovered another possible cause, which can improve assessment, treatment and outcome of many tennis elbow sufferers. It suggests that the nerve system can play a major role in this condition.
Often this pain is referred from the neck and upper back and has associated sensory symptoms such as burning, pins and needles and numbness. It can be persistent and unpredictable.
Irritation of this system can be caused by bad postures and unhelpful movement patterns sometimes related to poor ergonomics at work.
Cases of tennis elbow directly related to playing the sport have many possible causes including poor tennis training methods (especially incorrect backhand technique or excess wrist flicking during service), unsuitable rackets (often too heavy), wrong grip sizes (often too small), incorrect string tension and ball weight. Treatment will involve local electrotherapy, massage, acupuncture,stretching, exercising and strapping, which when applied appropriately can reverse the local mechanical degeneration and decrease the inflammatory changes. More importantly, therapists will also assess the patient’s total body posture. This includes both their stationary posture and movement patterns and will also often include an assessment of their nerve system.
From this assessment, treatment will be modified to include nerve mobilisation and often techniques directed to the spine and shoulder. Also, advice will be given to correct bad ergonomics at work and sports specific requirements will be considered. Therefore I hope that with appropriate holistic assessment and treatment we will all enjoy a long, hot, pain free summer playing the game we love.
Simple guidelines for good ergonomics at work:
1. Place your monitor directly in front of you rather than off to one side
2. Position the top of the monitor at eye level
3. Have the keyboard at a comfortable height to reach with bent elbows
4. Then set appropriate chair at correct height
5. Use a foot, hand and mouse rest
6. Learn to be ambidextrous with the mouse
7. Take regular breaks and stretch
Repetitive strain injury (RSI) is a name given to a group of injuries affecting tendons and nerves primarily of the neck and upper limbs. It is an umbrella term for Work Related Upper Limb Disorders (WRULD).
There are two types of RSI:
* Specific conditions – including tenosynovitis and tendonitis, (inflammation of a tendon), bursitis (inflammation within the tissue), carpal/cubital tunnel syndrome (pain and tingling in the fingers), epicondylitis (inflammation of the bone).
* Diffuse RSI – includes aches, pain, swelling, numbness, tingling and weakness.
The type of work and other activities you do can trigger RSI.
* 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.
MEDICAL CONDITIONS INCREASING RISK
include: thyroid disease, gout, obesity, hormone conditions (such as pregnancy, hysterectomy), fluid retention (such as pregnancy, birth control, sudden weight gain) and previous injuries.
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)
LONG TERM SOLUTION FOR RSI
An inter-disciplinary approach is required. The problem cannot be resolved until the cause is found and eliminated. This may include medical screening, physiotherapy, ergonomic intervention and specialist equipment. A GP or specialist’s opinion may be required to exclude any medical causes.
The physiotherapist uses techniques including acupuncture, correction of posture and muscle imbalance, stretching, mobilisation, manipulation and exercise.
The physiotherapist can also offer advice and education about:
* The correct posture
* Importance of breaks – at least five minutes every hour
* How to create movement in the work environment (including work-station set-up) or during a hobby activity which may be causing the symptoms
* Liaise with other professionals and departments: occupational health, health and safety, ergonomists and your G.P
An ergonomist assesses the design of the work-station in relation to the operators’ specific needs and makes sure it complies with the Display Screen Equipment Regulations (1992). They may suggest how to adapt the chair, desk, keyboard and desk accessories to maximise efficiency and reduce strain.
There are specialist pieces of equipment that can be provided to alleviate symptoms for example: specialist mice, keyboards, software, wrist rests, lap top raisers and foot rests.
Sarah Sunderland is a physiotherapist and I.O.S.H. recognised workstation assessor (Institute of Occupational Health and Safety). She is available 09:30 – 13:30 Tuesday and Thursday in Hatton Garden and in your workplace for ergonomic assessments by arrangement: 0207 404 0023.
The RSI Association: 0800 018 5012.
Alternative treatments for RSI by Alison Wyndham
RSI is caused mainly by the overuse of computers, musical instruments and other repetitive occupations.
In my experience as a holistic practitioner, some people are more vulnerable than others. This may be due to their immune system being compromised or their hormones imbalanced by a high intake of oestrogen from food or water.
Carpal Tunnel Syndrome accounts for more than 50 percent of RSI. This can be exacerbated by pregnancy, diabetes and thyroid problems. Diet also plays a part.
The risk of RSI and subsequent inflammation is always worse in an acidic body environment. Another factor is food sensitivities. Vulnerability to certain foods can be triggered during stressful times, after an illness, or a shock. This will be compounded if you are using the computer for hours without a break or stretching, especially if your posture is poor.
Pollution from electro-magnetic fields (EMFs) may also contribute to RSI. Offices full of computers and mobile phones could be detrimental to your health.
Tachyons are sub atomic particles, which travel faster than the speed of light. Scientists refer to this as Zero Point Energy. Although this may sound like Star Trek, there is positive scientific evidence that Tachyon can help reduce your risk from electromagnetic pollution, relieve pain and speed up recovery from illness or injury. Tachyon is available in the form of products which act as healing catalysts, rejuvenating depleted or diseased energy fields in the body. These include CD-like discs which can be attached to computers and small circular “cells” for mobile phones or the body.
Our editor wears a wrist band and a cell on each hand for RSI and has found that wearing these for several weeks has relieved the pain almost completely.
(Contact the School of Awakening: 01769 581 232,
Magnetic Therapy in the form of static low power magnets is also helpful for soothing aches and pains like RSI and tiredness. Bracelets, necklaces, and foot soles, are available at Upper Wimpole St.
Simple guidelines include:
Japanese ‘Pi Water’ (more appetising than it sounds! – ed) is a water filter, which alkalises and energises the body (both available from the WC)