Compiled by Greg Gibson, Physiotherapist. To book an appointment with Greg, or read his Meet the Team profile CLICK HERE.
Low Back Pain: How best to try and avoid.
Low back pain is something nobody wants to experience but unfortunately it is more common than you realise. It is one of the most disabling disorders in the Western world with an enormous personal, social and economic burden. At some point in their life 50-80% of the adult population will experience back pain and 40% can have back pain in any one year. But rather than having a negative outlook towards back pain, it is important to try and understand it a little more and realise that back pain is normal with periods of recurrence and persistent symptoms being common. When someone experiences back pain, whether it be new pain or persistent pain, there is a belief that there is a significant weakness associated with this pain or that there is a damaged structure causing this pain. Now occasionally this is true, but generally serious general health conditions or serious disc related nerve compression comprises less than 10% of cases.
The increased availability of scans has also led to an increase in the reporting of low back pain. The majority of the population, if scanned, would show some form of change in the lumbar spine, but that doesn’t mean those changes are abnormal. It also doesn't mean they will have pain or disability associated with these changes. Therefore relying too heavily on scans can add to the stress and anxiety of back pain, which are both big psychological drivers of pain. The belief that back pain is due to damaged structures is not necessarily true.
In a lot of cases low back pain can be caused by a relatively innocuous movement or can come on over time without any specific incident causing it. This pain, whether it be disc related, joint related, muscle or ligament related, may sometimes settle as quickly as it came on. However, more often than not, it takes a little time to do so. During this time it can cause changes in things such as the tone of the surrounding muscles and increased rigidity of movement patterns to try and “protect” the back. This can involve common patterns which we see including sitting rigidly upright or pre-tensing your abs/back before moving which there is very little evidence for. There is a need for certain levels of control however too much will lead to increased pain. Along with these changes people become fearful of movement and are afraid to exercise due to pain. All these aspects in turn can lead to more stress and pain on an already painful structure. This in turn adds to the cycle of stress anxiety and pain and can also impact on sleeping patterns which in turn delays recovery and increases pain.
Risk factors and how to limit/prevent them.
Like any injury, there are certain risk factors which can lead to a person being more susceptible to low back pain. Broadly, these can include individual risk factors which include a history of back pain or certain lifestyle factors such as a sedentary lifestyle. Physical risk factors which include things such as prolonged postural stresses through awkward or high load postures, prolonged or frequent bending and heavy or frequent lifting. Psychological risk factors are also a big trigger when it comes to this form of injury/pain. These include beliefs such as the back is a vulnerable structure, that it’s weak and not allowed to move freely and that low back pain is unchangeable, to name a few.
To try and prevent low back pain there are certain strategies that can be adopted in order to limit the individual, physical and psychological risk factors.
- Maintain an active lifestyle and make sure to get at least 30 mins of exercise a day with a combination of resistance training and cardiovascular exercise being beneficial in their respective ways.
- Keep moving in a relaxed and free way.
- During work, if it is predominantly desk based, set time aside to get up and move. That can be through printing something off on the printer at the far end of the office, getting up and going for a short walk or breaking up sitting time with standing if you have a standing desk. To shop our range CLICK HERE.
- Having a good understanding of manual handling techniques if needed for your work.
- Having adequate strength in order to maintain your workload if it involves repetitive lifting.
- Utilising certain devices to help you at your workstation such as lumbar rolls, seat wedges, foam rollers and trigger point balls which can all be found on our website. To shop our range CLICK HERE.
- Making sure your ergonomic set up is correct and not predisposing you to injury/pain.
- Maintain a positive mindset with regards to back pain.
- Knowing that your back is not a vulnerable structure that in fact it is a strong structure and is designed to move and move freely.
- That pain does not equal structural damage and to move is hugely important.
- Not to take everything that is reported on a scan as a source of pain.
- Sleep and rest are essential along with managing levels of stress and anxiety in your day to day life.
Hopefully some of this information will help you to possibly understand lower back pain and how you can limit or deal with it in a more proactive positive manner.
A personalised assessment and diagnosis from an expert Physiotherapist is always essential in order to properly diagnose and identify factors possibly leading to your injury - and then to plan out your individual recovery plan.
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