NB You should rather see a doctor or chiropractor than try to diagnose or treat your own back pain!
- Poor Posture
- Faulty body mechanics
- Stressful living and working habits
- Injury or disease eg Whiplash syndrome or Osteoarthritis
- Aging and/or a general decline in physical fitness and flexibility
The most common back disorders:
Postural Strains and Sprains
Many hours, weeks or years of strain placed on joints and/or muscles due to poor posture and/or stressful living or working habits.
Overstretching and/or irritation of the individual muscle or ligament fibres.
Correct chronic posture problems and strengthening and flexibility exercises. One should also learn to alter one’s position frequently.
May be from an acute strain or sprain healing without normal movement, or the result of longstanding bad posture.
Ligaments around joints become thick and inflexible. It’s painful to move the joint and the immoveability causes degeneration of structures around the joint.
Correct chronic posture problems and strengthening and flexibility exercises. Severe cases may need Physio eg ultrasound, massage or chiropractic intervention or even traction.
Muscle guarding and spasm
Muscles form a ‘splint’ to immobilise the area where you feel pain and this ‘muscle guarding’, when prolonged, causes muscle spasm which although very painful, may not be a sign of a serious problem.
Painful, tender muscle with slowed circulation and a low grade inflammation.
Need to identify the reason for the muscle guarding and correct it so that the problem doesn’t recurr. Ice packs, warm pads, hot baths, massage, muscle relaxants and relaxation therapy will help relieve the pain.
Disc strain (or bulge)
2 most common causes are a forward slumped posture and bending forward to lift things. This is rarely the result of one injury and often takes months or years to develop. Poor physical fitness and loss of flexibility are often related causes.
The jelly-like centre of the intervertebral disc is squeezed through the cartilage rings causing the outer wall of the disk to bulge putting pressure on the nerves in the disc wall which results in pain ‘messages’ being sent back as back and leg pain.
Treatment starts with correcting poor posture and bad lifting habits, and increasing physical activity and (backward bending) flexibility which caused the problem.
This advance stage of disc strain or bulge is also caused by slumped sitting, bending forward to lift things.
Pain, numbness, weakness and reflex changes (in the leg for lower back problems or in the arm for neck problems)
Requires medical intervention and treatment such as traction. Bad cases may even require surgery.
Acute strains or sprains
Improper lifting, twisting, falls or other injuries such as whiplash
Often there’s tearing, bleeding and/or the irritation of the individual muscle or ligament fibres
A minor injury may only require a few days of rest and avoidance of further aggravation. In severe cases , considerable time to heal may be required, and often the healing muscles become weaker, joints stiffen and poor posture may develop which can be treated by gradual reconditioning, sports massage and chiropractic treatment to restore full flexibility, strength and good posture.
May occur as a result of long-standing back disorders related to disc injury, strains, sprains or repeated wear and tear.
Osteoarthritis is described as the wearing out and narrowing of the disc and disc space, wearijg out and roughening of the joint surfaces, thickening of the joint capsiule and ligaments and narrowing of the intervertebral foramen (the space where the nerve leaves the spinal column). The disc material may be reabsorbed by the body.
Despite Osteoarthritis seeming serious and the fact it may cause many problems, some people have minimal pain and discomfort; also, the incidence and severity of back pain becomes less as a person agesc (after 50/60 yrs of age).
Regular exercise and maintaining a reasonable level of fitness and flexibility will result in less of a problem with osteoarthritis; but overexertion and overuse may aggravate exisiting conditions.
Less common back disorders:
- Facet joint locking
The joints catch and lock in one position
- Joint instability
May result from overtstretching or torn ligaments as in whiplash
- Traumatic fractures
Rare but serious (broken vertebra) resulting from an accident
- Stress fractures
Very Rare, resulting from repeated stress on the spine.
- Compression fractures
Occur in older people (and esp. women) as a result of inactivity and metabolic changes.
Very rare but may occur in someone with a previous cancer history
- Sacroiliac Sprain
Usually caused by heavy lifting,, twisting, falling or pregnancy.
- Coccyx fracture or sprain
Results from a direct blow to the tail bone
May occur in muscles, joints or discs and is usually secondary to injury or aggravation. Inflammation is present to a certain degree with most of the back disorders discussed.
- Disease and illness elsewhere in the body
Back pain may result from things such as meningitis or liver and kidney problems.
Treatment is moving away from the purely passive treatments such as bed rest, medication, hot/cold packs, massage and manipulation; as well as away from surgical intervention, towards a focus on involving the patient in a more active, healthy lifestyle with great attention being paid to proper body mechanics and posture.
Balance and Posture are key
Maintain good posture and balance in your spines as much of the time as possible. As humans our backs have to fight gravity every time we sit or stand up. A normal human spine has 4 gentle curves which allow the back to distribute the strain and provide flexibility and absorb shock – if you have a sway, flat or slumped back or spend much time in unnatural, stress-inducing positions, your spine is not in its normal balance, resulting in pain or injury.
Prevention is better than cure!
- Physical fitness and exercise
Regular exercise, started out gradually with the duration and intensity increased as you get fitter and stronger, including aerobic, strengthening, flexibility and relaxation exercises. This seems to be the single most important way of ensuring you have a healthy neck and back.
- Aerobic exercise
causes increased heart and lung activity and improves cardiovascular fitness eg running, swimming, cycling
- Flexibility exercise
reduces joint stiffness and the loss of flexibility often associated with neck and back injuries and pain. The trick is to increase the range of motion without overstretching joints or muscles.
click here to find out more about stretching
- Strengthening Exercises
strengthen the muscles which support the back and neck, ensuring you are able to maintain good balance and posture. Repetition and resistance work causes muscles to grow stronger and build endurance.
- Relaxation exercise
is an important part of helping the person relax and de-stress, especially important where a person is tense or fatigued and has to do a lot of sitting or standing in one position at work.
- Practice good posture
- Sleeping Posture:
Do not: sleep on a sagging mattress or use too many pillows, and try not to sleep in one position for too long. Use a mattress that is big enough, firm but neither too hard or too soft, and always get out of bed rolling to one side, sitting up sideways and using your arms to help.
- Sitting Posture:
Sitting properly is one of the best preventative measures w.r.t. back and neck problems.
click here for setting up your workspace
- Slump Sit (your lower back should be supported
- Lean forward and downward to reach for or look at your work
- Sit for long periods of time without getting up
- Sit close to your work
- Sit in a chair that is the right height to have both feet placed on the floor
- Have a chair that supports you back in a slightly arched position
- Maintain a good sitting posture while driving. This may require a small pillow against your lower back
- Sit close enough to reach the pedals and steeringwheel without slump sitting.
WHAT TO LOOK FOR IN A CHAIR:
- hydraulic controls
- Seat Back adjusts up/down
- Seat back pivots forward/backwards
- Seat pan tilts
- 5 caster-easy roll base
- Seatback supports natura lumbar curve
- Seat height adjusts
- Waterfall seat front
- Seat back and seat pan appropriate size for user
Additional features, when needed:
- Arm rests
- Stool height with foot rests
- Self locking casters
- Material/ fabric appropriate for environment
- Casters for carpeted vs vinyl floors
Standing Posture with good balance being the primary goal
- Wear high-heeled, hard-heeled or platform shoes for long periods of time
- Stand in one position for too long
- Stand with knees locked, stomach muscles relaxed and swayed-back
- Stand bent forwards at the waist or with your neck bent over your work in a low position
- Elevate or incline the work surface for precise, close-up work
- Put one foot up and change positions often when standing for long periods
- Keep work up at a comfortable height
- Alter position frequently
- Stand on a cushioned mat.
THE POWER POSITION:
Maintain a neutral, slightly arched position in the lower back when sitting, standing as well as when lifting objects and swinging a golf club to maintain a healthy posture and avoid back problems.
The Power Position is somewhere between a stooped, flat back posture and the excessive swayback posture. Stand up straight and feel a slight inward curve in your lower back and then stabilize this position.
Body mechanics It’s not how much you lift or carry but rather HOW you do it!
General lifting Rules
- Keep head high, chin tucked in and back in the ‘power’ position.
- Keep back arched when lifting (as a body builder does)
- Keep weight close to body and stand up straight
- Use proper lift technique to get weight in close and maintain a wide, balanced base of support
- Plan ahead & test the load before attempting to lift it
- Do not jerk as you lift
- Keep back in the ‘power’ position when lifting (keep head and shoulders up)
General Rules while working
- Clear your path
- Keep feet apart for good balance
- Wear comfortable, cushioned non-slip shoes
- Protect yourself
Ask your chiropractor about these lifts
- The Tripod lift
- The Golfer’s Lift
- Kneel when working in a low position
- Straight leg lift: bend at hips NOT the back.
- Partial Squat lift
How to lift very heavy objects
- Push or pull (preferably push) rather than lift
- Team work
Team work for heavy loads:
- Size upi the load
- When 2 or more people carry a load, 1 should act as the leader. Be sure you can see where you are going
- You can push double the load you can pull.
More about carrying loads
- Support loads on your shoulder when carrying for long distances
- Allow for clearance when going through narrow doorways
- Pivot, don’t twist
Other NB tips:
- Carry most of the load to the front
- Pivot with your feet – don’t twist!
- Allow for clearance
- Twist while lifting
- Bend your back forwards whiole lifting
- Carry obejects in a bent over/ stooped position
Remember to alter stressful positions frequently!
Healthy living: This includes aspects such as eating nutritious foods (lots of fruits and vegetables) drinking at least 8 glasses of water per day, maintaining one’s optimal goal weight, getting rid of bad habits such as excessive alcohol and caffeine consumption and quitting smoking.
Stress management & Rest You work to live, you do not live to work. Make time for sporting activities, hobbies, leisure pursuits (such as movies or the theatre), holidays and sleep.
Office and Home Exercise Routines to reduce stress in Office workers:
The aim of this programme is to reduce muscle tension and stress in the neck, shoulders and back brought on by daily office routines. The Office routine is one you can do at work and the home routine, at home. A healthy lifestyle, exercise and good nutrition will all help in ensuring the success of this program.
SOME CONSIDERATIONS for the workplace:
- Sit with knees higher than hips
- Stand with knees bent or one foot up on an elevated object
- Wear low heels
- Wear nylon pantyhose with support if possible
- Bend legs when lifting objects
- Push/ Pull rather than lift
- Never lift more than a third of your body weight
- Carry objects close to the body
- Avoid overly tight waist bands
- Make sure sleeves and trousers are loose and comfortable
GENERAL RULES for exercise routines
- Assume each position slowly
- Hold each position for 15-30 seconds. DO NOT BOUNCE!
- You should feel tightness but NEVER PAIN.
- If you experience any pain – stop and check with your chiropractor.
- Repeat on both sides of the body, when appropriate.
- REMEMBER to breathe!
- Repeat each exercise 2-3 times
- Repeat entire set of exercises 2-3 times a day
- Take a brisk walk at lunch
- Try to never work in the same position for more than an hour without taking a small break.
All these exercizes can be done in a chair.
- With arms straight at sides, raise them forward and upward overhead, stretch and hold.
- With hands clasped behind neck (dotted position), pull elbows together and hold. Bring elbows back out to side and hold.
- Roll shoulders up, back, down, and forward in a circular motion.
- Bring right ear close to right shoulder, hold, repeat to other side.
- Holding the edge of the chair, lean toward opposite side, hold. Keel upper body straight.
- Grab chair with left hand and reach right arm over left hip. Lean to the left, hold. Repeat to the other side.
- From position shown with feet flat on floor, gently pull and hold.
- CORRECT WORKING POSITION: Do not sit with head, neck and shoulders forward.
click here for more
- Warm up muscles (eg brisk walk 10-20mins, stationery cycle 10-20min or soaking in a warm tub 20mins)
- Do stretches daily
- Use massage therapy to further reduce stress
- Get a regular sports massage from a trained professional
- At home, use a lanolin-based cream, aromatherapy-oil eg arnica as a lubricant to massage with
- Move hands over large area
- Consider using a friend or spouse to help you.
- Stroke with the grain of the muscle
- Use a light to medium stroke towards the heart, return stroke without pressure.
SOME CONSIDERATIONS for the home:
- Stand with knees bent or one up on a box, stool or foot rest.
- Sleep on side with a pillow between your knees
- If you sleep on your back, elevate your knees with a pillow underneath.
- Bend legs when lifting objects
- Push/ Pull rather than lift
- Never lift more than a third of your body weight
- Carry objects close to the body
Stroke from base of head outward towards the shoulder. Then from between the shoulder blades out towards the shoulders
Begin below hips and stroke back up to the shoulder blades.
Neck/ Cervical Spine
Stroke the muscles in the neck from the shoulders up to the base of the head
Apply gentle pressure from below the ear to the forehead along the hairline, with small, smooth circular motions
Possible causes of back problems
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