Thursday, June 18, 2015

GENERAL GUIDELINES FOR LOOKING AFTER YOUR BACK



Low back pain is an extremely common complaint, not just with patients presenting to Physio Noosa but in the community as a whole.  Over 85-90% of us will have some degree of back pain at some stage in our lives.  For 90% of people affected, resolution will occur within 3 months.  But this is not the case for nearly 50%, as they will have at least one recurrent episode (Brukner and Khan, 2007)  Back pain is the most common complaint for people under the age of 45 years of age and causes significant loss of time at work and carries huge economic burden.  The cost of low back pain in Australia is over $9billion (Walker, Muller and Grant 2003)               


With this is mind, here are some tips on how to reduce or even prevent episode of back pain.

Limited sustained postures:  Vary positions.  This reduces the static loading that is placed though the spine when a task is either all sitting or all standing and assists in postural muscle activation.  Consider a stand-up desk option for work so sitting times can be reduced and postural variation can occur.

Exercise:  In general, get moving.  Improve and then maintain overall levels of fitness.  Start easy; aim for consistency; develop routine with simple load bearing activity such as walking.  Commence specific Physiotherapist guided exercises to improve spinal range of motion, strength and stability and implement these into your daily exercise routine.  You need to exercise every day for ‘exercise sake’.  Being active each day is important, but doesn’t take the place of exercise.  Remember what you do and how you do it is paramount.  Think about your lifting technique prior to loading (Is my spine straight? is my core engaged? Is the load too heavy? Do I need assistance?)
 
Posture:  Ensure ideal postural positions when sitting, standing and moving.  Make sure your posture is ideal prior to any lifting, carrying, pushing or pulling activities; no matter how light the task may seem.  Ideal posture will reduce the load and the mechanical forces acting throughout the spine and therefore prevent injuries. 



Improve overall health:  Do an honest assessment of your overall health.  With the abundance of information and education available to us in this digital age, it is easy to know where we are falling behind in areas of nutrition, hydration and general health care.  Make small changes each day to these areas and you’ll notice the difference in your health and wellbeing in no time.  Consider wholefood, plant based nutrition.  Reduce intake of animal products and ensure those consumed are the best quality you can afford.  Stop smoking.  Reduce alcohol intake to levels recommended by www.alcohol.gov.au and increase intake of clean, clear fluids. 


Risk factors to consider according to Bruker and Khan (2007)
Risk Factor
Evidence
Age
Inc risk until age 50, then relative risk decreases in men and increases in women
Gender
Multiparous (more than one pregnancy) women, three times the risk
Obesity
Unclear
Height
Unclear
Posture
No association with lordosis or leg length discrepancy
Smoking
Strong association with low back pain and sciatica
Physical Work
Inc risk in those whose work involves bending, twisting or heavy physical labour. 
Inc risk of low back pain and sciatica with exposure to vibration
Coal miners have fewer disc protrusions than other occupations
Low risk of low back pain in farmers
Sedentary Occupations
Inc risk when seated
Driving a car may cause LBP or disc herniation
Jobs involving all standing or all sitting show higher incidence of LBP than those with changing positions
Increased Fitness
Some evidence that good isometric endurance of back muscles may be associated with reduced LBP
Psychological Factors
Stress, anxiety, depression associated with work related LBP


Remember, if you are experiencing spinal pain or have concerns relating to any of the above, visit us at Physio Noosa where our team will provide specific assessment, directed treatment and an individualised exercise program to suit your needs.


www.physionoosa.com


This is posted as a general guide for people with non specific mechanical low back pain.  Should you not be certain as to what type of back pain you have, please see your health care professional for an assessment and diagnosis prior to commencing any of the above.


References:

Walker BF, Muller R and Grant WD  (2003)  Low back pain in Australian adults: the economic burden.  Asia Pacfic Journal of Public Health. 15(2)  pp79-87

Brukner, P and Khan K (2007) Clincal Sports Medicine 3rd Edition. McGraw-Hill, Sydney


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