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Back Pain… What’s causing it?

Updated: Jul 26

Backpain is a complex topic… mainly due to the diverse range of factors that can contribute to it. Whether it’s your job (eg. Desk job, heavy manual labour, or anything in between), sport, activity levels, age, hobbies or a combination of all of these. There is one thing for certain your back prefers to move through range rather than stay in one position for too long.


What we find is that we live in a flexion-based society. Most jobs these days require workers to be in varying degrees of flexion throughout the day. This may be sitting at a desk, digging during manual labour tasks, a mechanic leaning over a car, or a physio stooped over a treatment bed. Combined with this when we complete a hard days work we return to our car to drive home (flexion position) once home we sink into the couch to relax for the night (another flexion position). These flexion positions produce increased pressure on the front of your disks and places certain muscles in a shortened position. Your body can manage this in the short term but over many years this imbalance develops further potentially causing back pain.


Life can be busy and it is hard to see the effect of our choices in the early years because they don’t directly relate to pain or discomfort. Rather it is the years of poor sustained positions that catch up with us. This is why everyone needs to set up the needed habits to prevent back pain into the future.

Now let’s look at our top tips to prevent the development of back pain:


Sit stand desk



These have been an amazing development in ergonomic workstations. They provide desk workers with the opportunity to move between seated and standing positions. However, it is imperative that we use them correctly.

As mentioned previously your body does not enjoy sustained positions. This includes standing for too long. So, it is important that you move between sitting and standing positions during the day. We also advise patients that there is no point standing for the sake of it! Its counterproductive to perform a job in standing if your inefficient and take double the time.


Lumbar Roll





Lumbar rolls are fantastic at assisting to maintain a neutral spinal position in sitting. Ensure the roll / lumbar support is sitting just above your belt buckle, your feet are flat on the floor and that your bottom is touching the back of the chair. The additional benefit of optimising your sitting position is that placing your lumbar spine in an optimal position will have a roll-on effect to the position of your neck and thoracic spine.


Exercise



Regular exercise is a key to all health. Integrating exercise that you find enjoyable provides the best chance of success. This could include walking, stretching, resistance exercises, bike riding or hydrotherapy. What should be taken in consideration is the position that the choice of exercise places you in. For example, bike riding may not be the best choice if you sit at a desk for 8 hours a day, in this case running or walking may be a better alternative.


Load management



The body generally does not like dramatic changes in load. In many cases it may be wise to complete a job over multiple weekends rather than rushing to finish it over one. This is important if the job is something your body is not use to. Additionally, make sure you listen to your body and take a break. Frequent rest from sustained postures or repetitive tasks can help keep your back happy!


Stretches

There are so many beneficial back stretches however two of the most important stretches that we use to compensate for the positions we find ourselves in for the majority of the day are as follows:


1. Prone back extension – Picking the right starting position is imperative for the success of this exercise. Often patients who have aggravated their back require 1 – 2 pillows under their pelvis to begin with. If you are too aggressive with this exercise you may find it in fact aggravates your pain





2. Hip Flexor Stretch (also known as a psoas stretch) – This is an important stretch because when in flexion / sitting it is placed in a shortened position. If left unchecked this muscle can become shortened and tight placing additional pressure on your spine throughout the day.






Some additional things to keep in mind include:

· Manage your stress levels

· Ensure your getting enough sleep

· Maintain an adequate level of nutrition and a health weight


Written By:

Tim Delvins

Physiotherapist North Adelaide

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