Living with back pain
If you are over 35 and have no back pain you are one of the lucky ones. A staggering 80 per cent of Australian adults experience back pain at some stage in their lives, writes David Goding.
Most back problems stem from a strain in the muscles, ligaments or joints. Stress, a lack of exercise, poor posture and bad work practices are all considered to be major contributing factors to back pain.
If you are an office worker, for example, you may well experience all these factors on a daily basis. The average office worker slumps in front of a computer for 30-40 hours a week (often more), rarely gets adequate exercise during the week, is frequently stressed and in the process develops poor postural habits.
“The current lifestyle so many people lead is conducive to back pain,” says renowned physiotherapist, Dr Geoff Mackay, who has worked with the likes of Lleyton Hewitt, the Awesome Foursome rowing team and the Australian Olympic team.
“A lot of people are very sedentary, not only at work but in their recreational lifestyle as well. This kind of sedentary back pain is very common and tends to creep up over time. You often develop an acceptance of it at the start but as the pain starts to impinge on your lifestyle you’re forced to do something about it.”
A lot of women manage their back pain with anti-inflammatory medication and have their favourite back specialist – chiropractor, osteopath or simply a good massage – on hand to provide immediate relief. For a while.
“Relief is one thing and cure is another. All these types of treatment only give temporary relief,” Dr Mackay says. “You really need to change your behaviour if you want to confront those pains and get rid of them for good.”
Improving your posture
“Our creature comforts – the bed, soft armchair, car, office desk and computer – are the instruments of our torture,” says Barrie Savory, leading back specialist and osteopath, and author of The Good Back Guide.
“People may feel comfortable but they’re actually causing fatigue and gradually weakening their lower back muscles.”
True comfort ultimately resides in good posture. This means choosing the straight backed chair (or ergonomic chair) over the armchair, being careful not to slump at your desk and, perhaps most important of all, keeping your back moving whenever possible.
Take regular breaks during the day, walk to the next room and back, and do a few stretches before going back to your desk. Be aware of how you are standing, how you are sitting and make a concerted effort to form good postural habits.
Attention to foot and lower limb posture should also form part of the mix, as poor alignment or function of the foot can contribute to additional forces travelling up the leg, affecting spinal posture.
“There is no ‘one size fits all’ approach to footwear,” says Stuart Imer, a foot and ankle physiotherapist with Foot Solutions. “The key is having accurate assessment and prescription of footwear for each individual.”
Strength and movement
“If you’ve got chronic back pain, you’ve got to get up and do some exercise,” Dr Mackay says.
Regular exercise is crucial for a healthy back as it improves flexibility and builds strength and stability. Activities such as walking, running, tennis, stair climbing and yoga all provide an excellent workout for your back.
Including some form of strength training is highly beneficial as this develops core strength and builds supportive muscle that can help to prevent back pain.
“Strengthening the lower back plays a significant role in reducing back pain,” Dr Mackay says. “After the age of 35 we lose muscle mass every year, so instead of sitting around gracefully getting old you should involve yourself in a strengthening program and you will maintain your entire body function so much better.
“Developing good strength in your core has been proven to be highly beneficial in addressing ongoing back pain, particularly strengthening the deep lumbar extensor muscles. Contract your stomach muscles and you naturally contract these lumbar muscles and visa versa.”
Dr Mackay recommends a new technique called Kieser Training. Developed in Switzerland, these gym machines are designed specifically to target the lumbar extensor muscles and have been shown to be extremely effective in the treatment of lower back pain.
“These machines have been scientifically validated to isolate and strengthen that muscle,” he says.
When back pain does strike it’s rarely beneficial to keep still. Studies have shown that the longer you rest, the longer it takes to get better and the worse off you are in the long run.
For every day that you stay in bed, muscles weaken and scar tissue hardens. It is only recommended that you lie down if the pain is unbearable and even then, for no more than two days. It’s much better to keep active if you are able.