How Common is it?

Back problems are common. A sedentary lifestyle, poor posture, being overweight, bad working practices and a high level of stress all contribute to back problems. The majority of us will experience some form of back problem/pain at some point in our lives.

Structure in our backs

• The vertebrae
  24 bones stacked one on top of each other to form the spine.

• Intervertebral discs
  Cushions of cartilage separating the vertebrae. They act as shock absorbers and enable the spine to move in many directions. Each disc has a soft, jelly-like inner core surrounded by rings of fibres.

• Facet joints
  Small joints which maintain spinal stability and allows movement.

• Spinal cord
  A cable of nerves running from the brain through a canal at the back of the vertebrae. Nerves to the arms and legs pass through openings between the vertebrae.

• Ligaments
  Strong fibres that provide support to the joints of the spine.

• Muscles
  Many large and small muscles produce movement and give the back support. Other muscles groups from the shoulder girdle, chest, pelvis, hips and abdomen rely on their attachment to the spine so that they can move other parts of the body.

What causes back pain?

As you will realise, there are many structures in the back that can give rise to pain. Often the pain develops gradually or intermittently and the cause is not obvious. The back is a complicated structure and pain can occur anywhere along its length. Most commonly, it occurs in the neck and lower back.

• Back strains
  This is the most common cause of back pain. Abnormal stress, either sudden or over time can injure or strain the muscles, ligaments or joints of the spine. A back sprain may result from an unexpected jolt, e.g. fall, or incorrect lift. Alternatively, poor posture and weak muscles can lead to chronic back ache.

• Disc degeneration
  Degeneration of the outer layers of a disc results in flattening and bulging. The bulging disc can then put strain on the surrounding ligaments or nerves causing pain.

• Arthritis
  Like other joints of the body, the spinal facet joints can develop osteoarthritis. There may be degeneration within the joint and the growth of bony spur (osteophytes) on the edges of the vertebrae. Osteoarthritis can also affect the vertebrae. Commonly, osteoarthritis of the facet joints or vertebrae is associated with disc degeneration. This is the most common cause of arthritis in the spine. More rarely, some forms of inflammatory arthritis such as ankylosing spondylitis directly involve the spine.

• Sciatica
  The sciatic nerves run from the lower back across the buttocks and down the back of the legs. They can be irritated by a bulging disc or inflamed facet joint and pain can occur anywhere along their paths. Referred pain from spinal disease can occur anywhere in any limb.

• Osteoporosis
  Loss of calcium from the bones of the spine may result in partial collapse of the vertebrae. This is most common in postmenopausal women.

• Emotional stress
  Increased muscles tension will often stir up an existing back problem. Prolonged muscle tension will result in muscle imbalances and abnormal stress on the spine. Increased back pain may be associated with periods of stress.

Prevention and Control of Back Problems is Possible

• Always be aware of how you are using your back.

• Improve your posture and the way you move when you sit, stand, work and play.

• Include regular exercise as part of your normal lifestyle.

• Reduce the amount of stress in your life.

• Persistant or severe back pain may be best helped with treatment by a suitably qualified doctor or physiotherapist.

Care for your back

• Maintains the spine in its optimal position.

• Puts least strain on intervertebral disc, joints and muscles, and soft tissues.

• Allows spine, head, arms and legs to move more efficiently.

• Improves breathing capacity.

• Allows internal organs to work more effectively.

• Improves circulation.

• Looks and feels better.

Plan your lift

• Stand close to the object.

• Keep your back straight and bend at the hip and knees.

• Take a firm hold of the object, holding it close to your body.

• Keep your back straight and lift by straightening your knees.

• Pull or push an object rather than lifting it.

Avoid twisting movements, turn by moving your feet.

Working and other daily activities

• Always keep your back straight.

• Arrange your work space so that the most frequently used items are within easy reach to avoid a lot of bending and stretching.

• Squat or kneel down to work at a low level.

• Carry objects in both arms close to the body, avoid one-sided carrying if possible.

• When sweeping use short strokes, bend your knees and move your feet to avoid over-reaching.

Exercise your back

1. Knee to chest - Bend one knee up towards the chest and hold with hands for count of five. Slowly straighten other leg along the floor. Hold for five counts. Return to starting position, then repeat on opposite side.

2. Pelvic tilt - Tighten buttocks and stomach muscles so that lower back flattens and pelvis tilts upwards. Relax, tilt pelvis downward by arching lower back off the floor. Relax.

3. Knee rolls - Roll both knees to one side, then to the other. Keep elbows on the floor.

4. Semi sit-ups - Tuck in chin, slowly lift head and shoulders by stretching both hands between knees. Lower shoulders (keep chin in), stretch both hands to right and left knees. Lower completely. Relax.

5. Bridging - Slowly peel buttocks and back off the floor. Lower slowly, stretching spine along floor.

6. Mckenzie's exercises - While lying on your stomach, gently raise head and shoulders by straightening your arms. Hold for 5 counts. Then slowly lower head and shoulders. Relax. Gently raise one leg off the ground a few inches. Return to starting position, then repeat with other leg.