Low Back Pain - A Snapshot


I felt it was time I broached the monstrous subject that is ‘low back pain’ (dramatic fanfare). Naturally, this topic could completely fill 82 websites, so I will keep it to the most pertinent points to save your eyes from glazing over.
Unfortunately a number of factors plot against office workers in contributing to back pain.

1) Laptop computers: these were originally invented for short term use while travelling, but more and more, people like to use them all day, every day. Keyboard and screen so close together = a ‘c’ shaped person!

2) Long hours: Often people are spending their work day on a computer, then going home to do social suff (or more work) on the computer. This results in too many hours of work, stress and sitting.

3) Exercise and fitness is unappealing to many when they feel so fatigued from a big day of work.

With poor fitness, and many hours spent hunched over a laptop, stress is placed on the intervertebral discs. Discs are located between each of the vertebrae in our spine, and act like a cushion, or shock absorber. The disc has a little pocket of jelly in the centre of many fibrous layers of tissue. This jelly nucleus moves around slightly as we bend and move our bodies.
Picture a vanilla slice. You bite one side, and the custard bloops out the back. Our discs are similar (though don’t taste as good). When you bend forward, the jelly moves towards the back of the disc. When you bend backwards, it is the opposite. Unfortunately, most of what we do in modern times is bend forwards or flex. We sit at a desk, we sit in a car, we pick up a child’s toys, we lift groceries out of a car, we read on pillows in bed. Forwards, forwards, forwards! Over time, the jelly pushes on the back wall of the disc so much, that it creates little fissures, or tears. Then each time you continue to bend or sit, the jelly keeps pushing into those fissures, making them a bit bigger.

Here is the scary part! This process can be happening to your discs RIGHT NOW without you even knowing about it. You see, the nerve supply (and therefore your pain warning system), is only to the very outside layer of the disc, so internal damage can go undetected UNTIL…
You bend over to pick up a pen and BANG! Sudden pain and spasm in your back, as the cumulative disc load finally causes the outside layer of the disc to become swollen and distended, and therefore register a pain response via the nerve supply. For others, the onset of pain is less dramatic (a small niggle that builds), but can also become debilitating.

What do you do next? After you have released a few choice words, the best thing for you to do is lie down with a heat pack on your back. Heat is good at relaxing muscle spasm. A little bit of standing and walking around is also good, but try to avoid sitting or bending over, as these movements will increase the load on the discs. Often Physiotherapy intervention is involved, where things like taping and certain gentle exercises can be put in place to speed up the settling process. For some, this can take a week, for others, many months. If the disc damage is more severe, the disc can compress a nerve in the spine, resulting in numbness in an area of your leg, and/or weakness of some leg muscles.

Recovery from a disc episode can very greatly – the lucky ones will get the message, keep fit and active, watch their sitting positions and volumes, lift carefully and never have back pain again. More commonly, back pain can become recurrent, re-flaring in times of stress and/or physical overload.
So if your back is niggling, HEED THE WARNING! Don’t wait until you are unable to move with crippling pain, act now! Get regular exercise, check the ergonomics of your desk set up and bend your knees when you lift. 

If you have any further questions about this article, email me: karen@physios-online.com

Karen Finnin
Musculoskeletal Physiotherapist
BAppSc(Physio),MMuscPhys