Poor posture at your desk and limited movement: major causes of lower back pain

Lower back pain: why you need to get active now

I had the pleasure of meeting staff from the ITV studios in London recently as part of ITV’s ‘happy back’ lunchtime pop-in session. After working in an office myself for many years, I wasn’t surprised to see young office workers with varying degrees of lower back pain queuing eagerly for a therapeutic massage from Suzanne Wylde.

According to Royal London Bridge Hospital Consultant Neurosurgeon Bhupal Chitnavis, back pain is the world’s leading cause of lived-with disability. Speaking at the launch of the Back4Good Pilates programme in September 2016, Mr Chitnavis said there is a huge demand for treatment for back pain.

More than 80% of the adults will experience lower back pain at some time in their life. It is one of the most common reasons why people take time off work. It is often linked with depression and anxiety because of the way it affects an individual’s quality of life.

What is lower back pain?

Lower back pain manifests as pain or discomfort, muscle tension and/or stiffness between the bottom the ribs and the top of the gluteal muscles. It can restrict your range of movement, because you become frightened to move. This in time can lead to weakening of the muscle and a loss of functional range.

According to Mr Chitnavis, the intervertebral discs are the primary cause of back pain. Unlike the bones of the spine, which are constantly being deposited and taken away, the discs are not very metabolically active. This means they are prone to wearing out. Over the years, the discs lose their turgidity (like a deflated balloon) so the pressure inside them reduces.  The joints in the back then become overloaded and arthritic.

11 risk factors for lower back pain

There are many risk factors for lower back pain. Things you can influence include:

  • Smoking (which destroys collagen, one of the important components of the intervertebral discs)
  • Psychological stress
  • Low self esteem
  • Lack of fitness
  • Obesity: the spine is load-bearing structure linked to back pain
  • Sustained compromised posture
  • Awkward movements and postures. For example, standing up and leaning forwards (spinal flexion) increases the pressure in the discs
  • Prolonged sitting in one position diminishes the blood supply to the discs
  • Frequent bending and twisting
  • Heavy and repetitive lifting
  • Pregnancy

Three classifications of lower back pain

  • Specific spinal pathology: for example, due to arthritis, fractures, infections and tumours (about 1% of cases)
  • Nerve root pain: compression of a nerve leaving the spinal column can result in pain, tingling, numbness or weakness. For example, compression of the sciatic nerve, which runs through the buttocks and all the way down both legs, ending at the feet, can cause electric shock-like symptoms, usually in the buttocks and legs, along with general back pain.
  • Non-specific back pain: this accounts for 95% of cases. The pain is linked to mechanical causes, such as posture and activity. Non-specific pain is often localised, but can extend to the buttocks and thighs.

Warning signs

As you can see, lower back pain can be a symptom of something serious. It is essential that a qualified medical practitioner determines the cause. Back pain associated with any of the following needs urgent medical attention:

  • Rapid loss of weight
  • Pain or tingling between the legs or in the buttocks
  • Pain or tingling in both legs
  • Bladder or bowel incontinence (or both)

Exercise and lower back pain

Apart from helping to control your weight, which reduces the load on the spine, effective exercise delivered by a properly trained exercise professional can often help with the prevention and management of low back pain.

A 2005 study in the British Medical Journal compared spinal fusion surgery with psychological and physical therapy. It concluded that the outcomes of putting people through a three-week intensive exercise programme with cognitive behavioural therapy were the same when compared to spinal fusion surgery.

American College of Sports Medicine guidelines suggest individuals can begin exercise that minimises the stress to the lower back area during the first two weeks of an acute bout of back pain. Remember, you don’t have to be pain free before you can start exercising.

However, before you enrol in a bootcamp, it’s worth remembering that high-intensity, high-impact activity can cause further injury for those with back pain. Start with low intensity exercise and progress gradually. Pilates teaches you to use the small muscles in the back that link the bones to each other more effectively and to keep the movement synchronous. This can helps to manage your back pain and reduce that fear of movement.

 

The simple important lesson from Mr Chitnavis is to get active, undertake appropriate exercise, reduce your weight and don’t smoke: all preventive and important aspects of keeping your back in good condition.

Useful links:

The 2009 National Institute of Health and Clinical Excellence guidelines recommend that structured exercise should be part of managing lower back pain.

Backcare UK provides a range of information sheets that give background information and practical tips on various aspects of back pain and back care.

Back4Good®: Healthy back class: Pilates classes that help people manage their back pain