The Latest on Lower Back Pain

The Latest on Lower Back Pain

The Latest on Lower Back Pain

With all of this mild weather we have been experiencing in the Okanagan it really does feel like spring is just around the corner. I’m sure many of you have started to do some work in your yards in preparation for the gardening season. Each year during the start of spring there is something that comes along with the longer days and warmer temperatures: lower back injuries.

So what can we do to avoid hurting our backs?

A recent study published in the Journal of Arthritis Care and Research looked at just shy of a thousand patients over the age of 18. They found 8 different risk factors for lower back pain. In order of highest to lowest risk the 8 factors were: distraction during a task, manual tasks involving awkward postures, manual tasks involving objects not close to the body, manual tasks involving people or animals, manual tasks involving unstable or unbalanced objects, manual tasks involving heavy loads, moderate or vigorous physical activity, fatigue/tiredness. Being fatigued tripled the odds of suffering a lower back injury, while distraction increased the risk by 25 times! So based on this recent information when you are getting outside to do your yard work or gardening this spring make sure to remember this list and try to avoid these risk factors. Take frequent breaks during your day to avoid fatigue. When lifting, bring objects close to your body and focus on what you are doing to avoid distraction. When lifting, bend at your hips and knees (sticking the butt out) while keeping a straight spine to minimize dangerous pressure on the spinal discs and joints. As well, a recent study done at the University of Sydney in Australia found that almost half of the lower back injuries they looked at occurred in the morning between 8 and 11 am. The cause is yet unknown but it is thought that it may be due to the fact that your spinal discs fill with fluid overnight, making them more susceptible to pressure in the first few hours of your day. It makes sense then to take your time in the morning when possible and make sure your muscles and joints are warmed up before jumping right into your ‘spring cleaning’. Of course we don’t live in a perfect world where we can always completely avoid risk of injury. But keeping some of these latest study results in mind I hope that you can stay healthy during this upcoming spring season.

Sun City Physiotherapy Locations

Downtown

1468 St. Paul Street, Kelowna, BC
Phone: 250-861-8056
downtown@suncityphysiotherapy.com
more info

Glenmore

103-437 Glenmore Road, Kelowna, BC
Phone: 250-762-6313
glenmore@suncityphysiotherapy.com
more info

Lake Country

40-9522 Main St., Lake Country, BC
Phone: 250-766-2544
winfield@suncityphysiotherapy.com
more info

Lower Mission

3970 Lakeshore Road, Kelowna, BC
Phone: 778-699-2006
lowermission@suncityphysiotherapy.com
more info
Don’t take a holiday from good low back posture.

Don’t take a holiday from good low back posture.

Don’t take a holiday from good low back posture.

Trains, planes and car rides to visit friends and family; sitting down for a big turkey meal; sledding or hitting up the ski hill on snowy days; lounging around on Christmas morning admiring the tree and wrapped presents – this all sounds like a perfect holiday. While it is a wonderful combination for good times and many smiles, it unfortunately for some can also be a perfect recipe for a sore back. Something that all of those activities listed above have in common is a forward bent – or ‘flexed’ – position of the low back.

With normal standing posture, the low back has a slight curve, which is known as ‘lordosis’. When we bend forward or sit, we lose the lordosis and our lumbar spine – the low back – goes into flexion.  Spending too much time flexed, or performing heavy tasks in this position, can put a strain onto the lumbar discs. The ‘intervertebral disc’ is a structure that sits between adjacent vertebrae in the spine. It is composed of a tough, fibrous periphery with a gel-like nucleus in the centre. Repetitive or sustained flexion, as well as heavy lifts or bends, can injure the disc by causing tears in the fibrous rings. When this occurs, the gelatinous nucleus can bulge into the tear. In more severe cases, the gel can even push outside of the disc. It is most common for injury to occur in the back of the disc rather than the front.

To visualize what happens, imagine a jelly donut, where the dough is the fibrous outside of the disc, and the filling is the nucleus. Line up the hole that was used to fill the donut as being at the back/side of the imaginary spine. If you push on the front of the donut, the jelly will squeeze out toward the back, and can even push out of the donut (which would be the case in severe injury, or ‘prolapse’).  Forward bending is similar to this – there is an increased pressure on the front, and a suction force at the back, causing the gelatinous nucleus to move posteriorly if the fibrous rings are not holding it in place. Even with just an outward bulging of the disc (so, the jelly in the donut has moved but hasn’t escaped through the hole) can cause inflammation, and irritation of surrounding tissues, including nerves.

There are several strategies that can be used to help in the prevention of lumbar disc injuries. A few are:

  • Use a firmly rolled towel, or a ‘lumbar roll’, in the curve of your low back if sitting. It is helpful to keep one in your vehicle
  • Avoid the slumped position when sitting. A lumbar roll helps with this, as does your leg posture. Having your hips and knees in a deep bend, such as in a low chair, increases the forward bend in your back
  • Take standing and walking breaks when traveling, or during long meals
  • Stay flexible – tight hamstrings (backs of the thighs) in particular can have an effect on low back posture
  • Keep a strong core to help support your back during activities. This doesn’t necessarily mean doing crunches or sit-ups, but exercises that target the deep core muscles
  • During the post-holiday clean-up, avoid stooping to bend down to pick things up. Instead, bend your knees and hips to get into a good squat position. It’s a good way to exercise your legs, too!

Even with taking precautions, injuries can occur either with a single incident or over time. When this is the case and you notice you are having back pain, it is important to seek care from a health provider. Lumbar disc injuries, along with other causes of low back pain, can often be treated conservatively (meaning, non-operatively).  It is important to note that not all back pain is due to disc injury. A physiotherapist can help to determine what structure may be causing your pain, and give you appropriate exercises, stretches, hands-on treatment, and strategies for management, specific to your injury.

Sun City Physiotherapy Locations

Downtown

1468 St. Paul Street, Kelowna, BC
Phone: 250-861-8056
downtown@suncityphysiotherapy.com
more info

Glenmore

103-437 Glenmore Road, Kelowna, BC
Phone: 250-762-6313
glenmore@suncityphysiotherapy.com
more info

Lake Country

40-9522 Main St., Lake Country, BC
Phone: 250-766-2544
winfield@suncityphysiotherapy.com
more info

Lower Mission

3970 Lakeshore Road, Kelowna, BC
Phone: 778-699-2006
lowermission@suncityphysiotherapy.com
more info