Looking after your back

What is a ‘slipped disc'? The vertebrae are separated by discs: there are 23 discs that provide support and shock absorption between the vertebrae’s and allow movement. Discs naturally become less deformable over time as we age. This doesn’t necessarily mean that there will be pain but it can cause a decrease in flexibility.

‘Slipped discs’ are actually a herniation of the disc. This is where the inner part of the disc protrudes and the nerve becomes ‘pinched’. This can lead to pain that may refer down the leg, very painful!

Facts!

• Recent studies found that out of 2000 people 3 out of 4 people had at some time suffered with back problems.
• 82 % said that they sat hunched in front of a computer screen all day and they were sedentary.
• 49% said that they watched between 2 – 6 hours of TV a day. Have a look at your own posture when watching TV!
• 35 million days a year are lost to back or neck problems

What causes back problems?

I have worked with back patients for many years, receiving referrals from the local hospital and GP’s. Most cases that are referred are Non –Specific Lower Back Pain. This simply means that after investigation no serious problems were found. Most cases are caused by weak core muscles, muscle imbalance and poor posture due to the muscles not being used.

Think of your back as a ship; the mast is your spine. The mast of the ship is kept strong by a balance of ropes connected to it and attaching to anchor points. As the ship bobs up and down on the high seas it is kept upright and strong but if one of the ropes breaks or stretches the strain goes to the mast and damage can occur. Your spine has the same support from lots of muscles attaching the whole length of the spine and underneath your pelvic floor. If one muscle group is lengthened or weakened this can lead to damage to the structure of the spine.

Of course, there are other reasons, you may have been born with a spinal deformity, one leg longer than the other, had an accident or a medical condition has caused deterioration of the spine. Any back pain needs to be diagnosed so that it can be treated properly. Without knowing the underlying cause it could make the condition worse if you try to exercise or perform flexibility stretches.

Someone came to me once with back pain which affected one side, when I asked what she did she said worked on a conveyor belt and twisted to her right every day, I suggested that she changed conveyor belts which meant that she twisted to her left which resulted in her muscle groups balancing. She also attended the gym and we gave her a specific back care programme and her back health improved.

I once put my foot in it with a Golfer (if you know me you will know that I’m good at this) He said that he had back pain, which is common with golfers because of their golf swing, similar to working on a conveyor belt the muscles on one side gradually lengthen and become weaker. He attended Kinesis sessions at the Wellness Centre at the Stevenage Swimming Centre where we specialise in back care. We can mimic any activity using the Kinesis modules with résistance to improve functional moves and a chosen sport. This gentleman swung to the left and I suggested very innocently that he should try swinging both ways – where is that hole in the ground when you need it?!

I went into a colleague’s office today, the only way I can describe his posture at his work station was that he was practically lying face down on the table, his arms outstretched to his key board, his back well away from the back rest of his chair. He sat up to talk to me and immediately leant over to his left side. I asked him if he suffered from back pain on the righty side. “Yes” he said, “how did you know?” Hmm… just a wild guess! His work station is completely wrong for him; he is using a round table so he can’t push his knees under which results in a terrible strain on his back which he tries to compensate for when he sits back by leaning to one side.

Hairdressers are another profession where back pain is common, usually freelance hairdressers suffer more as they are going to people’s houses and cutting hair with clients sat on all different size chairs/stools so they are bent over  for hours. My hair dresser has the luxury of adjustable chairs so that he can get the height correct but in his case, it’s not for the comfort of cutting hair, more that my earlobe is the correct height so that we can have a good gossip! Whatever, he is still looking after his back!

What helps when your back ‘goes’?

The majority of back pain will as a rule heal within a few days or weeks if there is no serious underlying cause.

Acute back pain lasts for 1-6 weeks, sub- acute 6-12 weeks and chronic 12 weeks +. Not so long ago, complete rest was diagnosed for back pain; it is now known that this delays recovery.

Acute back pain should be rested for the initial period so that more damage doesn’t occur. Your back is actually sending out signals by releasing chemicals which cause pain and a warning, your body wants you to rest and this makes sure that you do!

Alternating between hot and cold helps if it is an injury; a bag of peas in the freezer applied to the area but not directly; don’t add to your discomfort! Wrap a towel around them. Keep this on for no longer than 10 minutes so that you don’t get hypothermic, then add heat, a hot water bottle or heat pad for 10 minutes, again not directly on to the skin. Repeat every hour

Eventually, the cold can be replaced with just heat which can be kept on for 8 hours, there are pads available in chemists with just heat or some with anti-inflammatories included. If you are taking other medication check with the pharmacist that you can have anti-inflammatories.

Lying on your back with a stack of pillows under your knees so that your legs are in a table top position can help to eliminate some discomfort.

During this acute time you shouldn’t have any manipulation or physio. Once this dies down you can then start to move around gently, by doing this you are stimulating blood flow which helps to speed recovery.

What exercise can you do or avoid?

Pilates- Most GP’s will recommend that people with non-specific lower back pain should do Pilates. I am a big fan of Pilates and I believe that it has a very positive on back health but, there are many ,many ,many exercise that a lot of people suffering with a bad back would not be able to do. Most of Pilates is mat based, have you tried getting up and down off of the floor when you have excruciating back pain? Ouch!

When we have a customer referred with back pain we will have an initial consultation to see what they can/can’t do, what makes the pain better, what makes it worse, discuss their lifestyle and activity level and what job they do.

• Regular physical activity releases endorphins and can have an analgesic effect
• Focus on posture – stand tall, shoulders back to reduce a round shouldered or kyphotic stance, tuck your pelvis under so that you avoid developing a deep curve or Lordotic curve to your lower back
• Make sure that you lift things correctly; keep you back straight, don’t bend from your lower back but bend from the knees in a squat position so that the legs and bum are doing all the work
• Learn how to ‘switch your core on’ Imagine that you are on a beach, you have your cozzie/speedos’s on (nice!), you need to walk past a group of people. What’s the first thing you do? Yep, suck your tummy in! This is fine for a short period of time but eventually you will turn blue and pass out as you normally hold your breath too! Hold your tummy in but breath normally – go on, do this now- now, release your tummy by half, you can still feel the tension in your abdominals, now release this by half again, you should feel a bracing in your abdominals. This is activating deep core muscles. Your core is the ‘power house’ of your body, every movement we do is initiated here. A strong core will help to protect your spine and also to help you to perform at your optimal best.
• Use gym balls, these balls are great for activating and strengthening the core and also help to improve posture. Your Fitness Instructor will be able to advice you on exercises that will be suitable for your back condition. Buy a ball for home, make sure that it is the correct size for you and if you are short of storage space, keep it in the bath.
• Stick to low impact, non-contact sports, the key is to take things slowly, don’t go back to the level you were before your back injury. Some times this means that you have to completely stop doing the sport that irritates your back which can be upsetting but, try other sports, they might be OK.
• Avoid sit ups, this puts a load through your lower back. Try back saver sit ups instead, lay on the floor, tuck your chin in, bend one leg, keep the other straight, put one hand under your lower back, the other with your finger tips on your temple. Come up to a sit up movement, when you feel pressure on the back of your hand which is on the floor stop and lower back down. This is a very small move and only activates the abdominals putting no strain on your back. Repeat for 8 reps then change legs.
• Avoid excessive twisting and bending
• Avoid using the Leg press machine
• Avoid over excessive back hyper flexion
• Swimming is good but avoid breast stroke leg kick as this compresses the lower back.
• Be guided by your pain, everyone is different; you will have your own pain limits. Don’t be tempted to push through pain, if it hurts it’s telling you it doesn’t like it!
• If you develop any new symptoms such as the area feels hot, there is a different pain, your legs go numb or you can’t go to the loo you must see your GP.
• Tight hamstrings can be a cause of lower back pain keeping flexible is good but you will need guidance as to what stretches you should do and which ones to avoid. If you have hyper flexibility stretching is pointless, you will need to do isolation exercises to strengthen the joint. A qualified Fitness Instructor will be able to help put a programme together, make sure they are REPs registered level 4 Non – Specific Lower Back Pain instructors. Sports Therapists or Physiotherapists can also advice you.

I’m not a betting woman but I bet you, at some point in your life you will have a back problem. Look after your back, follow the key points above and give yourself the best chance of keeping your back healthy, unless you’re a cat of course then you can ignore this.

Back to Blog