Back Pain – The leading cause of disability worldwide?
No surprise here really and it’s hardly an original piece of trivia – it’s back pain (GlobalBurden of Disease, 2010). There’s nothing trivial about the effects though and if you’re part of the 80% of the population to experience back pain you’ll know very well the impact it can have on your life.
Especially, if, like the majority of sufferers (54%) you work in sedentary job. There are plenty of other contributing factors as well.
Risk factors for back pain include:
- Mechanical restriction (stiffness)
- Poor posture
- Sedentary lifestyle/desk-based job
- Smoking/other harmful lifestyle choices.
- Genetics (rheumatism, scoliosis etc)
When it comes to lower back pain specifically the types can be divided into 3 categories:
- Acute back pain – pain lasting less than 6 weeks
- Subacute back pain – pain lasting between 4 and 12 weeks
- Chronic back pain – pain that persists for 12 weeks or longer – 20% of people who develop acute lower back pain
There are five main causes of severe, or chronic lower back pain:
Beware a poor slumped posture at your desk (just 5 minutes is enough to cause a 40% reduction in the ability of ligaments to protect discs from slipping). Beware too what they call, ‘loading activity’ (common sporting/gym/housework activities for example).
And lifting. We’re all familiar with that ‘keep a straight back advice’…here’s why
Lifting a 20kg weight with the back straight and the knees bent (correct form) increases the pressure on the discs by 73%. Compare that to a 169% pressure increase if you lift incorrectly. No wonder so many people slip a disc with a poor lifting technique.
But what exactly is a slipped disc?
It’s when the disc, sandwiched between the two bony vertebrae, pops (herniates) out of its lining (the annulus fibrosus). Are you male? Between the ages of 30-50? Then take care, you’re twice as likely to suffer a slipped disc as a woman of the same age.
The consequences? Normally a dull ache or a sharp pain in the buttocks and shooting pain going down the leg. Should symptoms progress to pins and needles, numbness or weakness in the feet you really should arrange an examination.
Acute muscle spasms are caused by sustained contraction, almost like when an elastic band goes ‘ping’ if you stretch it for too long. Muscular pain can affect anyone for any particular reason, though poor posture and psychological stress seems to be the main causes.
Studies attribute the cause to a lack of core control (by core we mean transverse abdominis, the deep muscle at the side of the abdomen (not the ‘6 pack’ muscle) ) that can pressure the passive tissues such as ligaments and discs and result in a strain/slipped disc.
Although muscular pain is nothing to worry about, it can be extremely painful with a 73% chance of at least one reoccurrence per year.
The good news is only 5% of people suffering with acute muscular/ligament lower back pain will see it extending into chronic lower back pain.
Sacroiliac Joint Pain
Sacroiliac joint (SIJ) pain is a commonly underdiagnosed ailment that affects between 15% to 30% of back pain sufferers.
Some of the risk factors for developing SIJ pain is a leg length discrepancy, previous spine surgery, traumatic injury and pregnancy.
SIJ related pain can commonly give what is called referred pain, a pain felt in another part of the body away from the original source. Pain is typically constant and one sided but worse during standing up, getting out of a car, or twisting in bed.
Spinal degeneration is ‘wear and tear’ at the joints in the spine (pictured as the disc and facets). This causes inflammation swhich is picked up by the nervous system and relayed on as pain.
What causes discs to degenerate? In a word… age. As the spine ages, the water content diminishes over time through a natural ageing process. Genetics and environmental factors such as frequent bending and twisting, manual occupations and smoking also contribute.
It’s worth noting that many people over the age of 30 suffer symptomless joint degeneration, so an image that shows degeneration of any joint , including spinal degeneration, doesn’t necessarily mean it would produce pain
Organic and pathological back pain account for less than 1% of complaints. The main reason for suspecting pathological back pain is constant pain with no relieving factors, pain that’s worse at night and other systemic signs (such as nausea, abdominal pain, night sweating, changes when going to the toilet and swelling).
If you have anything related to these symptoms please contact a healthcare professional.
As primary healthcare practitioners any Osteopathic assessment begins with establishing the cause of the problem. For peace of mind we also screen for potential general medical concerns. A common problem, osteopaths spend a lot of time and effort assessing and treating back pain; little wonder it’s our area of expertise.
Please don’t hesitate to contact the clinic on: 0161 209 3980
Ed Madeley M.Ost