According to the EPISER study of the Spanish Society of Rheumatology (SER), approximately 80% of the population suffers back pain at some time in their lives. Furthermore, in the last 30 years, in Western societies, disability associated with low back pain has become a major health problem, which transcends individual, health, occupational, economic and social issues. This highlights the complexity of its causes and, therefore, of its possible solutions.
Whether or not low back pain is strictly a medical problem, it undoubtedly needs to be treated properly and help to understand its pathophysiology. Although in the vast majority of cases, the cause of low back pain (80%) cannot be attributed to any specific injury, in this post we will cite many of the causes that can contribute to its development, the importance of avoiding its chronification and, with it, education for its prevention in terms of health.
From acute to chronic pain.
While it is true that we are familiar with the term chronic pain, we know little about its origin. For acute pain – generated suddenly – to become chronic pain, it must persist for at least three months. This leads to changes in the central nervous system which explains the establishment of pain and its chronicity. That is why it is so important to raise awareness in the prevention of chronic pain and, with it, to educate for the adoption of good postural practices, physical-sports recommendations and treatments that allow us to avoid or slow down the arrival of chronic episodes, in our case, of the lumbar area.
Origin of low back pain.
Let’s focus on back pain in the lower back. Low back pain, also called lumbar pain or lumbago, is pain located in the lower back, corresponding to the lumbar area of the spine and affecting some part of the area extending from the lowest part of the back ribs to the lowest part of the buttocks, with or without involvement of the lower limbs.
To begin to be aware of good habits related to the prevention of low back pain, the first thing to do is to identify its possible origins:
Do we know what they are?
Low back pain can appear for a wide range of causes such as:
- A forced posture adopted repeatedly or for a prolonged period of time.
- A precise movement made in an abrupt manner.
- A fall or direct blow that affects the biomechanics of the locomotor system.
- Handling heavy loads.
All these causes have a direct repercussion on the back and manifest themselves immediately or with a certain delay as a very localized pain in that specific part of the back.
However, there are other, less well-known reasons. It should be pointed out that one of the most important reasons highlighted by the EPISER prevalence study is the fact of suffering from osteoarthritis of the knee, which we will discuss in a future post. On the other hand, this same study does not support the general belief that osteoporosis is a direct cause of back pain in general and low back pain in particular, in the absence of vertebral fractures. Although bone health is relevant, no significant relationship has been found between densitometric values in the osteoporotic range and low back pain.
Low back pain and lifestyles.
Although it is true that the origin of this problem is varied, its prevalence in today’s society is motivated to a greater extent by the increasingly sedentary lifestyle, mainly in the working population who claim not to have time to practice any type of physical activity. According to data from the National Health Survey (ENS) carried out on a population sample of working people, 41.9% of the working population analyzed does not exercise in their free time. If to the lack of physical exercise we add an excess of sedentary practice that is accentuated by teleworking, the growing tendency to overweight is more than justified. This has a direct impact on the distribution of weight in our body, causing a lumbar overload and generating, ultimately, pressing health problems.
Therefore, it is more than obvious that the concern for lower back health has grown in recent years and it is necessary to educate to adopt healthier postural habits.
What is postural hygiene?
Good postural hygiene means taking care of your posture. Most of the time, back pain can be prevented by simply reducing the pressures and load on the spine through various activities, always advised by a health specialist, designed to compensate for the daily accumulation of tension in the muscles as a result of poor body posture and stress.
Over time, slouching and shrugging your shoulders when you walk or sit can throw your muscles, tendons, and ligaments out of balance. When this imbalance occurs as a result of poor posture, you may begin to experience headache, shoulder pain and back pain. But, by acquiring good postural hygiene, you can prevent these aches and pains and even help reverse some of the effects.
Prevention of low back pain.
Here are some recommendations to avoid low back pain:
- Avoid slouching, stand up straight, shoulders back, head up with your neck straight and contract your abdominal muscles.
- Avoid lax positions, both sitting and standing.
- Avoid hyperextension of the spine, do not stretch excessively to reach an object.
- Bend your knees when lifting objects and handle them as close to your body as possible. If you want to move an object it is always better to push than to pull.
- Always face the action you are about to perform and use safe support points.
- Avoid being overweight and get regular exercise. Exercise provides strength and tone to the muscles and releases tension. Swimming, Yoga and Pilates are especially useful to keep the spine in good condition.
- It is advisable to sleep in the supine or lateral decubitus position and never in the prone position, preferably on a hard mattress or bed base.
How to achieve better postural health at work?
- For work in a seated position, sufficient space must be provided to accommodate the lower limbs and to allow for changes in posture during the course of the activity.
- Make sure your chair is adjusted so that your feet are flat on the floor and your knees are at a 90-degree angle. You should avoid crossing your legs.
- It is important to have a height-adjustable chair with a backrest with a soft prominence to support the lumbar area and with devices to adjust its height and inclination.
- The working seat must be stable, providing freedom of movement and a comfortable posture.
- Make sure your shoulders are relaxed and not raised or rounded. To do this it is important that you take care of other elements of your workspace such as placing your computer screen at the right distance (at least 40 cm) and the keyboard so that there is enough space in front of it to rest your hands and arms. Position the display at a height such that it can be viewed within the space between the horizontal line of sight and the line of sight drawn at 60° below the horizontal. (See image on the previous page). Use a free-standing pedestal to position the display at the right height.
All these recommendations seen individually may seem trivial, but their implementation together and put into daily practice will allow you to prevent back pain, reduce the effects of chronic low back pain and, in short, improve your health.