Low Back Pain And What Causes It

Around 80 – 90% of adults complain of having some sort of back pain in their lifetime, an indication that low back pain, felt at the base of the back, is very common.  Lower back pain, unfortunately is often difficult to diagnose. Nevertheless, ligament and muscle strains in the lower back and less frequently disc injuries have been identified as typical contributing factors.

Although low back pain can affect almost any person, workers involved in physically demanding activities or manual handling, are at a higher risk. Manual handling, defined as any task that requires pushing, pulling, lifting and carrying of a range of objects, occurs in almost all working environments. Unfortunately, it may lead to musculoskeletal disorders such as work-related low back pain and injuries. Complicating factors may include load being difficult or awkward to grasp, too heavy, large or unstable. Other contributing factors include a slippery or congested working environment or one with uneven or unstable floors. This leads to gradual and cumulative wear and tear of the musculoskeletal system of the body (tendons, muscles, bones, ligaments, nerves and joints) leading to lower back pain.

Work-related lower back pain may have serious consequences for the workers and may prevent them from undertaking a wide range of work and leisure activities for the remainder of their lives. Prevention, therefore, is vital.

 

Excessive heavy lifting causes disc herniations and sciatica

Excessive and frequent lifting has long been identified as a risk factor for lower back pain in general as well as disc herniations in particular1. Intervertebral discs serve as little cushions in-between the vertebra in your spine. The discs are made up of tough fibrocartilage on the outside and jelly-like nucleus on the inside. With age the ability of these discs to absorb water reduces. This affects their ability to absorb impact when you walk, run, jump, etc. This and other factors predispose discs to tearing and possible herniation. Lumbar disc herniation is basically bulging out of the jelly-like nucleus through the tear in the outer layer of the disc (a toothpaste-like effect). This often happens because of undue pressure on the discs often associated with repetitive heavy lifting. In severe cases this bulge can squash the spinal nerve roots giving excruciating pain and weakness down one of the legs.

If you are employed in environments requiring heavy lifting, you can prevent sciatica by learning to lift properly. Also, avoid overburdening or overusing your back and discontinue the activity if it causes back pain.

Prevention

Some preventative measures include proper lifting techniques and controlling weight. Obesity is another factor that contributes to lower back problems.

Additionally, health care providers may recommend a back brace. A brace helps prevent injuries in people who lift heavy objects at work by helping support the spine. Unfortunately, using these devices in excess could worsen the problem as they can weaken the muscles supporting the spine.

A well-known New Zealand physiotherapist Robin McKenzie recommended performing back extension exercises immediately before and after performing a lift to minimize the risk of damaging spinal discs.
See how to do these back extension exercises here. Please consult with your health practitioner before starting to do these exercises as there is a chance they may not suit your type of b

Correct handling techniques

Lifting

Employ good body mechanics when moving or lifting objects. Do not use your back; let your leg muscles do most of the work instead.  This can be achieved by bending your knees and keeping your back straight instead of bending over at the waist to pick things up. Have a good grip on the load, and lift and carry the load with straight arms. Additionally, you should know the direction to the destination, and ensure the area is free from obstacles or anything that could make you slip. If the weight seems a bit too much for you to lift do not take risks and ask another person to help you. No point trying to be a hero and then suffering for the rest of your life and missing out on all the great activities life has to offer.

Pulling / pushing

Pushing and pulling is a strenuous task. To prevent straining the back, shoulders and arms, use the body’s own weight when pulling or pushing, that is; lean backward when pulling or lean forward when pushing. The floor should be hard and even; this ensures you have enough grip on the floor thus helping you lean forward/backward without falling. Additionally, ensure the handle height is between the waist and the shoulder. This helps you push/pull in an appropriate posture.

If you have to engage in heavy lifting activities, stretch throughout the day (we recommend McKenzie back-care method above) and ensure you take regular breaks.

If possible, manual handling should be avoided as much as possible. You can use automation, mechanisation, hoists and other equipment such as cranes, trolleys, or conveyors to lift and transport a load.

 

References:
1. Bejia I, Younes M, Jamila HB, Khalfallah T, Ben Salem K, Touzi M, Akrout M, Bergaoui N. (2005). Prevalence and factors associated to low back pain among hospital staff. Joint Bone Spine, 72(3):254-9.

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Mt Wellington Physiotherapy Located at
CLM Fitness, 45C Mt Wellington Highway, Mt Wellington, Auckland.
Phone: 09-5328942