We spend long periods sitting, whether at our desk, at the computer, in the car or at home, these longer periods of sitting inflicted by our modern lifestyles is having a direct impact on our backs and necks. Sitting for prolonged periods in slumped or sloughed postures can create muscular imbalances and predisposes certain areas of the spine to ‘wear and tear’ or arthritic changes and disc injuries.
Lower Back Pain
The lumbar spine is a very complex area to treat. The changes in the structure of the lower back compared to the upper back means there is an increase in the stresses and strains through its joints and tissues. Interconnecting soft tissues from the upper back and hip mean that pain cannot always be indigenous to the lumbar spine but may be referred from other misused areas and poor biomechanics.
However, some structural problems can occur within in the lumbar spine that can affect different age groups. Below are some common ones:
Spondylosis (or osteoarthritis)
Wear and tear at the spinal segments, like all other joints, can take their toll on the lumbar area. The lumbar spine carries the weight from the upper back, neck and upper extremities, and therefore can be susceptible to arthritic changes. Unfortunately these changes in the spine are irreversible.
Changes can occur in the main body of the spinal vertebrae or in the lateral zygapophyseal joints (which can be known as facet joint syndrome). Symptoms are usually felt in the back, buttock and legs.
It is important to have a preliminary medical assessment with your GP to ensure you are on the right course of pain relief where required.
Physiotherapy will teach you how to manage and reduce your symptoms. Postural re-education and core retraining will always be a central aspect to your rehabilitation to ensure pain prevention, stronger deep abdominal and back muscles.
Disc Protrusions (or ‘slipped discs’)
Disc protrusions occur most commonly between the ages of 16 and 55. Disc protrusions can occur with trauma but more commonly with repetitive strain of the spine like over flexing or twisting, with or without load. Long periods of sitting, especially in a bad position can also increase your likelihood of having a disc injury. Uneven pressures on the discs of the spine, when doing the movements mentioned allow the disc to move in different directions depending on the stresses imposed on them. Often discs can protrude towards the neural structures and cause uni-lateral or bilateral hip and leg pain as well as back pain. Some complain of neural symptoms such as pins and needles, numbness and weakness. If you start to experience such symptoms, an assessment is strongly advised to prevent further deterioration in symptoms.
How to prevent disc injuries when lifting
Here are some key points to remember:
- MAINTAIN NEUTRAL SPINE WHEN SITTING, STANDING AND ESPECIALLY WHEN HANDLING HEAVY OBJECTS
- TRY TO AVOID LONG PERIODS OF SITTING
- AVOID REPETITIVE BENDING TASKS, AND USE YOUR LEGS INSTEAD OF YOUR BACK
- KEEP BACK AND POSTURAL MUSCLES STRONG
Sciatica – Sciatica is the medical name for pain that radiates from the buttock into the back or the side of the leg. People can often complain of pins and needles, numbness, shooting pains, weakness and or pain in one or both legs. It is important to note that sciatica is a symptom of another medical condition that needs to be addressed to prevent reoccurrence of your sciatica.
The most common cause of sciatica arises from compression of the nerve root from prolapsed or ‘slipped’ lumbar discs. However, this is not the only reason sciatica may arise. Compression, injury or irritation at any point of the sciatica nerve can reproduce the same type of symptoms.
It is important to have an assessment as soon as possible to determine the cause of the symptoms and address them before the symptoms worsen.
The neck, like the back is a very complex area to treat. There are a number of structures within a small area. When patients complain of neck pain, it is crucial to take a detailed history to deduce the cause and formulate an effective treatment plan. Serious pathologies and conditions need to be excluded, particularly in sporting or trauma injuries.
Complaining of pins and needles or numbness?
Pins and needles (or paraesthesia) can originate for a number of reasons. Around the neck region, a common reason can be cervical nerve root compression. Compression of the nerve as it comes out from the spine can be due to ‘slipped’ discs, bony spurs or arthritic changes. The compression of the nerve disrupts its electrical output therefore giving a prickling sensation and the feeling of numbness. Some of these changes are irreversible, but with physiotherapy assistance, pain can be reduced and prevention of your symptoms can be addressed.
Sometimes paraesthesia does not always occur due to compression of the nerve directly but can be due to a phenomenon known as trigger points, also known as ‘muscle knots’.
Trigger points are areas of tight, overactive muscles which have been overused over a long period of time, or spasm in acute injuries to provide a protective response. Active trigger points act as if a nerve is ‘trapped’ and can produce similar symptoms to that of true nerve compression. Trigger points require stretching and tissue mobilisation. Deep tissue massage and acupuncture can work very well in such cases by releasing deeper in the muscle. As always it is best to seek an assessment first in order to determine the best course of treatment to suit your needs.