The prevalence of low back pain is reported to be as high as 84%, and the prevalence of chronic low back pain is about 23%, with 11-12% of the population being disabled by low back pain.
Mechanical low back pain arises intrinsically from the spine, intervertebral disks, or surrounding soft tissues.
Examples:
1. Lumbar strain
2. Degenerative
3. Osteoporosis
4. Spinal stenosis: Occurs as a result of narrowing of the space in the spine.
5. Spondylolisthesis: A spinal condition in which one vertebra slips forward onto the other.
6. Traumatic fracture
7. Severe kyphosis
8. Severe scoliosis
Causes of mechanical back pain:
Back pain often develops without a cause that shows up in a test or imaging study.
Common conditions:
· Muscle or ligament strain. Repeated heavy lifting or a sudden awkward movement can strain back muscles and spinal ligaments. For people in poor physical condition, constant strain on the back can cause painful muscle spasms.
· Bulging or ruptured disks. Disks act as cushions between the bones in the spine. The soft material inside a disk can bulge or rupture and press on a nerve.
· Arthritis. Osteoarthritis can affect the lower back. In some cases, it can cause a narrowing of the space around the spinal cord, and eventually lead to spinal stenosis.
· Osteoporosis. The spine's vertebrae can develop painful breaks if the bones become porous and brittle.
Risk factors
· Age. The most common age group is 30 or 40.
· Lack of exercise.
· Excess weight. It puts extra stress on the back.
· Improper lifting.
· Psychological conditions: Stress can cause muscle tension, which can contribute to back pain.
· Smoking: Smokers have increased rates of back pain. Smoking can also decrease blood flow to the spine and increase the risk of developing osteoporosis.
Predisposing factors to LBP:
1. Bad sitting posture:
· Slouched sitting places the spine in the same amount of flexion as a fully flexed standing posture.
· Intradiscal pressure increases in a slouched position and decreases the more the spine approaches an erect position.
2. Frequency of flexion:
We flex a lot. i.e. we do a lot of activities bending from the spine, we do not extend that much.
Why are strength and endurance training essential for the spine?
o To maintain postural control.
o Sustained postures require continual, small adaptations in the stabilizing muscles to support the trunk against fluctuating forces.
o Large repetitive movements also require muscles to respond to control the activity.
o In either case, as the muscles fatigue, the mechanics of performance change, and the load is shifted to the inert tissues supporting the spine.
o With poor muscular support and a sustained load on the inert supporting tissues, creep and distension occur, causing mechanical stress.
o In addition to the above, injuries occur more frequently after a lot of repetitive activity or long periods of work when there are muscular imbalances.
Why is core stability important?
o Prevent unnecessary load on the spine.
o Improve stability of the spine.
o maintaining an upright body posture.
o helping to change positions when sitting, standing, and walking.
o to improve body balance and postural control.
Tips to prevent back pain
GOOD POSTURE
The first step is to become aware of your body so when you're holding yourself stiff you instantly recognize the tension in your muscles.
Standing or sitting, you should put minimal strain on the muscles of your lower back by pressuring the spine's natural curve.
MAKE THE RIGHT MOVES
Lift using your leg muscles, not your back muscles. When lifting something heavy like a grocery bag or a packed suitcase, bend at your knee and lift it, keeping your back straight.
LEVEL OF HEIGHT
Bring your work, food, or book to a position that allows you to keep your eyes straight ahead and your head high, and that does not require you to crane your neck forward.
DROP THE LOAD
If you are overweight, try to lose the extra load on your back. Keep at bay the potbelly that adds to the strain on your back.
TAKE A BREAK
Avoid sitting in a chair for longer than 30 minutes at a time; get up and move around.
PERFORM BACK-STRENGTHENING EXERCISES
If done religiously, these exercises can give your back muscles strength, flexibility, and range of motion.
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References:
2. Non-specific low back pain Dr. Federico Balagué, MD & ©. Anne F Mannion, Ph.D. • Ferran Pellisé, MD • Christine Cedraschi, Ph.D. Published: October 07, 2011, •