Back Pain Prevalence

Back Pain Audit shows worrying trend.

Recent National Pain Audit figures show a worrying trend. A staggering 20% of health expenditure in the UK is now spent on back pain services. Chronic pain affects 8-60% of the population depending on the definition of pain (1). Severe pain affects 11% of the population and 8% of children. Yes 8% of children, a group that are generally ignored as problems are put down to" growing pains".

If more attention was put to diagnosing and recognising that young people start their journey to chronic pain young then maybe something could be done to redress the trend.

Severe chronic pain affects relationships, work status, sleep, mood, general ability to do daily tasks and all aspects of general health. Even more worryingly, daily back pain is linked with increased risk of a coronary event. This makes sense as less activity means reduced cardio-vascular fitness. Movement of the spine and joints also feeds activity into the brain and the resulting reflexes help to support and drive not only movement but also the autonomic responses that control body functions such as blood pressure and heart rhythm.

So why is back pain so common and getting more common?

The simple reason is that as a population we are less active. People drive to work or school nowadays then many have sedentary roles that mean the body is held still for long periods. This will cause mild pain as your body will want you to move. That in itself is not a problem until it is repeated day after day for long periods. Gravity is a very strong force and even when you are not moving it exerts constant pressure. For example looking down at your smart phone will increase the weight of your head threefold. That's a heavy load on your neck muscles and discs.

If you are also getting heavier then the forces become greater and the stress on structures and changes in posture results in a greater chance of back pain. If you are active you will generate reflexes and fire nerves that help to suppress pain, for more on this go here.

The more you fire, the more you wire.

Nerves love to fire if they are healthy. If you fire them enough they will grow new and stronger connections and the result is healthier tissue and better faster, more accurate responses. If you don't fire the body will remove the connections and the opposite occurs. You get less energy, less accuracy and tissues that are supplied become weaker.

However if you are already weakened, then firing too much can fatigue the nerve to the point that it can become so tired it will actually become very weak and eventually die. This is a process known as apoptosis. So if you are weak already or have nutritional compromise then you may overdo it and cause harm.

How Do You Strengthen The Nervous System?

Firstly make sure you have the raw ingredients to support good nerve cell activity. A good healthy diet should give you this. So avoid fast food or ready meals with flavour enhancers. Monosodium glutamate will fatigue your cells very rapidly as it acts like a turbo, so will high sugar diets as nerve cells do not need insulin to absorb and use sugar. The result is like an engine over-revving, it will go pop at some point! Avoid too much caffeine, never drink energy drinks that is nerve cell suicide! Excessive alcohol and smoking are also highly detrimental to nerve health.

Leafy green veg is full of great nutrients to support cell health. Fish is a good source of protein and essential fatty acids, as are seeds, nuts and pulses. Magnesium is very supportive of energy release in cells and is found in dark leafy greens, nuts, seeds, fish, beans, whole grains,avocados, yoghurt, bananas, dried fruit, dark chocolate, and more.

Assuming your nutrition is good the next step is to start exercising your body and mind. If you are very weak start gently and build up incrementally at a round 5-10% increase in activity a week. If you feel very tired make a note of when that happened and only do 70% of that. Stay at that level for a few weeks and then start to increase activity. It may be a slow road but if it's steady you will progress smoothly. If you try and jump activity too fast you may get more tired and / or injured.

Gradually you will start to feel a lot better. This isn't easy though as the reason you got bad in the first place may be down to bad habits and these can be hard to break. So make gradual changes to your lifestyle and you will be more likely to keep on the straighter and narrower path.

References:

1. Elliott AM, Smith BH, Penny KI, Smith WC, Chambers WA. The epidemiology of chronic pain in the community. Lancet. 1999 Oct 9;354(9186):1248-52.