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.
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.
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.
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.
It has long been a subject of hot debate between the medical profession and Chiropractors about the efficacy of longer term patient management programs. In a medico-socioeconomic model it has long been thought by the majority of the medical profession researchers that continual care for musculo-skeletal problems is not effective and that ongoing care is based purely on an economic basis for the benefit of the Chiropractor and not the patient.
This has on occasion put the professions at loggerheads when looking at care. It is important when considering this to question what is health? See previous post on this subject.
With the recent cold snap we were all left taking tentative steps, for some the result was a crash down to earth. I saw 2 people do it myself. A fall onto one’s derriere at speed causes damage to the ligaments of the sacro-iliac joint and lower lumbar vertebrae.
In fact cadaver studies(1) show that as many as 20% have sustained damage to the lumbar interspinous ligaments that support the lumbar vertebrae.
This leads to increased motion at those levels and eventually disc degeneration and facet joint hypertrophy due to increased stress on these structures. The result down the line is possible nerve impingement and sciatica or in long standing cases stenosis (a narrowing of the central canal that the nerves run through).
These conditions can require surgery to prevent nerve damage, but in most cases people just have to accept that they can only walk a hundred yards or so before needing to sit and rest due to the cramp like pains they get in the calfs. Stenosis can also lead to bladder and bowel problems in old age.
Do you know someone like this? Do you know someone who’s slipped on the ice? Help them achieve a better old age by pointing them in the right direction. Fix it now and these issues can be reduced.
1: Rissanen, P.M.(1960)The surgical anatomy and pathology of the supraspinous and interspinous ligaments of the lumbar spine with special reference to ligament ruptures. Acta Orthop Second, (Suppl.46)
Well not quite, but the infamous words of Noddy Holder have probably been ringing out for a while now on the high street, but I wouldn’t know about that. Instead of doing this a bit at a time, I join the usual rush of stressed out men looking for that last minute present. So how do I keep from getting knots and aches when out? Buy vouchers and be done with it I hear you cry! Certainly an idea, but believe it or not I do carry bags and this is how I avoid the pains and aches over the Christmas period right up to New Year.
But you said “I do it last minute”. That’s true, but I give myself time and before I shop, I mentally prepare myself by remembering that Christmas is about being festive. So while sauntering around and letting everyone else twist and duck and dive past I hum a carol or two and get in the spirit of things. How does this help? Stress will lead to increased tension and more likelihood of muscle strains. So relax and enjoy it.
You know how it is, you’ve already got a load of bags and the shoulders are feeling sore, but you’ll just pop into M & S for a few more bits, then you come out looking like a sherpa on the Himalayas.
Disc Prolapse Here We Come!
Well don’t do it, when you’ve got a few things take them back to the car, lock them in the boot and feel the tension go as you stroll back to your next target. Better still, do it online! (it’s not the same though is it, you’ll miss the joy of seeing someone wrapped in tinsell after the office party).
Simple this one, if it’s freezing and windy you’ll immediately be more vulnerable to a muscle strain, wear a scarf and layers so if you get hot you can always take one off.
Why not do this after dropping off the first load in the car, then you won’t have someone standing on Mum’s new cardy in the cafe. Have a warming drink and a snack to recharge your batteries, if it’s caffeinated make sure you have water though so you don’t dehydrate. Muscles are more likely to strain if dehydrated. If you had a sneaky sherry or mulled wine somewhere this is even more important!
You’ve been out all day, hopefully not fed up and hungry, but full of joy as you don’t have to go back again for another year! You now have a boot full of presents, some wanted, some useless, but it’s the thought that counts. When you lift, pull things towards you and keep your lower back locked out. Don’t try and do it all at once if it’s heavy. The same goes for when you stuff it under the bed, at the top of the cupboard or in the loft, don’t twist and lift. Keep your back straight. We all know that one, but how often do you really take care when lifting?
I’m not expecting you to get on all fours, but there are a few exercises that you can do when stood in a queue that can really help your lower limb strength and stability. Firstly, as you’re wearing a big coat you can do buttock tenses and no one will be any the wiser as long as you remember to breath! Stand with legs shoulder width apart, and simply tense buttocks while gently pushing feet outwards while they stay firmly rooted to the floor, you can combine this by tensing the lower abs too. Remember to breathe!! Another is to stand feet shoulder apart, grip the floor with your feet, and lean forward slightly keeping your body rigidly straight. Do this until your heels just start to lift off the floor, think of Eddie “The Eagle” Edwards (ski jumper extraordinaire for those too young to remember). Hold both exercises for count of 5 and relax and repeat. If you spend an hour in a queue you’ll have had a great workout.
You don’t need to lean this far forward!
Self explanatory really, you’ve had a few sherries, eaten too much, got bored with being cooped in with all the relatives, so you commandere the sofa or armchair and settle down for an assault on the chocolates, while watching a film you’ve seen before. Well, before that military manouveure make sure you have a cushion behind you, and if its a particularly soft sofa, have one underneath your hips as well so that they are level with your knees. Make sure you regularly get up and move around, even better go for a walk and stretch those legs. You’ll feel much better for it and it’ll help the lunch go down. If you’re having to travel, get out now and again and walk about too. Don’t lift your heavy bags straight after arriving, stand up for a while first, see our travel tips.
There are occasions when this could be very beneficial, but best left to younger generations or students.
It’s pretty common to see a few self inflicted injuries due to overindulgence and temporary visual and reduced balance injuries! If your colleagues are dancing on the tables and you want to join them please make sure it’s sturdy, Limbo dancing is also best left to the professionals. Choose your dance partner wisely to avoid dislocated shoulders and whiplash.
Last and by no means least, if you’ve had problems before, have a check up so that you know you’re working better and not on the verge of an injury. Christmas time means less availability and it’s a time for enjoying yourself in the company of others. Don’t ruin it with a bad back or neck,pop in and make the most of it.
Have fun and enjoy it.
All the best