Nurse Mary: Oh, My Aching Back!

By Mary A Drobnak RN, BSN, MSN Ed

Nurse Mary offers her advice on preventing back pain.

Did you know that back pain is one of the most common medical complaints (only second to a headache and the common cold)? It is estimated that 8 in every 10 people will experience back pain in their lifetime.

The causes of back pain are numerous, but many are self-inflicted and/or due to a lifetime of bad habits. Back pain causes include accidents, muscle strains and sports injuries; however disc degeneration, disease, infection and inherited conditions can also be influential factors.

The lower back, which starts below the ribcage and is referred to as the lumbar region, accounts for the majority of mild to severe conditions. Symptoms can range from a dull ache to a stabbing or shooting sensation that may radiate into the buttocks, lateral to the hips down and cause numbing to one or both legs.

Our daily activities are our main culprits. And because sometimes it may take months or years for the aches and pains to manifest, people do not often make the connection between what they are doing and how this is affecting their body. Let’s explore a few reasons why people may suddenly experience back pain and discuss ways to avoid more serious problems by becoming aware of what causes them.

Sitting for prolonged periods of time

One unavoidable activity many of us do is work at a desk and/or sit in front of a computer all day, going hours without taking a break. Slouching, sitting up too straight, without lumbar support for long periods of time is “the worst thing in the world you can do for your back,” sports and rehab doctors often emphasise.  Our muscles simply do not get used when we sit for prolonged periods, causing them to spasm and shorten, thus becoming tight. The consequence being that our muscles become strained when we go to use them again which leads to injury, sudden pain or both.

Rehab doctors recommend getting up from your desk every 30 minutes to take a short walk, stand and stretch, or lean back (allowing your back to bend slightly) in your chair with your feet flat on the floor, stretching your arms to the ceiling for a few seconds while taking deep cleansing breaths.

They also suggest performing everyday tasks standing up wherever able, such as taking a phone call or reading work material. Simply put, don’t stay chained to your desk all day!

Lifting heavy objects

Lifting is yet another necessary daily activity for many of us, and for some, lifting is a big part of our jobs. Body mechanics play a huge part in lifting and it’s common sense that you shouldn't lift anything that might be too heavy for you.

However, it's not always necessarily how much you lift, it's how you lift it. Physical therapists recommend when lifting to keep your legs shoulder length apart and squat, bending at the knees and the hips, close to the object (see picture). Keeping your back straight and head up, stand using the strength of your legs (not your back muscles) to lift the load. Avoid twisting or bending at the waist while lifting items, as this action may seriously injure your back. Get into the habit of using this technique even with lighter objects. Your back will thank you!

Carrying heavy bags

Another back aching culprit is the bag, the backpack, the handbag or the briefcase that you carry every day. Even though this might be carried in the hand, on the arm or on the shoulder, it is your back that supports the upper body and carries the extra weight. Carrying a heavy bag on a daily basis will take its toll on the back over time. Consider using a roller bag when you have heavier stuff or many items to carry, and when using a backpack, use as intended and wear it on both shoulders for even support of the weight.

Lack of exercise

Extra pounds of body weight can also contribute to back pain, as this can increase the curve of the lower back leading to structural compromise and damage. Fact is, back pain is more common for people who are out of shape, so staying fit by exercising and stretching regularly helps prevent back pain and injuries.

Using the gym infrequently or playing occasional weekend sports can play a major role in developing acute back pain. "Weekend warriors,” i.e those who engage in vigorous activity only on the weekend after sitting around all week, are frequently treated for symptoms of back pain, says Shanghai-based osteopath Alejandro Prieto. For the same reason as sitting for prolonged periods, lack of regular activity shortens and tightens our muscles leaving us vulnerable to strains when we exert energy after a long period of not using them. 

Other causes of back pain include wearing shoes that are too high (stilettos) or too flat (flip flops) as these can place extra strain on your back. Experts recommend a supportive low heal for daily walking and high heels no more than three inches.

Sleeping on a too firm or too soft mattress, and sleeping on your stomach or in twisted positions may also contribute to back pain. When sleeping on your side, use a pillow between the legs to keep the spine straight, and support the neck to keep the spine aligned. When on your back, place a pillow under the knees to allow the lower back to rest while you sleep.

If pain is acute, resting can help, but it's a myth that you should stay in bed. A day or two in bed can make your back pain worse! Pain medication may take the edge off temporarily, however this also masks the symptoms, which allow you to keep up those bad habits instead of correcting them. If you are already experiencing back pain, whether it be occasional or more chronic in nature, it may be reversible if you start taking the right steps to improve your body mechanics and correct your bad habits today.

Moral of the story is to stay fit, stretch often and keep those muscles flexible and active. Just because you sit at a desk all day does not mean you cannot move around. Be conscious of how much you carry and how you lift heavy objects. Changing bad habits can have positive long-term effects on your body!

Send Nurse Mary your health questions and concerns at [email protected]

Chronic Back Pain

Chronic back pain is pain that lingers and lasts more than three months. If your pain is no better within 72 hours or after a few weeks of more gentle activity, you should consult a doctor. Additionally, severe back pain after a fall or injury should always be checked out by a health care professional. Other warning signs that alert you to seek medical attention include a loss of bowel or bladder control, leg weakness, fever, and pain when coughing or urinating. If you have any of these symptoms along with your back pain, you should immediately contact your doctor.