Desk Work

Any job that involves sitting down for hours at a time, particularly if the position is unvarying, is likely to lead to pressure on the discs between the vertebrae. In a sitting position the action of the iliopsoas muscle exerts a continuous pressure on the vertebrae in your lower back. The increased pressure in a sitting position raises the risk of the disc moving out of place or losing the soft, cushiony material inside. It also reduces the space between the vertebrae, leading to an increased likelihood of facet joint problems. What’s more, if your sitting posture isn’t good, there’s also risk that the damage will be long term.

How to reduce your risk:

• Take frequent breaks to walk and stretch.
• Adjust your sitting posture.
• Check that your chair and desk are at a suitable height and that your chair back is angled correctly.

Driving Jobs

Any job that involves long periods behind the wheel involves a risk to back health. Some of these are the same as for any other sedentary work, principally, disc compression. Perhaps surprisingly, the backs of those who drive cars are more at risk than those who drive trucks, buses and other large vehicles for a living. This is because the angled position that many car drivers adopt involves a greater strain on the back than the more upright posture of a truck driver. When you are tilted back, too much of the driver’s weight is placed on the lower back. In an upright position much of your weight is supported by your thighs. Unfortunately, the constant vibration of driving has a damaging effect on the spine in all types of vehicle.

It’s also worth mentioning the risk of whiplash injuries. These most commonly occur as a result of motor vehicle accidents in which there is an impact either from the front or behind. Whiplash injuries can cause back, neck, and shoulder pain that may persist for several months. What’s more, the kinds of impact that cause whiplash may occasionally cause more serious spinal damage.

How to reduce your risk:

• Whether a driver or a passenger, always have a headrest in position to prevent the neck from jerking backward in a collision.

Standing Jobs

A large number of jobs can involve long periods of standing. These include retail work, security, restaurant and bar work, and many others. The back risk in this type of work is that tiredness can lead to poor posture, which in turn can create stresses on your spine and in the surrounding muscles.

How to reduce your risk:

• Walk about whenever you can.
• If possible, stand with one foot up on a stool or footrail. It takes a lot of stress off the low back. Alternate the foot you rest periodically.
• Do stretching exercises every hour or so.
• Lie down, if practical, during longer breaks.

Jobs That Involve Lifting, Carrying, and Repeated Movements

Day after day, week after week, you can perform the same movement without a problem, then one day you feel your back “go.” This is because regular strain on he back along with poor posture can damage the discs over time, so that, eventually, even a minor stress can cause a disc to rupture or prolapse. Other possible problems related to regular stress include inflammation of the facet joints and over-stretching of the supporting ligaments – both which can weaken the whole structure, and allow the vertebrae to be nudged out of alignment.

How to reduce your risk:

• Avoid lifting and twisting at the same time. Always lift a load straight in front of you.
• Rest frequently if carrying out task that involves repeating the same movement for an extended period of time.

Lower Back Pain Specialist

Dr Mathew Tung

What Can Go Wrong?

Lots. Your back and the problems that may affect it change at each stage of life. As you move through childhood, engage in new activities, have a family and grow older, you and your back will encounter new challenges. On this article, you’ll find an overview of the causes of the back problems that can occur.

Muscle and Ligament Strain

The muscle and ligaments of the back can accommodate a wide variety of movements, but can be damaged if they are stretched beyond their accustomed range, leading to strains that tear muscle fibres. In response, the affected muscles often go into spasm – becoming painfully stiff – until the damage has healed. The following are leading causes of muscle-related problems:

• Strenuous exercise Especially if you are not accustomed to it and have not warmed up properly beforehand, this is often responsible for minor muscle strains. Sports that involve twisting movement – tennis, for example – can also strain muscles and ligaments that are not sufficiently strong or flexible.
• Lifting incorrectly This is another key cause of muscle and ligament strain – and it needn’t involve hugely heavy loads. Many occupations involve a great deal of lifting and carrying, and over time, this kind of repeated strain can take its toll on your back. If your technique for lifting is faulty, you can easily end up with a seriously painful and stiff  back.
• Repetitive actions These involve making the same set of movements for an extended period of time and can lead to muscle stiffness and spasm. This is one of the main causes of back pain related to the workplace.
• Carrying excess weight Whether as a result of excess body fat or pregnancy, an increase in weight, especially in the abdominal area, can increase strain on your back muscles. It can overstretch the abdominal muscles and make them less effective in sharing the work of lifting.

Accidents and Injuries

Some of the most common back problems, especially among younger people, are the result of a fall or other accident. A fall can bruise the back and, in more serious cases, the vertebrae can be fractured. The immediate concern with a fractured vertebra is that the spinal cord that it encloses will be damaged, creating a risk of long-term disability.

Whiplash is a type of injury that is frequently caused by car crashes. A sudden jolt causes the spine (usually the neck region) to jerk back then forward beyond its normal range of movement, stretching and straining the supporting ligaments, muscles, and facet joints. The result is neck and back pain, stiffness, and often headaches. Be aware: whiplash always requires assessment by a physician.

Disc Problems

Many people are familiar with the term “slipped disc” in the context of disabling back pain. The condition is accurately referred to as a prolasped disc and describes a situation in which a disc between two vertebrae protrudes from between the vertebrae and the soft, cushioning material can be leaking out. This can put pressure on the spinal cord and nearby nerves, producing pain and other symptoms. It usually occurs as a result of long-term stress on the back that has caused the inner material of the discs to lose resilience and the outer covering one or more of the discs to be damaged.

Facet Joint Damage

These tiny joints between neighbouring vertebrae are a major cause of long-term back pain. The facet joints can be damaged if they are pressed together too tightly. This can occur if:

• The discs between the vertebrae shrink, narrowing the gap between the vertebrae.
• The surrounding ligaments become slack, as can happen in older people.
• You sit in one place for an extended time.
• You have poor posture or wear high heels.

Bone Degeneration

The vertebrae are made of the same material as bones elsewhere in the body and are therefore vulnerable to similar types of bone degeneration. Bone can degenerate as a response to poor diet, little exercise, or simply as part of the aging process which is known as Osteoporosis.

Nerve Damage

Because the spine provides a protective channel for the main nerve pathways of the body, it is not surprising that many problems originating in the bones and soft tissues of the spine can also have an impact on the nearby nerves. For example, inflammation of the tissues around a damaged facet joint can cause pressure on a spinal nerve emerging from that point in the spine. Similarly, a prolapsed disc can put pressure on the spinal cord. And, importantly, spinal injuries can also damage the nerves themselves.

Tell-tale symptoms that a nerve may be affected include numbness and tingling and/or shooting pains. The precise location of the symptoms depends on the area of the back and therefore the nerves affected. Damage to certain nerves can also affect the functioning of various organs.

Inflammatory Conditions

Inflammation is usually characterised by swelling, redness, and heat in the affected area. It is the body’s normal response to attack by germs or other “foreign substances. Unfortunately, this response can also occur when there is no threat, or if the body perceives the threat as coming from its own tissues. Inflammatory conditions that occur as a result of this “mistaken” response are known s autoimmune disorders. The main autoimmune disorders that commonly affect the back are rheumatoid arthritis and ankylosing spondylitis.

Repeated damage or trauma to body tissues can also cause inflammation. In the spine, this type of inflammation is most often the result of osteoarthritis, in which the cushioning between the joints degenerates and the joints become inflamed as a result of excessive wear and tear.

Pregnancy and Back Pain

Most women experience back pain at some point during the course of their pregnancy. The lower back is the area most commonly affected. The reasons for this are twofold. The impact of of the increasing size of a pregnant woman’s belly. Not only does the added weight in this area affect the muscle tone of the abdomen, but it also alters the mom-to-be’s centre of gravity and therefore her posture. As a result, muscle strain in the lumbar region is not uncommon.

The second reason that underlies back pain in pregnancy is the impact of hormonal changes that occur at this time. The pregnancy hormone relaxing makes your ligaments more elastic, allowing the pelvic bones that form the birth canal to accommodate the baby’s head during delivery. Unfortunately, because hormones are carried all round the body in the bloodstream, other ligaments also become loser and you are more at risk of general joint strains, as well as strain to the joints in the spine.

Back Pain Specialist

Dr Mathew Tung