Washing dishes, loading the dishwasher, feeding the dog and putting on your shoes– what do they have in common?
Answer: They are all functional activities that involve repetitive bending and often include twisting movements. The upside is that the dog is happy, your feet are protected, and the kitchen is clean. The downside is that repetitive bending predisposes you to lower back injuries.
Lower back pain is one of, if not the most, common reasons patients visit physiotherapy. In fact, lower back pain is the main reason for a premature exit from the workforce. There is an enormous impact on early retirement in terms of direct health-care costs and indirect costs (i.e., work absenteeism or productivity loss). Additionally, The World Health Organization projections show that the number of people with low back pain will increase in the future.(2)
For some people, it’s a temporary ache that eases up after a few weeks. Whilst others will experience chronic and disabling pains. This type of pain can derail lives and significantly impact quality of life.
While band-aid solutions, like massages or heat packs, can temporarily relieve pain, lower back pain can often come back with a vengeance.
As a practising physiotherapist, I often treat patients for lower back pain due to activities involving repetitive bending and repetitive movements.
A lower back injury frequently involves overburdened discs and the soft tissues surrounding the lumbar spine. This causes swelling of the irritated disc and adjacent soft tissues. Swelling leads to constant lower back pain (discogenic pain), that may be aggravated with sitting and bending forwards. In addition, irritation may become more intense in a sustained sitting position. The pain can also extend (refer) to one of the buttocks and legs.
Following a back injury, it is important to seek medical and health advice. An appropriate assessment, treatment, medication, and advice from a physiotherapist, can provide relief from pain, and importantly, education regarding injury prevention. However, preventing an injury, as well as the inconvenience and accompanying expense, is a preferred scenario.
What can I do to prevent and reduce the risk of lower back injury?
The good news is, there are several preventative actions you can take to help protect against low back injury:
1. Gain and maintain strong core muscles and lower limb muscles.
Strong and stable abdominal, buttock and back muscles are protective of the lumbar discs and other soft tissues supporting the spine. Strong leg muscles will allow you to bend at the knees and load your legs rather than your lower back. Many people with lower back pain often have trouble moving and activating their gluteus muscles. Without proper control of these muscles, the back can begin to compensate and become painful. Strengthening your buttock muscles through specific exercises will help provide the lower back with protection. For further information and insight, click here.
2. Being physically active.
Physical activity, such as walking or playing sports, has a whole range of benefits. Examples include increasing muscle endurance, reducing the risk of cardiovascular conditions (e.g. stroke, heart disease, etc.), improving mental health and even preventing lower back pain. A large study by Alzahrani et al. (2019) found that those who performed just a moderate amount of physical activity had a significantly lower risk of back pain.(1)
3. Improve flexibility around the hips, lower back and thoracic spine (chest). It is important to allow free movement and adequate range of motion of the joints and muscles adjacent to the lumbar spine. Refer to other blogs I have written about back injury, abdominal strength, and stretching for additional insight.
4. Reduce the number of times you are bending.
Underestimating repetitive tasks is common. Even though the activity may seem gentle by nature, too much of anything is still too much.
Find other ways of doing things – for instance, squat rather than bend:
- Bend from the hips and knees rather than from the lower back. Keep your lower back straight to maintain a neutral lumbar spine. This reduces the load on the discs and soft tissues.
- Brace your abdominal muscles as you bend or squat. This will help to stabilize your core and spine and protect against overloading the vertebral discs.
5. Psychological factors.
The last few decades of scientific research have shown that psychological factors (3), such as stress and anxiety, can contribute to low back pain. Being distressed can change how you perceive pain and can amplify your discomfort. This is comparable to the volume dial on your radio. The more stress and anxiety you experience, the louder the pain can become.
Managing psychological distress can be challenging. However, strategies such as mindfulness, sufficient sleep and deep breathing relaxation techniques can be beneficial. You should also seek assistance from a medical professional if this is an ongoing issue for you.
Written by Deborah Hunter
Move Better for Life Armidale
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1. Alzahrani, H., Mackey, M., Stamatakis, E., Zadro, J., & Shirley, D. (2019). The association between physical activity and low back pain: a systematic review and meta-analysis of observational studies. Scientific Reports, 9(1). doi: 10.1038/s41598-019-44664-8
2. Musculoskeletal health. (2022). Retrieved 13 August 2022, from https://www.who.int/news-room/fact-sheets/detail/musculoskeletal-conditions#:~:text=Low%20back%20pain%20is%20the,7.4%25%20of%20global%20YLDs)
3. Pillay, S. (2016). The psychology of low back pain – Harvard Health. Retrieved 13 August 2022, from https://www.health.harvard.edu/blog/psychology-low-back-pain-201604259537