At any given time around 20% of adults in the workforce suffer from back pain. In addition, a survey of 3000 working-age kiwis found a 9% absenteeism rate from work due to lower back pain. In ACC statistics; the building and construction industry has had the highest number of accident-related claims year on year. As a physiotherapist we frequently see people in our clinics presenting with acute or chronic low back pain because of injury or overuse.
With this in mind, it is easy to believe that the spine, specifically the lower back – is fragile and easily injured. However, it will be surprising to hear for many that this is not entirely true. As part of undergraduate training, physios attend labs at the Auckland Medical School. This includes several lessons in the cadaver labs. It was in these labs I had the personal realization of quite how stable and robust the human spine truly is. The solid, brick-like bones carefully protect the spinal cord. Meanwhile, rubbery cushioned discs in between each vertebrae allow for movement and shock absorption. This is before we have even considered the barrel of muscle helping to protect and move you. We have abdominal muscles at the front, oblique muscles on the sides, diaphragm on top, and pelvic floor underneath. The lower back is literally encased in muscle from all sides.
However despite all of this; the challenge is that the lower back has one of the highest associations with stress, anxiety, and chronic pain. It is as though we have forgotten quite how amazingly robust the spine truly is. Managing acute low back pain is crucial in order to prevent it from becoming a chronic condition. The key is movement. The spine is designed to move freely, without bracing, rigidly blocking or avoiding movements. Moving into painful ranges of movement may not be advised early on, but even simply getting out walking after a lower back injury can make all the difference. Just because it hurts, doesn’t necessarily mean it’s harming you. When pain levels are more under control, strength exercises become crucial to recovery. A cartoon that I once saw on the wall of a doctor’s office summed it up well, the forlorn patient being told, “Well your back’s out because your front’s out!”.
The best thing that you can do to ensure a healthy spine is to stay active, stay strong, and maintain a healthy body weight. If in the unfortunate event, you do end up with a lower back injury, just remember…movement is medicine!
Nb. Written as Health columnist for the Hibiscus Matters.
