How to avoid the 5 common causes of back pain

old lady stretching

One of the number one questions I get asked is how to I avoid back pain?   Nearly all of us will experience back pain at some point in our lives.  But how wonderful would it be to minimise the risk of getting back pain?  Read on to find out how.....

1.  Stress

We all know too much negative stress is bad for us and some of you may know that it affects us physically.  Stress is part of our lives and it helps us achieve success and conjure bravery when we need to step up to the plate.  You have a stress threshold - a line that once crossed begins to compromise your immune system.  It slows your recovery and healing rate so normal repairs that should occur result in tissues getting left and more damaged.  This can be as small as an ulcer or a big as your back pain.  The best source of information I can give to you is about your perception of stress and I cannot say it better than Health Psychologist Kelly McGonigal in her recent TED talk.  It's 8 minutes and a revelation you will not want to miss out on. 

2.  Lack of movement

You are designed to move.  Sustained poor posture is a major cause of back pain and structural damage.  Make sure you move throughout the day.  If you are desk bound, walk around the office, take the stairs for a few flights, leave for a lunch break.  In the recent article "The making of a corporate athlete" by performance psychologists Jim Loehr and Tony Schwartz that was published in the Harvard Business Review it is recommended that every person does at least 2 strength training workouts a week for endurance and to promote mental and emotional recovery.  

3.  Poor posture

Sit, stand and walk tall.  If you are exercising, exercise tall.  Another major contributor to back pain is poor posture.  If you already have back pain then poor posture will make it worse!  You may be blissfully unaware that your posture is bad but if you are currently pain free it is well worth investing the time and effort to work on your posture to minimise the risk of injuries occurring.  In this day and age, with the mountain of information and specialists to help you there is no excuse for poor posture.  Seek help.

4.  Repetitive faulty movement patterns

This is an extension of poor posture but relates more to exercising with poor form.  I have seen so many clients walk through my door who hit the gym 5 days a week but when I assess their movement patterns it is clear they do not have good technique and their movement patterns are contributing to their pain.  If you are working out in the gym and have not had any guidance at all in the past 6 months then ask a professional to look over your technique.  

5.  Poor nutritional intake

Your nutrients for every day micro damage to your body come from food.  Food provides you with the building blocks for repair, to create new cells, to strengthen your muscles, to strengthen your bones and connective tissue.  It is imperative that you take care of your nutrition and nourish your body it is as much a part of minimising the risk of injury as movement is.  

For more information on exercise for the prevention of injury and for back pain and injury recovery please email me at 

KT@precisionmovement.co.uk

Featured Expert: Helen Skehan RSI physiotherapist

manual therapy

Helen Skehan specialises in the treatment of RSI (repetitive strain injuries).  She is the owner of

Physio Solutions

clinic in Islington, a clinic that she built herself over 16 years, houses 9 therapists and also offers massage and ergonomic assessments in the work place.  

KT:  Helen, what is RSI?

HS:  RSI stands for repetitive strain injury.  It is a term given to work related non-specific upper limb injuries and does not always mean the injury has come from repetition or is a strain.  Patients present with a number of symptoms that may not always be the same from person to person.  

KT:  What symptoms are common with RSI?

HS:  I test for many things - often clients present with varied pain in the neck, shoulder and arm, tingling ,numbness, temperature changes, swelling.  I look for specific tightness, muscular imbalance and postural misalignment.  I may also send clients to be tested by a rheumatologist to eliminate other underlying conditions.

KT:  How does RSI develop?

There are many different ways RSI can develop.  It is often a combination of a poor workstation, poor posture, lack of exercise (although not always sometimes I see patients who are real gym bunnies),not taking enough breaks at work, high stress, lots of typing and ignoring initial symptoms.  

KT:  How does stress play a part in the development of RSI? 

I would say stress exacerbates symptoms.  Mechanically, stressed induces increased muscle tension in the neck and shoulders where the nerves exit the spine and pass through the shoulder joint down the arm.    Also, breathing rate increases and during stressful times we tend to adopt a upper chest lead breathing pattern which utilises the accessory respiratory muscles surrounding the neck and shoulders.  The nerves are supposed to glide through neighbouring structures but if the muscles are contracted it can squeeze the nerves causing pain, numbness and tingling.

KT:  What is your opinion on exercise for RSI?  Does it create more strain or can it help?

HS:  I always try to get my patients to engage in some form of stretching, mobilization and exercises.  There is always a role for graded exercise in the recovery of RSI.  It is important to go by a tolerance factor - the patient should not work into areas of pain.  

KT:  What affect does posture have on the development of RSI?

HS:  Sustained postures for long periods in poor alignment are definitely not healthy and can contribute to RSI.   Typically patients that have RSI injuries have a rounded upper back, a forward head carriage and their shoulders are rotated inwards.  It is very common to find neck an shoulder stiffness as well as a lack of mobility in the upper back.  Some patients can suffer from headaches.  Even more distally you find that patients often have hamstring and calf tightness. 

KT:  What impact does modern technology like smart phones and portable laptops and tablets have on the recovery of RSI?

HS:  All these devices encourage a poor posture as you tend to look down at the device you are using.  People tend to overuse their smart phones which stresses the fingers, wrists, hands and forearms.  With tablets and laptops they can be heavy to carry around and we tend to look down when we use them which strains the upper back and neck.  

KT:  What advice can you give to people using smart phones and tablets for work?

HS:  Modern technology is improving all the time.  For smart phones you can use the voice activation system to cut down on your typing time.  Try to avoid using your phone and tablet when you travel on the tube and bus to give your hands and arms a rest.  At work place a tablet on a stand or a removable keyboard.  For laptops and desktop computers invest in an ergonomic mouse or a roller mouse that sits at the front of your keyboard. 

KT:  What are the early symptoms of RSI?

Any hand symptoms that are related to desk work including pain, muscle cramps, tingling, numbness, swelling or feeling of swelling and restricted movement.  Also be aware of any of these symptoms in the shoulder and neck area even repeated small episodes.  We should be able to function without pain.  I would recommend diarising your symptoms and check over a period of time whether the symptoms remain or get worse.  If in 10-14 days the symptoms are still there then seek treatment.  

KT:  What other advice would you give to those suffering with RSI?

HS:  For those with mild symptoms I would advise regular movement that is based on improving postural alignment and mobilising the upper back.  Backstroke can be helpful and calming to some.  Avoid cycling as the posture can encourage symptoms to get worse.  RSI is an injury that develops over time and through the continual use of bad habits.  The most important thing is educating yourself on how to minimise the risk of injury and taking responsibility for your health and wellness at work.  

For more information please visit the website at 

physiosolutions.co.uk

 or to make a booking with Helen please contact her clinic, Physio Solutions, on

0207 713 7780

.  For more information on how exercise can help you recover from RSI injury please contact me at

KT@precisionmovement.co.uk

.

5 things for back pain before you see your doctor

I see a number of people who have had no success with the long term relief of back pain by going to see their doctor.  There is a lot that can be done with injury and back pain before you seek medical treatment.  Even when you go to your doctor they recommend you exercise to relieve back pain.  What they don't specify is what exercise is best for you.   One thing is for sure, pain medication will only mask your symptoms and can make you think you are ok again until the medication wares off.  Medications also put your liver and digestive system under stress.  So what can you do to ease your back pain before going to see your doctor?

1.  Notice your pattern of pain

The more information you can gather about your patterns of pain the more likely you will notice what triggers your back pain and what exacerbates it.  Do you wake up with pain?  Does it occur later in the day?  How bad is it?  Does it decrease?  By how much?  You might find that by noticing the patterns of your pain you are able to make changes to help ease the discomfort.  

2.  Move 

Movement may seem like an unlikely remedy for a back ache but it is surprisingly effective.  The key to movement for relief of pain is doing it gently.  Walking can often provide a sense of relief (however if it makes it worse and sitting relieves it then take a rest periodically).  I recommend my clients do gentle back specific mobilizations upon waking daily to ease the back into the day.  You can download your copy of the Precision Movement Daily Mobilizations

here

.  

3.  Activate your core

If you know how to do this then focus on it by activating consciously throughout the day.  For more information see my article "Does having a strong core relieve low back pain?".  If you do not know how to do this then seek out a specialist who can teach you how.  Ultimately, if your back is aching it is telling you something is not right.  From a mechanical perspective it means certain areas of your body are taking more stress and other parts are not doing their job.  You'll need help with restoring this balance so seek out a corrective exercise specialist to help you with this.

4.  Stop, look, listen

Notice what might be causing or contributing to your back pain.  It might be the heavy boxes you moved yesterday or the position you are sitting in at work.  It may even be the exercise you are doing that makes your back pain worse.  Think broadly, it might not be a mechanical cause, pain can come from digestive issues such as food intolerance or constipation and in my clinical experience pain always gets worse when you are stressed.  Look at everything.  As obvious as it seems stop doing what you think may be causing/exacerbating the pain and see if your back calms down.  

5.  Think and take control of your thoughts

I know this sounds a little ominous but stay with me for a moment.  Sometimes people who have structural damage do not experience any pain.  It is a conundrum that puzzles medical practitioners even today.  What this really means is pain does not come solely from structural or mechanical issues or everyone who has structural damage would be in pain.  What tends to happen with pain is that we let it take control and rule our lives.  I have a wonderful client who went on a silent meditation retreat last year.  While he was sitting through a 6 hour meditation session his knee began to hurt.  His meditation teacher advised that he think on the pain and try to deconstruct it.  After some time he managed to break it down into a feeling of pressure and heat.  He changed his relationship with pain and it took his pain away.  Your brain is as adaptable as your body and it will learn what pain does for you and establish a trigger that sets it off without your conscious permission.   When you let pain take over and control you no amount of exercise and treatment will help you get better in the long term. 

5 sources of stress that make your pain worse

stress ball

In my

1st newsletter

where I shared the link to

Kelly McGonigal's Ted Talk

on How stress can be your friend I promised I would also share the other 5 unsuspecting sources of stress that may be compromising your health.  Although is true that your conscious perception of stressful situations can transform the outcome, there is little you can do about forms of stress you do not know about.  

Did you know that stress can come from foods, hormone imbalance, electromagnetic sources, too little or too much exercise, and temperature changes?  And did you know that all these sources of stress can contribute to a relapse of your injury, pain or discomfort?

Stress build up throughout the day

I'll use an example of how stress can build up without you even knowing.  You wake up to an alarm after a restless nights sleep. You force off your tiredness with a coffee and rush out the house because you are late.  You leave the house without a coat and it's too late to go back to get one now - you'll be cold all day.  When you get to work the computers are down  The You won't finish that proposal for a client today, you'll lose the contract and your bonus!  You have a makeshift late lunch and more coffee to stay awake.  You decide to shake off your stress by going for a run even though your back hurts and when you get home, you order a take-out and you can't wait to get the kids in bed so you can 'unwind' with a few glasses of wine before you fall asleep on the sofa in front of the TV.  Sound familiar?

Many stressors one response

What if I told you that everything in the above example stresses your body?  Think of your body having a threshold - a tolerance for all the stressful things we put it through.  What if I told you that repeating this over and over would create a build up of stress that might result in a seemingly 'random' injury or illness?  It does.  The body only has one response to stress.  It does not matter if the stressor comes from a food that you are unknowingly intolerant to or over exposure to the sun.  The body's response is to shut down so it can heal.  Repeated abuse of these systems results in tiredness, compromised immunity and suppression of healing and recovery.  This leads to discomfort, pain, injury, illness and disease.

How to combat these sources of stress...

In this blog i'll give an overview of how to combat these unsuspecting sources of stress so you can begin to change your mindset on how to deal with your discomfort, pain, injury and or illness.  As each of these subjects are pretty hefty on their own I'll be sharing information in more depth over the coming weeks.

1.  Nutrition

Eat from the earth.  Refrain from eating any foods that are packaged, processed and tampered with.  Reduce stimulants like coffee to the minimum to prevent stressing out your adrenals.  Be aware of your alcohol intake

2.  Hormonal/Adrenal

Sleep enough and rest properly.  Sleeping and rest are not the same thing!  Sleep 8 an average of 8 hours in a blacked out room in silence.  Maintain balance between work and life.  Acknowledge that you are not superman/woman and that rest is as important as action.

3.  Electromagnetic

Get enough sunlight for vitamin D but not too much - hardly a problem in the English winter months!  Eliminate all electronics from your bedroom and switch off lights at the mains.

4.  Exercise

Definitely exercise but make sure you are not overdoing it.  If you are injured seek professional help to recover effectively.  Strike a balance between healing restorative exercise like tai chi and hatha yoga and more energising forms of exercise like hitting the gym or running.

5.  Make stress your friend

If you haven't watched this video on how to make stress your friend I highly recommend it.  Kelly McGonigal says it better than I ever could.

How to make stress your friend

6.  Thermal 

This seems rather obvious but pay attention to your body temperature. Anything that keeps you too hot, burns you or adversely keeps you too cold is a stressor.  Make sure you are temperate in all situations - at home, work and when you sleep.

Lastly, this is a huge topic and I'll be covering smaller chunks in finer detail as the weeks go on so you can begin to make changes that will result in a healthier, happier pain free life!  If you have questions please email me.  

Information sourced from Paul Chek's How to Eat Move and Be Healthy book, CHEK Institute, USA.