Back Pain Myths

Back pain is one of the most common presenting problems that I see on a day to day basis… At some point in our lives 8/10 of us will suffer from an episode of back pain. Despite this statistic we arent exactly well educated when it comes to our backs!!! Here are some common “myths” about how to save our backs…

1.    “I shouldn’t lift heavy objects” : there is slight truth to this comment, repetitive lifting can put undue stress on our lower back and predispose to injury. However this can be avoided if the correct lifting technique is used. Lifting should come from the legs, bend the knees and keep the back straight….. Use your quads and buttocks; they are after all two of the biggest muscles in our bodies!!

2.    ” I always sit with good posture so I shouldn’t get back pain” while having good posture is important, even a perfect ergonomic setup won’t reverse the negative effects that 6-8 hours of sitting can have in our spine. Sitting places stress through our intervertebral discs which are the shock absorbers of the spine. The seated position also puts our hip flexors in the shortened position and encourages our deep abdominals to be lazy, particularly when you slouch ( that’s 80% of us by 3pm)

3.    “I do 100 situps a day so my back should be nice and strong”....unfortunately it takes a lot more than 100 situps a day to achieve a strong spine. Ideally you need a good core stability program. Our core stabilisers are the deepest layer of abdominals consisting of the tranverse abdominus, lumbar multifidus, pelvic floor and diaphragm. These muscles help to provide a corset and give support to the discs and joints of our spine.

4.    ” When I have back pain I should lie flat on my back in bed till it goes away”....there is no doubt that in an acute episode of back pain that rest is essential. However exercise is the best thing  for speeding up your recovery. You should consult your physiotherapist for appropriate exercises that will be safe for you in the acute phase and as your pain resides these exercises can be progressed and become a long term maintenance program for your back

5.    “Sleeping position doesn’t really impact our backs” for all the tummy sleepers our there it’s time to ditch this bad habit… The best way to sleep is on your side with a pillow between your knees (the lazy S). This position maintains the natural curves of your spine

6.    “Other health factors don’t affect my chance of developing back pain” incorrect there are several health factors that actually increase our chances of suffering from back pain.

Smoking: the chemicals in cigarettes actually dehydrate our intervertebral discs and speeds up the process of degeneration. Research indicates that smokers will take 6 months longer to fully recover from disc related back pain.

Extra pounds: carrying extra kilos will place excessive on the shock absorbers in our spine and also increase the load through the weight bearing joints causing them to wear out faster

Hydration: our intevetebral discs are made up of around 70% water. The amount of water will depend on the amount of load applied through the disc ( this will differ at night – discs tend to rehydrate over night as we sleep) when a disc is dehydrated its mechanical properties are altered significantly and can no longer absorb stress as efficiently.


via- http://yoursportsphysioblog.com/2012/05/07/back-pain-myths-busted-3/

The Effects of Virtual Reality-based Yoga on Physical Function in Middle-aged Female LBP Patients

The objective of this research was to determine the effects of a virtual reality-based yoga program on middle-aged female low back pain patients. Thirty middle-aged female patients who suffered from low back pain were assigned to either a physical therapy program or a virtual reality-based yoga program for a period of four weeks. Participants could check their posture and weight bearing on a monitor as they shifted their weight or changed their postures on a Wii balance board. There were a total of seven exercise programs. A 30-minute, three times per week, virtual reality-based Wii Fit yoga program or trunk stabilizing exercise was performed, respectively. Repeated-measures analysis of covariance revealed significant differences in between before and after VAS, algometer, Oswestry low-back pain disability index (ODI), Roland Morris disability questionnaire (RMDQ), and fear avoidance beliefs questionnaire (FBQ) scores. The VAS, algometer, ODI, RMDQ, and FBQ scores exhibited significant differences in groups. Regarding the effect of time-by-group interaction, there were significant differences in VAS, ODI, ODI, and FBQ scores.

The study concluded that for middle-aged female patients who have low back pain, a virtual reality-based yoga program was shown to have positive effects on physical improvements, and the program can be employed as a therapeutic medium for prevention and cure of low back pain.

For the full study, visit-

http://www.physiospot.com/research/the-effects-of-vr-based-wii-fit-yoga-on-physical-function-in-middle-aged-female-lbp-patients/

Effectiveness of manual therapy on low back pain with working adults

M.Sc. Markku Paatelma defends his doctoral dissertationtitled "Orthopaedic manual therapyonlow back pain with working adults; clinical tests, subclassificationand clinical trial of low back pain”. Opponent Docent Markku Kankaanpää (Pirkanmaa Hospital District) and custos Professor Ari Heinonen (University of Jyväskylä).

Abstract-

Orthopedic manual therapy on low back pain with working adults; clinical tests, subclassificationand clinical trial of low back pain. Although the natural history of low back pain (LBP) is considered to be good, most sufferers have further episodes during the first year. Debate continuesonthe comparative effectiveness of adviceonbed rest and staying active as part of the primary care management to avoid a vicious circle, preventing LBP from becoming chronic in its early phase (of < 12-week duration). LBP in its early phase is also a commonreasonto consult aphysiotherapist.The objective of this dissertationwas to evaluate the intertester and intratester reliability of selected clinical tests betweenphysiotherapists to assess LBP patients in the early phase, and to discover the sensitivity and specificity of these tests in acute/subacute and chronic LBP patients, and in a group of no “patient status” subjects. A further objective was to evaluate the intertester reliability of a pathoanatomical/pathophysiological classificationby general practitioners in primary carephysiotherapy compared to findings classified by a specialist in orthopedic manual therapy (OMT) and the findings of two OMT specialists when examining patients with early-phase LBP using selected clinical tests. The objective was also to compare effectiveness against low back and leg pain, disability, and sick leave of OMTphysiotherapy using a pathoanatomical/pathophysiological classificationto the effectiveness of the McKenzie method and effectiveness of “Advice”only to stay active.The inter- and intratester reliability of clinical tests seemed to be at an acceptable level globally, although tests had both high and low reliability among test categories. Intratester reliability was slightly better than intertester reliability.Of all the selected clinical tests, few tests were moderately sufficient in sorting the chronic low back pain patients (CLBP) from subacute low back pain patients (SLBP), and distinguishing patient groups from controls. These 31 clinical tests quite poorly sorted the CLBP or SLBP patients from the controls. It may be possible that a combinationof tests may enhance the sensitivity and specificity in sorting the CLBP or SLBP patients from the controls.Subclassificationinto clinical subgroups is reliable in the two most commonsubgroups also withphysiotherapists without specializationin OMT after a short post-graduate training. No further conclusioncould be drawn from other subgroups because of the low number of subjects in these categories.The OMT and McKenzie methods, compared to Advice-only to stay active for low back and leg pain, and disability showed no significant difference in effectiveness during aone-year follow-up of working adults. However, the OMT and McKenzie method groups showed treatment effects compared to the Advice-only group in form of the smaller number of days of sick leave because of LBP. Regarding sick leave days, there was also a statistically significant difference between OMT and McKenzie groups in favor of OMT-physiotherapy.Keywords: orthopedic manual therapy, McKenzie method, clinical tests, sub-classification, low back pain in early phase, randomized controlled trial.

For further information:
Markku Paatelma, tel. 040 501 4822, email- markku.paatelma@auron.fi

The dissertationis published in the series Jyväskylä Studies in Sport, Physical Educationand Health, no173, 98 p., Jyväskylä, 2011, ISBN 978-951-39-4428-5, ISSN 0356-1070.