Back pain explained
Dr Richard Parkinson is a highly trained neurosurgeon who has performed ground breaking and complex surgery on some of Australia's elite sportspeople and recognised as a leading expert in sports injuries.
Why is the lower back so prone to injury?
Why do so many people suffer from lower back pain? Studies have found the answer lies in the pressure in the lumbar disc with different physical activities. The more active you are, the less pressure on your disc.
If you walk, the pressure in your disc is a lot less than if you sit and the pressure in the disc is amongst the highest if you’re sitting for long periods of time, than if you are upright. Bottom line is to get active.
It’s important to have regular breaks from sitting down – I recommend everybody have a set break from sitting every hour, to get up stretch your legs and perhaps do some basic exercises.
There are other health benefits to taking a break—not just to your lumbar disc—it is very good for your health to improve your blood flow, improve your muscle tone, reduce your cortisol, improve your weight just to name a few.
Six tips to prevent back pain:
1. Be careful how you lift
Don’t lift more than 10 or 15 kg out in front of you and try to keep the weight as close to your centre of gravity as you can, rather than reaching out.
2. No twisting
Don’t twist your body at the waist while lifting. Avoid forcible bending, twisting or pulling as much as you can while carrying heavy weights (this includes children – try to keep them close to you and lift them when they’re in front of you).
3. Don’t wing it at the gym
Get as much help as you can, especially if lifting more than 10 to 15 kg. Ensure lifting aids are available to you. Don’t lift big weights straight off the get-go.
4. Look after yourself
Maintain your health, weight and lifestyle – excess weight and body fat puts unnecessary pressure on the back and increases the risk of injury.
5. Stop smoking
The silent killer for backs, smoking increases the risk of degeneration in the lumbar disc and it increases the risk that you will herniate the disc again, if you’ve had a disc herniation. In the event you need a lumbar fusion, smoking increases the risk it won’t work as it reduces the amount of oxygen to the disc and releases toxins into that disc.
6. Ask someone
Before embarking on a new fitness or strength-training regime, seek out a physiotherapist or an athletic trainer to help.
When to get help for back pain
When should you consult a spinal surgeon rather than a chiropractor or physiotherapist for your back pain?
I recommend within four to six weeks of an initial diagnosis, if the pain hasn’t gone away then you should seek a specialist review. That’s about the time where serious ongoing pain is generally not going to improve.
Making the decision
I’m very keen on physical rehabilitation and I work with several physios and chiropractors and a couple of osteopaths, however despite their merits, these health providers also have their limitations.
When there is no choice
Only a very small percentage of people experiencing back pain will require surgery. Persistent pain should be referred to a surgeon, as it may be nerve pain, that should not be ignored. Nerve symptoms include severe nerve pain radiating down an arm, leg, or elsewhere; or if you have numbness or weakness in the distribution of a nerve and loss of function, then surgery is usually needed.
Recurrent back pain
If back pain has gone away and come back at a later date, the causes needs to be seriously looked at and surgery may be required to fix the problem. These are the three main indicators I go by - dysfunction, intractable pain, or progressive deformity are all definitive indicators that the treatment for back pain has to go beyond rehabilitative treatment.
Do you suffer from chronic back pain? How do you deal with it? Let us know in the comments below.
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