It is quite literally a pain in the neck. Or the backside. Or in the discs which make up your vertebrae.
Back pain, be it spinal, muscular or from the tendons which connect the body together, is the most common physical complaint in Britain, affecting four out of five people at some point in their lives and accounting for half of all chronic pain.
And when it hits, there’s no misinterpreting it. It could be anything from turning on a bath tap to discover your back has seized up to living with months of chronic pain affecting your ability to walk, sleep and remain your normal self. While it might not kill, it certainly tortures.
It also costs – every day back pain costs the NHS £1.3 million, every day around £13m in disability benefits are paid to sufferers, and with 7.6m working days lost to work-related back pain annually, that costs the UK economy £37m a day in productivity.
Expect to see these figures mentioned a lot over the next few days as Backcare Awareness Week swings into action, with the focus on office workers and trying to avoid lower back pain in particular.
According to Backcare, the UK association for back and neck pain, sitting for hours at a computer keyboard stores up trouble for your back as the body can only tolerate being in one position for a short time. Positioning keyboard, monitor and mouse properly are all key to healthier workstations, as is being able to stand and stretch your back at least every half hour and taking regular breaks.
Edinburgh osteopath Gavin Routledge agrees – and he approves of “rising desks” in offices which allow people to stand and work. “A huge proportion of the cases we see are either caused or exacerbated by poor sitting positions,” he says. “We don’t often think about it this way, but we are descended from wild animals. We were not designed to spend huge amounts of time in an orthodox sitting position. Varying our working position, particularly being able to work while standing for parts of the day using sit/stand desks, is a deceptively simple but very effective way of reducing back pain problems.”
Gavin says that lower back pain can affect 80 per cent of people at some time in their lives and the single biggest predictor of back pain in the future, is that you’ve already had some in the past – statistics show that 60 per cent of back pain reoccurs within a year.
“This happens because people don’t change their risk factors,” he says. “People think that if they’ve hurt their back it’s in some way weakened, and in some cases that might be true, but if the pain comes back again the majority of cases show that it’s because people didn’t change their lifestyle.
“If you always do what you’ve always done you’ll always get the same result. If you have bad posture, have low levels of activity, are overweight, smoke, and you hurt your back and don’t change any of those things, then it will happen again.”
He adds: “Smoking, for instance, affects circulation so if you’ve hurt something it may not heal properly and stress, particularly work-related, raises tension in the body, including muscle tension, so that can make back pain worse.”
It seems, though, that lower back pain is so prevalent because of the way we’re built. Walking on two feet is an evolutionary weak point.
“Being bi-pedal compresses the discs and joints much more so than animals on four legs,” says Gavin. “This causes them to wear out faster and it’s our muscles which have to hold us up, which results in strain.”
Gavin, Clinic director of Active X Backs, has spent years working with employers such as Standard Life, Aegon and Ineos to try and ensure lower back pain among staff doesn’t become a headache.
And today he is launching an online solution for lower back pain and sciatica sufferers and hopes to help a million sufferers. “I reviewed 226 apps on the Apple store which all claimed to help people’s back pain and found a very low level of adherence to clinical guidelines and a low level of user-preferred content. To be honest, they were pretty rubbish and I thought I could do much better.
“Although it’s not a mobile app, it provides so much of what people want to know, such as why back pain is so unpredictable, what causes it and what exercises to do. For instance, there’s not a lot of evidence across the population that core exercises make much difference, but we know physical activity does, it’s finding one that suits you.”
The new site boasts around 50 videos which can answer some of the most common questions – when should someone go to the doctor, what painkillers to take, what exercises to do.
“It means if people can’t get to see me personally, which is always the best way to address the problem, then there is an online video option to put my 25 years of experience to work on their problem.
“I like a big challenge and I’d love to help as many people as possible. During my career I have helped literally thousands of people with lower back pain and sciatica, so I feel ready for a really big challenge.
“I know it’s a big target considering it’s taken me 20 plus years to help just 10,000 people; but with the easy accessibility of information and media via the internet, I figure that even if I fall short I’ll have helped many many thousands. Even though the chances of helping a million people in my lifetime are slim, I’m very excited about the challenge of trying, and about the benefits I can bring to so many people.”
The Active X website can be found at www.active-x.co.uk
10 Top Tips for lower back pain
People who are more active in their leisure time suffer less lower back pain, and recover faster.
Fitter people suffer less back pain – but take advice on just what exercise you can take.
Use correct medication
Get advice from your doctor. Painkillers and other prescription medication can help you cope with the pain while your body heals.
Sleep well, sit well
Sleep is very important to healing.
Sit well and sit less. Most lower back pain is aggravated by sitting. Get up and move around frequently, and try “active sitting” – sitting on the front edge of your seat and holding yourself up.
Stop smoking and get to a healthy weight
Smokers suffer more back pain than non-smokers. If you’re significantly overweight you’re more likely to have back pain.
Don’t call it a ‘bad back’
Labelling your back as ‘bad’ is very negative and will tend to make you think you have a weak back.
Anxiety and tension lead to more pain and make it more likely that you’ll avoid movements – this creates a vicious cycle of pain: pain... worry... muscle tension... more pain... worry... muscle tension... more pain.
Get recommended treatment
Osteopaths, chiropractors and manipulative physiotherapists are recommended for the resolution of low back pain.
and . .
Recent research shows that understanding the causes of back pain and how pain works has been shown to lessen pain.