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Watch your back - A guide to helping your back

Surveys show that 60-80% of Australian will experience back pain at some stage in their lives, with 15-30% suffering back pain at any one time, according to the Medical Journal of Australia. Back Pain is the second most common reason (after respiratory complaints) for visiting aout GP and is the leading musculosketetal cause of health system spending in Australia the Journal says.

Back pain is a common and debilitating problem but some simple steps and help keep you upright and protect you from injury.

Back pain isn't always caused by back-breaking work – often, it can result from the tiniest movement.

Our modern lifestyle constantly undermines our spine. We hunch over computers or other work tasks for hours on end, exercise little and become overweight with alarming ease.

And then, when the muscles supporting our spine are weak and out of condition, we bend awkwardly to shift heavy furniture, lift grocery bags from shopping trolleys or shovel mulch on to garden beds. Sometimes, because of small, incremental damage over many years, all it takes is a coughing fit and we're in agony.

Back pain is an epidemic

Physiotherapist to Australia's Olympic and Commonwealth Games triathletes Mark Alexander labels back pain an epidemic. And, he adds, it's little surprise our backs cause us so many problems. We routinely neglect it, yet it is instrumental in holding us upright, protecting our spinal cord and enabling mobility.

The Human Spine

The spine is an S-shaped column made up of 24 bones called vertebrae. These are divided into three sections which support the upper body: cervical (neck), thoracic (upper) and lumbar (lower).
Most of our problems occur in the lower back and neck, with the thoracic spine relatively rigid and benign.

"The thoracic spine in the stiffest part of our spine because it has 12 ribs attached to it protecting our lungs and heart." Says Alexander, who lectures at La Trobe University in Melbourne. "So it doesn't move or hurt much. What moves are our lower backs and our necks."

To enable us to bend, walk and move freely, the 24 vertebrae are separated by softer intervertebral discs, which are designed to have a cushioning effect. As their name suggests, these discs have a flatter structure and are made of cartilage with a gel-like centre. The vertebrae also surround and protect the spinal cord – the main nerve route for messages travelling to and from the brain. Pairs of small 'facet' joints connect the vertebrae, while the spine as a whole is held together with ligaments and muscles.

This complex system means a lot can go wrong. And it often does.
Back pain can be caused by anything from torn ligaments or discs, to strained facet joints and bony growths that press on nerves.

Sciatica is often used to describe any pain that radiates into the leg. But technically, it refers to the pain felt along the back of the leg when the sciatic nerve exiting the spine is pinched or irritated.

Referred pain is pain that is distant from the actual problem. Signals from several areas of the body often travel through the same nerve pathways to the spinal cord and brain. As a result, the brain can get confused, says Dr Jason Stone, Victorian president of the Australian Osteopathic Association. "Headaches around the forehead and eye are commonly referred from a problem with an upper cervical facet joint" he says.

Age and back pain

Age also increases the chance of back pain. As we get older, generally from our early 30s onwards, the intervertebral discs become drier and thinner and increase the likelihood of wear and tear on our joints. Discs can also bulge or the gel-like interior can leak (herniated), says Dr Stone. As well, some diseases and medical conditions, such as pregnancy, osteoporosis and scoliosis (curvature of the spine), can lead to back pain.

However, says Alexander, you can avoid the everyday causes of back pain with three simple steps:
– maintain a straight back,
– bend correctly and
– exercise for 20 or 30 minutes a day.

Achieving & maintaining straight posture

To achieve straight posture, stand with your back to a wall, your feet slightly away form it and your knees bent, says Alexander. Flatten your buttocks, back and shoulders and head against the wall, then step away from it. "That's the optimum position for you" he says.

To maintain this straight back, bend from the hip for everyday tasks that don't require heavy lifting. This advice applies to everything from leaning forward to brush your teeth, to picking newspapers off the coffee table. If you need to left or shift heavy items, also bend you knees, he says. An exception is vacuuming – a major cause of back pain. Alexander recommends bending you knees to vacuum, with your arm at your hip.

Gardening

Gardening involves one of the worst actions for your back – bending and twisting. And often, such as with a shovel or fork, it's with a heavy load. Experts advise to take it carefully, use proper tools and stop regularly to stretch and alter your position.

What to do if you have hurt your back.

If you do hurt your back, there are plenty of specialists available to help. You can go to a GP or seek advice from a physiotherapist, chiropractor or osteopath. They all treat back pain but with varying approaches.

Treatments include manipulation, hot packs, electrotherapy, soft tissue massage, strapping, joint mobilisation and exercises. Chiropractors are highly specialised in spinal manipulation, although physiotherapists and osteopaths also perform it. Manipulation involves stretching the joints slightly, causing increased pressure and a release of gases that makes and audible "pop", says Alexander.

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