I DON’T HAVE TIME FOR THIS! 

Causes of low back pain and prevention

Maureen Dwight Registered Physiotherapist, Clinical Musculoskeletal Specialist, Advanced Spinal Practitioner ISAEC

No one wants an injury.  First and foremost it hurts! 

Injuries stop you from participating in the things you enjoy, limit your involvement with family and just plain get in the way of life. When we first realize that we are in pain most of us hope that it’s just one of those uncomfortable muscle strains, like the ones we suffered when we were younger.  No matter our current age most of us remember our early injuries, the ones that recovered by walking it off or by taking a few days of rest and combining it with ice and stretching.

These strains usually come from exercising too hard, but as we get older minor irritations become less the norm and instead, overdoing means we can damage tissues. Whether we tear a ligament, herniate a disc or sprain a joint, these tissues need more time to recover and that time can seem astonishingly long when you are in pain.  I find most people are caught off-guard when I tell them that their recovery will take a minimum of 6 to 12 weeks. What is even worse is that these tissues are also less likely to heal as completely as a muscle strain, so what is even better is to not get injured in the first place.

  • Injuries cause pain, damage tissues and take 6-12 weeks to recover

What causes low back pain?

Fortunately we are now at point where we are beginning to understand why we injure and research is providing guidance on the cause and prevention of injuries.  In this time of financial constraints this change in direction is particularly important as the long term effect and the cost of injuries to the health system is quite compelling. 

For example we now know that up to 50% of knee injuries will go on to arthritis within 15 years[1]. This disturbing statistic tells us that not only is an injury limiting at the time of the damage it can also be considered to be one of the most expensive conditions in health care and the work place.  From a cost perspective it ranks second only to the common cold.

  • There is over a 75% chance of having repeated episodes of low back pain

Up until a few years ago the cause of low back pain was largely unknown.  Unless you had a car accident or lifted an excessive weight most back pain is insidious.  This means that most people cannot identify the incident causing the injury even though it can be profound enough to change the course of their life.

  • Most people cannot identify what caused their low back pain

In the past the only predictor of low back pain was a previous history of low back pain.  Needless to say when it comes to prevention, this predictor is too little too late however there are now several strong studies that are beginning to show predictors for a first episode of low back pain. In my review I have come across four factors that can be identified as playing a role in increasing the likelihood of injury and although the research is not there yet, I have also found that many of these factors continue to play a role in repeat episodes of low back pain.  These factors are:

4 Factors Causing Low Back Pain

  1. Sleep deprivationcauses of low back pain
  2. Abdominal muscle’s reaction
  3. Weight
  4. Poor balance strategies

Over the next 4 e-blasts and monthly posts on our website I will be exploring each one of these causes of low back pain.  If you haven’t had back pain and want to limit the likelihood of it or if you want to lower the risk for future episodes then you may find that this advice is of benefit to you.  Remember that we are still in the early stages of understanding the causes of low back pain and that there are likely several other factors that we have yet to discover influencing this condition, however in the interim there is enough evidence in place to suggest that these physical causes are a good place to start.

Sleep Deprivation causes Low Back Pain

Getting a consistent, good night’s sleep is one of the simplest strategies to prevent back pain.  Not only does it help to prevent back pain, there are a whole host of conditions where it is clear that many of our body’s functions benefit from just getting a better night’s rest[2].  Many studies indicate we are a sleep deprived society and it is becoming more and more apparent that this is not a healthy state for our brain, body or our back. Despite the obvious importance on a general health level I find that most people ignore or dismiss this strategy’s effect on causing back pain until they understand the science behind the changes. 

When it comes to the spine, the effect of sleep deprivation is attributed to an alteration in our cellular chemistry.  Sleep deprivation prompts an increase in the production of substances called inflammatory cytokines[3].  An increase in these chemicals is thought to be the factor causing back pain. Even prior to understanding this relationship more completely I found that if you are not sleeping properly it took longer to heal.  A review of sleep patterns and habits is often one of the first strategies I review with my clients.  This often leads to a discussion on the barriers to good sleep as the problems interfering with sleep are as varied as the people.   Some just need to go to bed earlier whereas others need a full sleep study and benefit from more intensive treatment of underlying conditions such as sleep apnea. If you are not getting enough sleep or waking up not feeling rested it is important to determine what is getting in the way of your sleep.

Here are a couple of links with simple strategies to get a better night’s sleep: http://www.helpguide.org/articles/sleep/how-to-sleep-better.htm

https://www.psychologytoday.com/blog/high-octane-women/201203/5-strategies-ensure-great-nights-sleep

http://psychcentral.com/lib/14-strategies-for-sleeping-better/

Depending on the level of involvement you may need to see a professional to help you get to the underlying factors.  If you are having trouble with sleep try not to wait for symptoms before addressing what many of us already know is a problem as I can almost guarantee that the time taken to recover from an injury will exceed the time you spend in preventing an issue in the first place. Next time:  How important is core strength as a cause of low back pain? Maureen Dwight is a registered physiotherapist practicing in downtown Toronto at the Orthopaedic Therapy Clinic. For more information on treatment options for prevention and alleviation of low back pain please contact us at physio@orthophysio.com or drop by our Toronto Clinic.

The advice in this article is not meant to replace advice from your health care professional.

[1]http://www.tandfonline.com/doi/full/10.3109/17453674.2013.765621; http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3584607/;

[2] http://www.ncbi.nlm.nih.gov/pubmed/23300350;

[3] http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3491449/#!po=0.867052