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How Does Lower Back Pain Work? Part I

Lower back pain is so common that 8 out of 10 us will experience it at some point in our lives.  Any person who has experienced lower back pain can testify to how debilitating lower back pain is and how much it can negatively impact on your daily life, making common gestures like picking up a tissue off the floor, nearly impossible (read my post on how to strengthen your abs when you have lower back pain).  Not only that, suffering from lower back pain is likely to make driving extremely difficult, if not even more painful (click here to read more about driving posture to reduce lower back pain).  Sitting for long periods at the office or even trying to continue with your normal sport or recreational activities are also negatively impacted when lower back pain comes to call.  All in all, one of the least desirable ailments (read my post on how picking up your children badly can cause lower back pain).

How then does lower back pain work?  Understanding something is the first step in learning to deal with it better and hopefully to help find a way to reduce it’s impact in our lives.

Broadly speaking, your lower back pain will either be mechanical in nature or inflammatory (read about inflammatory lower back pain), or a combination of these.

lower back pain
Image by LadyofHats Mariana Ruiz Villarreal under Public Domain

When your lower back pain is mechanical in nature, this means that it relates to your biomechanics and to your musculoskeletal function.  In other words, it’s how your bones, joints, muscles, nerves, blood vessels and discs are affected by your movements, postures and your rest, to either cause you lower back pain or relieve your lower back pain.

As some of you would know, often when you have lower back pain, some postures and movements are hell and others keep you sane and able to function.  

It’s important to take note when this is the case.  Some people suffering from lower back pain tend to take no notice of what aggravates or eases their lower back pain and they are missing out on very important information in helping to understand and treat their problem correctly and swiftly.

When your lower back pain is due to a mechanical cause, any movement such as sitting/rising/walking/bending/arching backwards/straightening your knee etc. will either increase, decrease or maintain the intensity of your lower back pain.  This is because the mechanical forces created by these movements will have increased, decreased or remained constant on parts of your body tissues such as your spinal discs, facet joints, muscles or nerves.

In addition, you need to understand that different structures in the body are affected by different movements and postures and the forces that they apply.  They are also affected by the type of damage that has occurred and how this causes the affected body tissue to respond to different mechanical forces.

Spinal discs for example are generally aggravated by bending and twisting and can be eased by arching backwards (in certain circumstances, in other circumstances the opposite is true – hence it’s important to see your OMT specialised Physio for assistance since they are especially trained to know these differences and much much more).  On the other hand, generally speaking, your facet joints are aggravated by arching backwards but eased by bending and twisting.  Thus, it’s really important to take note of which movements ease, aggravate or maintain your lower back pain.  This information will help your OMT Physio get to the root of your problem faster.

Next time I will discuss chemical causes of lower back pain.  Any comments?  Please feel free to post them, I would love to hear from you.

 

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How Does Lower Back Pain Work? Part II

We’ve said it before, but it bears repeating.  Lower back pain is very very common.  People who are at risk are office workers and drivers (in other words people who sit for long periods of time) as well as people such as nurses, manual workers in a factory/farm/warehouse setting (since they perform a lot of lifting and bending).  In other words, most of us are at risk of developing lower back pain because of sitting for too long in a bad posture or because of lifting and bending poorly day in and day out in our jobs.  That is why at least 80% of the world’s population will suffer from lower back pain at some point in their life.

To broadly understand your lower back pain, you need to think of it as mechanical in nature (read my post on mechanical lower back pain), or inflammatory, or a combination of these.

When your lower back pain is mainly as a result of chemicals in your body, this means that hormones and chemicals are circulating in the area of your pain, triggering a pain response from the brain.  This can be due to trauma, arthritis, infections, physical pressure on a nerve or other tissue, or chronic pain syndrome (a very complex disorder involving the nervous and chemical systems of the body).  Physically increasing the blood’s circulation through movement often aggravates lower back pain of an inflammatory nature.  Too much rest (swelling and pressure build up when you rest too much if there is inflammation present) will also aggravate lower back pain in these circumstances.

Inflammation
Image by CDC/Dr. Karp, Emory University under Public Domain

Sometimes, lower back pain as a result of a mechanical problem can also result in an inflammatory response in the spine.  When this occurs, this can really slow down your response to treatment, since the inflammation will need to settle, which normally takes anything between 3-7 days.  If you keep aggravating your lower back pain (which many people do), you are liable to keep your inflammatory process active and delay healing further.

At other times, lower back pain of an inflammatory nature can leave scar tissue behind as a result of the inflammation, which in turn can cause mechanical problems for some body tissues such as a nerve impingement that again can result in lower back pain.

Another factor to bear in mind is that when your lower back pain is due to inflammation, anything than causes a change in your circulation will aggravate your lower back pain.  This generally means that too much movement can increase your lower back pain because increased movement results in an increase in your circulation, which in turn increases the amount of chemicals causing your lower back pain to be present in the area of your injury.  Too much rest also will cause an increase in your lower back pain, since when your circulation slows down, fluid moves out of your blood vessels and into the tissue surrounding it.  This causes a pressure build up in your injured tissue which in turn increases your lower back pain.  The key when you have lower back pain of an inflammatory nature is to do small amounts of movement often.  Not too much movement and not too little.  If you listen to your body, it will guide you to get the balance right.

Understanding what type of back problem you have is important to treat it properly.  Make sure you have the correct person with enough expertise and medical knowledge to help you.  OMT specialised physiotherapists are among the best people to help you resolve your back pain.

Do you have any questions or comments? Please take the time to post it, I would love to hear from you.

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How the Position of Your Computer Screen/ Tablet Can Cause Neck Pain

You’re stuck at your desk behind your computer, hour after hour, day after day looking at that darn screen!  “This can’t be good for my health”, you think.  Actually, you are right.  It’s not.

Besides the glare and fatigue, and let’s not mention the stress (all of which add up and contribute to your frequent aches and pains) (read my post on stress and neck pain), there is something else, something mechanical which WILL end up in neck pain.  Simply bending your neck for too long (read my post on 4 computer monitor positions that cause neck pain).

Bending your neck is so common and so ordinary and most of us do it for far too long during the day, which is why at least a 30 -50% of us will experience neck pain.

Why do we bend our necks for too long increasing our risk of developing neck pain? The most common reason that we bend our necks for long periods of time during work hours is because our computer screen is positioned too low on our desk.  Alternatively, if we’reworking with a tablet (or smart phone) in our hand for far too long, these devices with their small screens and integrated keyboards cause us to work in a hunched over position with our heads hanging down.  Prime posture for developing neck pain (read my post on how to correct a low monitor position causing neck pain).

Another reason is because we are working with papers on our desk as well as trying to type on our keyboards, or because we can’t touch type (read my post on touch typing and neck pain).  All these things cause us to bend our necks for too long.

"Catching Up On Email..." by Ed Yourdon under Licence CC BY 2.0
“Catching Up On Email…” by Ed Yourdon under Licence CC BY 2.0

Researchers have discovered that bending your neck for more than 70% of your working day will double your chances of developing neck pain.

So, what position should your neck be in when you work? What posture will help prevent you from suffering from neck pain? Remember that spinal s-curve? (read my post on spinal posture and back pain)

Vertebral Column by Unknown and is licenced in the Public Domain

Vertebral Column by Unknown and is licenced in the Public Domain

Well, that spinal s-curve needs to be maintained when you’re looking at your screen/laptop/tablet/smart phone for extended periods of time.  It also needs to be maintained when you’re typing or working on papers!  (check out our store for assistive devices to help place your monitor/tablet in the correct position).

"IMG_3771" by Joe Loong under Licence CC BY 2.0
“IMG_3771” by Joe Loong under Licence CC BY 2.0

In order to maintain your spinal s-curve and the curve of your neck, you need to raise the screen of your monitor/laptop/tablet to eye level using books, monitor raises, adjustable monitor arms, or a proper laptop raise/ tablet docking station (I’ll discuss this further in another post) to achieve this.  If you’re lucky, some desktop monitors are adaptable, allowing you to elevate them without aids.  Ensure that when they are on their highest setting and that your monitor is in fact at eye level, otherwise you still need some books etc to get it to the correct height.

Need more help with computer ergonomics?  Check out our ergonomic desk exercise software.

All in all, make sure that your neck is in a good position while you work if you’re suffering from neck pain or want to avoid suffering from neck pain.

 

Reference:

Ariens G.A.M., B. P. (2001). Are neck flexionk, neck rotation, and sitting at work a risk for neck pain? Results of a prospective cohort study. Occupational and Environmental Medicine, 200-207.

Cagnie B., D. L. (2007, May). Individual and work related risk factors for neck pain among office workers: a cross sectional study. European Spine, 16(5), 679-686.

Guzman J., H. E.-J. (2008). A new conceptual model of neck pain linking onset, course and care: The bone and joint decade 2000-2010 task force on neck pain and its associated disorders. Spine, 33(4S), S14-S23.

Guzman J., H. S.-J. (2009, February). Clinical practice implications of the bone and joint decade 2000-2010 task force on neck pain and its associated disorders. Journal of Manipulative and Physiological Therapeutics, 32(2S), S227-S243.

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How Strong Quadriceps Muscles Help with Anterior Knee

Anterior knee pain is a very common cause of knee pain in people across all ages. Some people may also know it as patello-femoral syndrome.

"Image illustrating the areas affected by w:en:Patellofemoral pain syndrome" by BodyParts3D/Anatomography under Licence CC BY 2.1
“Image illustrating the areas affected by w:en:Patellofemoral pain syndrome” by BodyParts3D/Anatomography under Licence CC BY 2.1

Anterior knee pain (or patello-femoral syndrome) is pain that is found in the front of the knee.

Anterior knee pain will commonly get worse when you use stairs.  Going downstairs is generally more painful than going upstairs, or going downhill is also generally more painful than going uphill.   This is because going downstairs or going downhill places a greater demand on your quadriceps muscles than going uphill or upstairs.  Anterior knee pain is also aggravated by any activity, movement or exercise that places strain on your quadriceps muscle and knee cap.  Why is this?

Firstly, you need to understand the parts of the body involved when you get anterior knee pain (or patello-femoral syndrome).  If you look at the illustration below, you will see that the knee cap is positioned above the thighbone (femur) and that there is a muscle that is attached to the knee cap via a tendon, that is called the quadriceps muscle.  The quadriceps muscle is actually made up of 4 muscle bellies (recently a 5th muscle belly has been discovered).

"Knee Anatomy"Blausen.com staff. "Blausen gallery 2014". Wikiversity Journal of Medicine. DOI:10.15347/wjm/2014.010. ISSN 20018762. with written author permission for use.
“Knee Anatomy”Blausen.com staff. “Blausen gallery 2014”. Wikiversity Journal of Medicine. DOI:10.15347/wjm/2014.010. ISSN 20018762. with written author permission for use.

The action of your quadriceps muscle is to straighten the knee when the quadriceps muscle contracts.  Because the knee cap is attached to the quadriceps muscle, when you straighten and bend your knee, your knee cap moves up and down along the thigh bone in a groove.  This action is controlled by the quadriceps muscle.  In fact, your knee cap is there to shorten the lever of your quadriceps muscle and thus improve the contractile strength of your quadriceps muscle when it acts.  Thus they work together like hand and glove.

If you have weak quadriceps muscles, however, the knee cap is no longer well controlled in its movement up and down the groove in the thigh bone.  What happens is that when your quadriceps muscle contracts in this instance, your knee cap is pushed against the thigh bone and grinds the underside of your knee cap against your thigh bone, causing inflammation and your anterior knee pain/ patello-femoral syndrome.

What causes your quadriceps muscles to weaken and cause your knee cap to grind against your thigh bone creating anterior knee pain?  There are various scenarios.  A very common one occurs in children and teenagers, where a growth spurt has occurred and the bone is longer, but the quadriceps muscle and tendon haven’t caught up, causing a biomechanical imbalance resulting in anterior knee pain/patello-femoral syndrome.  Another scenario is when an injury to the knee has occurred that results in pain and swelling.  Any pain or swelling in the knee causes inhibition of your quadriceps muscle, which left untreated, can result in the development of secondary anterior knee pain/patello-femoral syndrome.  If you have had a knee injury, make certain that you have been to see your sports or OMT physiotherapist.  They are specially trained to help you resolve this problem quickly.

One of the factors that your sports or OMT physiotherapist will attend to is how to avoid anterior knee pain if you’ve had a growth spurt or knee injury or how to undo anterior knee pain caused by weak quadriceps muscles.

Since your weak quadriceps muscles are key to the problem of your anterior knee pain, knowing how to strengthen your quadriceps muscles in a pain free way, until the muscle is strong enough to pull your knee cap away from your thighbone while your knee bends and straightens during your activities, is pivotal in resolving the problem (read my post on strengthening your quadriceps muscles when you have anterior knee pain) and go see your sports or OMT physiotherapist for some treatment.

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How to Stretch Your Hamstrings Despite Suffering with Lower Back Pain

So, you have lower back pain and are wondering if  your tight hamstrings are an aggravating factor in your lower back pain (read my post on tight hamstrings and lower back pain).  How do you know if your hamstrings are in fact tight?

There are different postures that you can use to test your hamstring length.  One way is to test your hamstring length in standing.  Bend forwards and try and tough your toes.  How far down can you go while you keep your feet together and your knees straight?

Alternatively, you can test your hamstring length in a position we call long sitting.  Again, reach down towards your ankles/feet and see how far down you can reach while you keep your legs together and your knees straight?  It’s important that when you do thee tests, that you do not stretch into pain.  If you are at all concerned about your posture/hamstring length/lower back pain, go see your OMT trained physiotherapist.  They are especially equipped to help you.

touching toes
“Touch Your Toes” by Ben Sutherland under Licence CC BY 2.0

Now that you’ve tested your hamstring length, your next question should be: What is normal hamstring length? Well, actually, that is quite debatable.  What is normal for some people can be very different for others.  For example, some people can easily reach their ankles, whereas others can’t get below mid shin level or even their knees.  So, how do you know if you have tight hamstrings and whether they are contributing to your lower back pain?

Your hamstrings are too tight, when your lower back curve is flattened when you perform your regular activities such as sitting at your desk, driving your car (read my post on driving posture and lower back pain), playing your sport and generally carrying on with your daily life.

The next consideration you need to make is how do you stretch your hamstrings effectively, especially if you have lower back pain?  I am personally not a great fan of passive stretches.  Often people take the stretch too far and hurt the muscle, actually causing more muscle spasm and shortening.  This is counterproductive.

Another consideration when stretching your hamstring is the sciatic nerve.  This nerve runs through the hamstring muscle, and if your sciatic nerve is sensitised or tight for whatever reason, your hamstring muscle will stay tight no matter what you do, in order to protect the nerve.

I also believe that your stretch should be functional, and this is especially important when you are suffering from lower back pain.  Standing places far less loading on the spine than sitting or long sitting (as in the stretch above).  In addition, long sitting is often an aggravating posture for lower back pain for a variety of reasons, hence a posture to avoid.  To assist in a better hamstring stretch, add gentle resistance while stretching, producing an active stretch so to speak.

 

Active Hamstring Stretch
Active Hamstring Stretch (Taken from our Pain Management Software for Computer Users) Copyright 2015 CS Body Health cc. All Rights Reserved.

 

Lastly, it’s always prudent to seek professional help when you are suffering from pain.  Your OMT specialised physiotherapist are highly specialised and equipped to quickly and safely help you when you have tight hamstrings, particularly in the presence of lower back pain.  They will help to uncover the real reason that your hamstrings are tight, and assist you in resolving the problem.

 

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How Do Tight Hamstrings Aggravate Lower Back Pain?

Lower back pain is a very common ailment affecting far too many of us.  In fact, the World Health Organisation puts the incidence of lower back pain at 80%.

Lower back pain has many causes for its occurrence.  These causes include disease processes (like rheumatoid arthritis ), infections (sometimes TB can cause lower back pain), injuries (like a fall down the stairs or a car accident), genetic predispositions (like spondylolysis) and then you get mechanical factors (like poor lifting technique and poor exercise habits amongst a whole host of others).

One common mechanical aggravating factor for lower back pain is when a person suffers from tight hamstrings.  To understand more about how your tight hamstrings will contribute to your lower back pain, we need to first understand more about the hamstrings.

Let’s start with where the hamstrings are found in our body.  Where do the hamstrings start and end in the body?  The hamstrings attach to the bottom of your pelvis and end just below your knee.  Because the hamstrings attach to the pelvis and to the tibia (the shin bone), when the hamstring contracts, it will affect both the hip joint and the knee joint.  We call it a 2 joint muscle.  2 joint muscles typically are important in controlling movement in the body.

Hamstring
“Animation of the relaxation and contraction of the hamstrings group of muscles when the leg flexes” by Niwadare under licence CC BY 4.0

Thus, the hamstring muscle is responsible for helping to pull the hip backwards and to bend the knee, and we use these hip and knee movements throughout the day, for example when we walk.  The hamstring also helps to control and stabilise the knee during sport, although this has little to do with your lower back pain and more to do with knee function.  I will discuss this more in a future post.

We now know how the hamstring muscle moves the body when it contracts, but how does your hamstring move the body when it is stretched? What happens when your hamstrings are tight?

Because the hamstring attaches to the bottom of the pelvis, when the hamstring is stretched, or your hamstring is tight, it will result in your pelvis being rotated backwards which has the knock on affect of flattening the important lumbar curve in your lower back (Read more about the important curves in your spine here).  This lumbar curve helps prevent and control lower back pain.

Vertebral Column by Unknown and is licenced in the Public Domain
Vertebral Column by Unknown and is licenced in the Public Domain

Hamstrings that are on stretch and when they are tight, will negatively affect your lower back and predispose you towards lower back pain, particularly when you are in a sitting posture, for example when you are driving (read my post on driving posture and lower back pain) or during any activity that places your hamstring on stretch (for example during sport like running, kicking etc).

How does one end up with tight hamstrings?  Some people are born with them, it’s a genetic predisposition.  Other people have tight hamstrings because of an injury to their muscle and the subsequent scarring that results due to the injury in the hamstring muscle.   Other people have tight hamstrings as a result of pain in their sciatic nerve (which causes the muscle to go into spasm around the nerve to protect the sciatic nerve from being stretched and further irritated).  Tight hamstrings can even be as a result of a mild form of spinae bifidae (a birth defect).  However, a lot of people have tight hamstrings because when they use their hamstrings a lot during their daily life (such as in hiking, cycling, exercises in the gym or even lifting at home/work), they fail to adequately stretch them after their activity, slowly causing their hamstrings to tighten.  And tight hamstrings, thus predispose you to develop lower back pain.

Read my post on how to stretch tight hamstrings if you have lower back pain.

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Do You Experience Wrist Pain? How Do You Know if it’s Carpal Tunnel

Have you been experiencing pain in your hand, especially in the thumb, index finger and middle finger area?  Or maybe a fuzzy feeling or pins and needles and/or numbness in the same described area?

wrist pain
Image by FreeImages under FreeImages.com Content Licence

These are all symptoms of carpal tunnel syndrome.

What is carpal tunnel syndrome?  Carpal tunnel syndrome is a problem where one of the nerves (the median nerve) that feeds the hand, becomes irritated and inflamed.  This inflammation of the median nerve in the wrist area results in swelling of the tissue surrounding the median nerve.  Because there is very little space in the area where the median nerve passes through the wrist, swelling in this area causes pressure on the median nerve.  This pressure on the median nerve in turn causes your symptoms of pain, pins and needles and numbness in the thumb, ring finger and index finger and the area in the palm just below it.

carpal tunnel syndrome
“Carpal Tunnel Syndrome” by Bruce Blaus under licence CC BY 3.0

Inflammation of the median nerve is normally due to overuse of the hand, and this condition is also known as repetitive strain injury or RSI.  Office workers and factor workers are both at risk of developing carpal tunnel syndrome.

In office workers,  RSI/carpal tunnel syndrome is quite a common injury.  Not quite as common as neck pain or lower back pain (read my post on 4 computer positions that cause neck pain) but quite common nonetheless.

One of the reasons office workers end up with RSI/carpal tunnel syndrome is due to excessive use of the computer mouse.  Strangely enough, too much typing is not associated with the development of carpal tunnel syndrome.  Another reason office workers are susceptible to developing carpal tunnel syndrome is due to pressure on the underside of their wrist.  People who use mouse pads place themselves at risk of developing carpal tunnel syndrome due to the pressure they place on their wrist when they rest their wrists on their mouse pad.  This is slightly ironic, since the mouse pad was developed to help with carpal tunnel syndrome.  Research has shown though, that mouse pads actually increase the incidence of carpal tunnel syndrome rather than reducing it.  So, please throw your mouse pad away!

Factory workers are at risk of developing carpal tunnel syndrome due to excessive hand use, particularly in activities that cause them to bend their wrists, such as jobs that involve repetitively folding boxes all day.

Sometimes, carpal tunnel syndrome can also be due to mechanical compression that occurs as a result of scarring in the area from a wrist injury.  Injuries result in inflammation, and inflammation always creates scarring in the inflamed area.

One of the reasons it’s always important to get physiotherapy when you have an injury, is because your physiotherapist will help to reduce secondary complications that in themselves can cause problems for you down the line, such as the scarring mentioned above.  Your physiotherapist has many many years of training and specialising in injury management (Find a Physio near you).

How do you test whether you may or may not have carpal tunnel syndrome?  Simply bend your wrist forwards (fingers and hand moving palm downwards towards the forearm) and sustain that position for a few moments (about a minute).  If your symptoms appear or increase, you likely have carpal tunnel syndrome.  If you go see a specialist (e.g. a neurosurgeon/neurologist), they may do a nerve conduction test to see if the nerve is functioning properly and to assist in diagnosing carpal tunnel syndrome.  Ensure that you also go see your physiotherapist for your rehabilitation.  Physios work hand in hand with your specialists to help get you back to normal as fast as possible.

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What are common causes of headaches at the computer?

A pounding headache.  Thump, thump, thump….  Who of us, stuck behind a computer for hours, has not experienced this?

headache
“Can’t Concentrate” by Sasha Wolff under licence CC by 2.0

Headaches and neck pain are very common in office workers and have a debilitating affect on our mood, concentration levels and productivity.

Since headaches are so common, it’s worthwhile understanding what can predispose us to developing a headache in the work place.  What are some of the common causes for developing headaches at work?

  1.  Glare on your computer screen

Glare can be a real problem in the office, especially when it causes you a headache.  To resolve glare, you need to first find the source of your glare.  Is your glare coming from the light above you or is your glare coming from a window?  To help reduce glare, you may need to move your computer screen and sometimes even your desk so that the glare is no longer a problem.  If that’s not an option, you can get anti-glare films to put onto your computer screen or even changing the angle of your screen to reduce the glare may help.  If the glare is from a window, consider blinds or curtains to help address the problem.  Speak to your co-workers, I’m sure that they will understand that headaches caused by glare are not fun and then they will be more willing to help you find a solution.

 

2.  A poking chin posture

A poking chin posture is a common cause of headaches for people working behind a computer.  A poking chin posture causes compression of the neck joints just below the skull, which in turn causes your headaches.  A poking chin posture is often as a result of a poor computer monitor position.  Ready my post on 4 monitor positions that cause neck pain or my post on how the how the position of your monitor causes neck pain to learn more about it.  Neck pain and headaches often go hand in hand.

 

3.  Working for too long without a break

Working for too long without a break is a common mistake that most people make.  We forget that we are not robots, and that our bodies require time out to function properly.  Read my post on work breaks to learn more.

 

4.  Tension in your neck muscles

Tension in your neck muscles will most certainly cause both neck pain and headaches.  This tension will be created as a result of stress or poor posture at your desk.  Read my post on stress and neck pain to learn more.

 

5.  Using the wrong spectacle prescription

Using the wrong spectacle prescription while working at a computer or reading will strain your eye muscles that commonly leads to headaches.  When last did you have your eyes checked?

 

6.  Not drinking enough water

When you are dehydrated, one of the symptoms is a headache.  You may be dehydrated because you don’t enjoy drinking water, or because you’ve been drinking too much coffee and tea which stimulates your body to eliminate water.  However, if you drink too much water, and eliminate too many salts from your body in the process, you may also develop a headache.  Moderation is key.

 

7.  Hunger

When you don’t eat properly, you affect the finely tuned equilibrium that your body is constantly seeking and designed to seek.  When you don’t eat properly, you affect the sugar levels in your blood and low blood sugar levels trigger a system of responses that can lead you to experiencing a headache.  Do you often suffer from headaches and do you also eat badly?  Have you had your blood sugar levels tested?  Maybe it’s time to go see your GP and maybe a nutritionist to help you look after yourself better.

 

Overall, working for long hours without a break can cause many of the problems mentioned above.  Too many people tend to neglect themselves at work, without realising that doing so negatively affects their work and their health.  Are you one of them?

 

References:

Johnston V., Souvlis T., Jimmieson N.L., Jull G. 2007. “Associations between individual and workplace risk factors for self-reported neck pain and disability among female office workers.” Applied Ergonomics 39: 171-182.

Grimby-Ekman A., Andersson E.M., Hagberg M. 2009. “Analysing musculoskeletal neck pain, measured as present pain and periods of pain, with three different regression models: a cohort study.” BMC Musculoskeletal Disorders 10 (73). doi: 10.1186/1471-2474-10-73.

Helland M., H. G. (2008). Musculoskeletal, visual and psychosocial stress in VDU operators after moving to an ergonomically designed office landscape. Applied Ergonomics, 39, 284-295.

Malinska M., B. J. (2010). The Influence of Occupational and Non- Occupational Factors on the Prevalence of Musculoskeletal Complaints in Users of Portable Computers. International Journal of Occupational Safety and Ergonomics (JOSE), 16(3), 337–343.

Wahlstrom J., H. M. (2004, June). Perceived muscular tension, job strain, physical exposure and associations with neck pain amongst BDU users: a prospective cohort study. Occupational and Environmental Medicine, 61(6), 523-528.

Wahlstrom J., L. A. (2003, October). Perceived muscular tension, emotional stress, psychological demands and physical load during VDU work. International Archives of Occupational and Envronmental Health, 76(8), 584-590.

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Why the Spinal S-Curve is Important in Back Pain

Lower back pain is extremely common.  It is so common that 8 out of 10 people will experience it at some point in their lives.

Lower back pain can be caused by many factors.  These include factors such as genetics or birth defects (spondylolysis), trauma (falls or car accidents), infections (bacterial infections or even TB of the spine), and poor posture and movement patterns.  Sometimes a combination of causes is to blame for our lower back pain.  Out of all the factors I’ve listed, the one that we have the most control over on a day to day basis, is our posture and our movement patterns.

Back Pain
Personal Injury Back Pain by SanDiego’s PersonalInjury Attorney’s Photostream is licenced under CC by 2.0

The most at risk postures for developing lower back pain are sitting and bending postures.   These two postures when performed badly put our spines at a high risk of developing lower back pain, and people who do a lot of sitting and people who perform a lot bending are often the people who complain of lower back pain.  Think of office workers, drivers, nurses, machine operators, fatory workers, manual workers and more.  These people and others who engage in a lot of sitting and/or bending on a day to day basis are the people who are at risk and who do develop lower back pain.  Does that sound like most of us?  Exactly, hence the high incidence of lower back pain!

Read my post on driving postures and lower back pain.

One of the most important elements of our posture in helping to prevent lower back pain, is the s-curve of our spine and maintaining the s-curve of our spine in different postures and movement patterns.

Read my post on correct lifting posture for picking up children.

The spinal s-curve consists of 3 different curves.  There’s a curve that goes in at the neck (the cervical lordosis), followed by the curve that goes out in the upper back (the thoracic kyphosis) and the curve that goes in again at the lower spine (the lumbar lordosis).  The depths of these curves may vary in different people, but we all have the 3 curves illustrated below and they are very important for our biomechanics and general spinal health.

spinal s-curve
Vertebral Column by Unknown and is licenced in the Public Domain

The importance of these curves in helping to prevent lower back pain, is that these spinal curves throw our centre of gravity between our feet.  With our centre of gravity lying between our feet, the compressive and shearing forces on our spine which may lead to lower back pain are reduced.  Keeping these shearing and compressive forces as low as possible acting on our spine helps to keep the forces acting on our backs within limits that our body tissues can naturally withstand, which then helps to reduce or prevent lower back pain.

centre of gravity
Center of pressure in relation to centers of gravity while walking by Jasper.o.chang under licence CC BY-SA 3.0

When we change these curves through engaging in poor posture while sitting, standing, lifting, driving, picking up children etc., we increase the forces on our spine unnecessarily causing many problems with the complex spinal biomechanics and anatomy that result in injury and lower back pain.

 

How often do you lose your spinal curve in your activities during your day?  Do you suffer from back pain?  Is your poor posture partly to blame?

 

 

 

 

 

 

 

 

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Ergonomics and Work Breaks – Helpful or not?

I recently read an interesting article regarding taking effective breaks at work.  This article stated that the most productive 10% of their surveyed population took a regular work break of 17 minutes out of every 52 minutes.  The authors surmised that this improvement in the productivity of the individuals who took work breaks was due to the fact that as people, we get bored easily, and as our boredom grows, our attention to our work similarly decreases, resulting in lower productivity over time, unless we take a work break.

Timer
Pomodoro Technique by Michael Mayer is licensed under CC by 2.0

I used to study classical piano performance at university, and when one practices for 5 plus hours a day, things can become monotonous and unproductive unless you have a plan.  In addition, the musical works one is learning (which are also many), are long and intricate and require a clear mind and direction.  My piano professor used to make me divvy up my piano practicing day into 30 minute blocks and then divide the musical works that I needed to learn and master across these blocks.  Then, strictly adhering to this schedule, I was required to practice for 25 minutes and then stop and take a 5 minute work break before continuing with the next 30 minute block and piece of work.

I used to think that I would never get anything done.  However, surprisingly, a lot of work was covered over time.  Following this method of taking work breaks, I used to succeed in learning a lot of difficult musical work, faster and better than I would’ve done, had I never followed his model and taken my work breaks.

This is pivotal, since many musicians (and office workers) tend to think that they need to get started with their work and then drive forwards until they hit that sweet spot of concentration and continue until they hit the wall of physical and mental fatigue.  We all know, however, that once you’ve hit that wall, your productivity takes a serious dive.

The problem with this approach to work is that you end up exhausting yourself so that after 2 or 3 hours, your brain is a rag and anything you do afterwards is unproductive and sometimes counterproductive.  When you’re tired and depleted like this, the other downside in addition to reduced productivity is that you also become prone to making mistakes.  This is because your mind is no longer clear and sharp, rather it is clouded by fatigue.

There are other studies that have been undertaken to determine the benefits of work breaks for office workers.  These studies looked at the optimal work break schedule as well as the effects of taking a work break on the participants.

Due to different study models, an optimum work break schedule is hard to pin point, however, some researchers recommend taking a 5 minute work break every half an hour, or 2 x 15 minute work breaks in your day, or 4 x 5 minute work breaks over the course of your day.  What was clear from the research was that it was very detrimental to your health and your productivity if you worked for 4 hours or more without taking any work break.

These studies also found, however, that taking work breaks also helped to improve productivity, reduce fatigue and  reduce phycial aches and pains.

 

Food for thought next time you feel that you’re far too busy to take a work break because of a deadline that you have to meet?  Perhaps, you might find it easier and faster to meet that deadline if you plan a few work breaks into your day?

 

References:

P., Tucker. 2003. “The impact of rest breaks upon accident, risk, fatigue and performance: a review.” Work & Stress 17 (2): 123-137.

Galinsky T., Swanson N., Sauter S., Dunkin R., Hurrell J. et al. 2007. “Supplementary breaks and stretching exercises for data entry operators: A follow-up field study.” American Journal of Industrial Medicine 50 (7): 519-527.

Johnston V., Souvlis T., Jimmieson N.L., Jull G. 2007. “Associations between individual and workplace risk factors for self-reported neck pain and disability among female office workers.” Applied Ergonomics 39: 171-182.

Balci R., Aghazadeh F. 2003. “The effect of work-rest schedules and types of task on the discomfort and performances of VDT users.” Ergonomics 46 (5): 455-465.

Grimby-Ekman A., Andersson E.M., Hagberg M. 2009. “Analysing musculoskeletal neck pain, measured as present pain and periods of pain, with three different regression models: a cohort study.” BMC Musculoskeletal Disorders 10 (73). doi: 10.1186/1471-2474-10-73.