It might be the stereotypical complaint of old-aged pensioners, but a free bus pass isn’t a requirement for suffering with back pain and a lot of young people have issues with this too. So what can cause back pain and what can you do about it? Qualified physiotherapist and Pilates teacher, Anna Clayton, is back to give you the lowdown…
What Does The Back Do?
The back is a complex and simple structure at the same time. It’s a column that contains your neural structures whilst providing stability to the trunk, transmits upper body weight and loads to the pelvis and lower limbs. It is designed to be mobile in all ranges – forwards, backwards, side to side, twisting and combined movements of these. Some segments are more mobile than others and people an have lots of normal variations in the curves in the spine.
What Can Cause Back Pain and What Can You Do About It?
Tightness in some areas, weakness and underutilised muscles in other areas (think about the front of the body/ back of the body as we sit a lot) can make muscles shorter, weaker and tighter. Pain can be triggered either from a prolonged stretch (like when your muscles aren’t happy because you need to move!) or from excessive movement beyond a happy range.
Pinching of the nerves from bulges in discs, spasms to muscles and inflammation from muscle tears can all trigger the nerves to ‘protect’ the surrounding structures (mostly legitimately) and force you to stop moving whilst they settle. When this happens, anti-inflammatory medication and gentle movement to keep mobile within comfortable ranges will help.
With chronic pain, the body triggers pain without necessarily having a fresh injury cause for pain, restricted movement or the ‘guarding’ of a muscle or structure. The brain/neural system can become sensitised (think of it as an overprotective worrier!) and will often trigger pain because it doesn’t differentiate well between previous injury movement and a new altered movement.
Often pain leads to reduced movement and stiffness in joints, and the joints can then also trigger tightness in muscles, which when stretched fire off stretch receptors in the muscles. The brain interprets these signals, deciding that a potential threat is imminent, and issues you pain. This may not be due to inflammation but can become a habit where we relearn a movement pattern and behaviour that is not a useful one. However, it is reversible with graded movement and re-educating the brain to accept increased movement is actually physiologically normal and ok!
Tightness in the muscles when suddenly overstretched will fire off the stretch receptors of the muscles and (legitimately) warrant pain – designed to protect you until this has eased. Try not to load the muscle any more, stretch and offload with non-weight bearing activities like swimming.
Too much demand on the back and muscles too soon, will see the body reach it’s tolerance/capacity to be in a happy place. Try to scale things back and build up exercise up gradually to prevent overloading.
Deconditioning or Increased Weight
If you have had time off due to illness or your weight has increased for whatever reason, this will increase the load through the muscles, ligaments, nerves and joints of the spinal column. The brunt of this tends to be felt in the lower back. Try to introduce gentle regular movements to strengthen and stretch with some aerobic exercise to balance out how the body is moved and again, build up slowly. A lot of pain is because we load the body with inadequate strength or mobility, which it will do to a point and then either fatigue or fail in the form of aches and pains.
Altered Movement Patterns
Altered movement patterns links with chronic pain (above). Bad habits may be developed if we are lazy and/or if the resistance is too high for the correct movement range to be completed. This can make us move differently and often not in a good way! To prevent this, make sure to check your posture and form – use a mirror or a ask a trainer or friend to see how you are moving. You could even film yourself – you’ll be surprised to realise what you feel you’re doing and what you are doing can be very different things!
This blog was written by Anna Clayton: Anna works at Bury Physiotherapy Clinic as a Senior Musculoskeletal Physiotherapist and has recently completed a MSc in Advanced Physiotherapy. She teaches regular Pilates classes including a Pink Pilates; specifically for breast cancer patients. At the clinic she offers patients acupuncture alongside other treatment techniques to help people back to normal day to day activities, sports and hobbies - she is all for functional movement! Anna enjoys keeping fit and active with regular running (the odd half or full marathon), occasional cycling and was a rower and heptathlete in her youth.