Low Back Pain Myths

There is a lot of information out there on low back pain and injuries. Some of which is very useful but on the other hand there is a lot of misinformation which can sometimes lead us in the wrong direction. In this blog we will look to debunk some of the most common low back pain myths!

Myth # 1 : I Should brace my core or I will get pain

This is a very common thought and is a big reason why people seek help for their low back.  Although we have previously thought bracing can help relieve symptoms it can in fact increase the forces going through the back and in some cases lead to pain. The muscles around the trunk play an import role in movement and stability but trying to actively brace these muscles can often lead to stiffness and inefficient movements. The body is clever, our trunk muscles will naturally contract and work when required to assist in tasks such as lifting.

Myth # 2: My low back pain is cause by my back/pelvis being out

One of the most common myths when it comes to low back pain. The back is extremely strong and robust and without serious trauma or force the back and pelvis does not go ‘out’. Manual therapy techniques such as manipulations and adjustments DO NOT put these structures back in to place but they can however provide pain relief which is helpful in the short term.

Myth # 3: I have a disc bulge and degeneration and that is causing my pain

Disc bulges and degeneration are very common and have a high occurrence rate amongst people who don’t have low back pain. We consider these changes to be age related and are not necessarily linked to pain.  Approximately 30% of people in their 20’s will have a disc bulge in the absence of low back pain and this percentage goes up approximately 10% for every decade in life. Further to that disc bulges and protrusions have shown to recover on imaging over time. So, it is likely that a disc bulge that you may have previously had is no longer there!

Myth # 4 I need to stand and sit in “good” posture, or I will get pain

There is no such thing as good or correct posture! Despite what we have previously thought and what we may have been told as kids. Research has showed us that there is no direct link to how we sit and stand and pain. Instead, it is recommended to find a posture that you are comfortable with. This may differ from person to person but that is okay. Of course, it is always recommended to keep moving, so taking regular breaks to move around may help reduce the occurrence of discomfort from prolonged positions.

Myth # 5 Bending your back when lifting is bad for your back and you should lift with my knees

The spine holds some very important structures, and it would be a big design flaw if the back was not robust and strong to protect them. In fact, it is one of the strongest parts of the body and can handle large forces. When trained correctly the spine can comfortably handle loads in positions of lifting, squatting and twisting. We are often told to avoid bending the back when lifting however this can often create problems such as inefficient movements and fear avoidance.  Like all activities, we need to exposure our body to them for us to get better at it!

 Our physiotherapists at East Vic Park Physiotherapy can help answer all your low back related questions. If you would like more information or help with your low back do not hesitate to get in touch!

Workstation Ergonomics: Tips to staying pain free

With a large percentage of people now working from home the team at East Vic Park Physio thought it would be a good idea to provide some simple but useful information on workstation ergonomics.

Previous to what we used to think, there is not one way to correctly sit at your workstation. Your set up should be able to accommodate for a range of comfortable positions that you can frequently change throughout the day. The optimal/most comfortable sitting position will change from person to person and will depend on:

• The type of work being done

• Visual demands

• Individual body shape

Figure 1: An example of an acceptable sitting position. It will allow for a range of supported postures that can be changed throughout the day.

Tips for setting up your home workstation:

• Sitting with body close to desk

• The head and neck are in a forward facing and in midline position (i.e no backward arching of the neck and or forward extension of the chin)

• The shoulders are relaxed and relatively symmetrical, elbows close to the side of the body

• The back is supported by the chair backrest. The curved lower part of the backrest should sit into the lower back

• Having an open angle of 100-120 degrees (slightly more than right angles) at the hip. This can be achieved by adjusting the seat pan tilt and the backrest

o   As a general rule have your knees at a height lower than your hip

• Ensuring a gap or 2-3 fingers widths between the front of the chair and the back of your knees

• Having feet flat on the floor or footrest

A Pain in the Neck: How does posture influence neck pain?

Neck or cervical pain is becoming increasingly common, with the highest prevalence among office and computer based workers. Physios commonly hear clients admitting to ‘bad posture’ – but do we really know what bad posture is?  

There can be many causes to neck or cervical pain, from a joint sprain, disc or nerve injury. This blog will focus on postural neck pain arising from a condition called myalgia, meaning tight, fatigued, painful muscles. This generally occurs without a history of trauma and yet is one of the most common causes of neck pain.

It is a common misconception that ‘sitting straight’ will solve all postural pain. 

The neck is designed to move and although you may not realise, sitting in one position for an eight hour shift is quite a work out for your postural muscles. 

Posture can have an influence on neck pain: rounded shoulders can create a forward head or chin poke posture, resulting in the muscles at the back of your neck working overtime to hold your head up. What some may not know is sitting very tall off the back of your chair can have an equally bad effect. An overly upright posture places a huge demand on the postural muscles, having a similar effect to clenching your fist for a long time – the muscles get tired and sore!

Although we aim for a ‘neutral’ posture, every body and spine is different and this ‘ideal’ posture looks different for everyone. The most important factor is finding a comfortable position, often with some low and mid back support. Having support over these areas helps ‘unclench the fist’ by offloading the postural muscles. It is important to remember that if you must be sedentary for a long period, you take breaks or change your sitting posture regularly. Neck stretches or rotations, walking to a collegue’s desk rather than emailing them or using a sit-stand desk are all ways to take a break from one sustained posture. 

Studies have shown individuals with chronic neck pain (neck pain for 3 months or longer) show reduced endurance of deep stabalising muscles in the neck and have a reduced ability to maintain an upright posture. Although physiothearpists can provide hands on treatment to relieve symptoms, often the underlying cause of pain is a lack of strength and endurance of the muscles supporting the head. Manual therapy should always be paired with postural control and upper limb strengthening exercises. 

Take home points: 

1. Every spine is different, and there is not one ideal posture for everyone 

2. Sitting in ANY posture for a prolonged time can cause pain, plus being sedentary isn’t good for our physical health

3. Finding a comfortable, supportive posture at work will reduce the risk of developing postural neck pain

4. General exercise and specific strength training for the postural muscles will increase robustness and significantly decrease the risk of neck pain