In order to get back pain you have to strain it in some way. In order to strain your back there needs to be:
- a muscle or joint in the area of the injury that was abnormally tight,
- muscle weakness or skeletal asymmetry to reduce stability, or
- the force of the injury was greater than what your body could handle.
In most cases it is the joints of the spinal column (the facet joints) that tighten over time with daily activities and they are easy to strain as this is where the movement takes place in the body. It is a lot harder to strain muscles as they are a lot more flexible and dynamic than joints and can ‘give’ to a fair degree. Joints however can only go so far before they are strained beyond their physiological limit. Once strained they become inflamed and sore. This inflammation then causes adhesions to form around the joints resulting in more joint restriction. They then become more susceptible to being strained again. This then causes repeated exacerbations of the original injury and the pain that was intermittent starts to become more continuous.
Back pain is usually caused by being in an asymmetrical position for too long.
Back pain is not generally caused by traumatic injuries. Indeed it can be caused by trauma but by far the most common thing that people with back pain say is that they don’t know why the pain started, or it came on after a seemingly innocuous incident. The most easily recognised form of back pain is stiffness and pain in the lower back after spending time in the garden bent at the waist for a while and trying to stand back up. This is similar to sitting on the ground for any length of time and finding it difficult to stand up straight.
If your body is stuck in one position for any great length of time it will slowly adapt to that position by stretching into it. The ligaments, tendons, muscles and joints will lengthen and stretch to get comfortable in that position. The problem is that your body will now find it more difficult to come out of this position in a hurry. So when you stand back up it will generally take some time to straighten out or it wont straighten out at all.
It is fairly easy to identify the site of pain and when you visit the chiropractor, part of the spine will still be stuck in the position that you were in that caused the problem in the first place. In summary your body adapts to the position that you are in and it gets stuck there. To correct this condition you will need a chiropractor to adjust the joints, freeing them up so that they are no longer stuck in an asymmetrical position. The longer you wait before seeing the chiropractor the more the inflammation and swelling will set in and the worse the condition will get.
Sitting is a common cause of back pain.
In as much as bending forward while gardening will give you back pain so too will sitting for any length of time. The reason for this is that the spine is in a rounded position and it gets stuck there. When a person sits you will generally sink into the sitting position and in so doing you round your lower back into one long ‘C’ shaped curve that extends from your shoulders to your pelvis. This rounded lower back curve is opposite to what it should be and as your body adapts to this position it will get stuck there and you will find it difficult to stand back up again. It is the same feeling you get after a long drive and you get out to stretch your legs. Office workers with desk jobs will suffer more lower back pain than most other people in the population.
How can I sit without getting a sore lower back?
The only way to avoid pain from gardening or sitting is to avoid rounding your back and not to stay in one position for too long. Make sure you are constantly moving and changing position so that your body doesn’t have a chance to adapt to the position that you are in. When sitting try to do so with your knees lower than your hips. This forces the pelvis more upright and it will make it a lot easier to avoid rounding the lower back. The best chairs to sit on will have a forward seat tilt. If you lower it all the way forward so that your knees are lower than your hips you will find that you don’t have to use the lumbar support because you are actually sitting upright. Also make a point of getting up at least every hour to get movement into the joints of your spine. The other chairs that are good for the spine are the Swedish fitballs, the kneeling chairs, and the saddle seats. All of these chairs are designed so that your knees are lower than your hips.
The computer work station.
How do you set up a computer work station that is friendly to your back? We have already discovered that sitting in a position that has your knees lower than your hips is the best position for your lower back. The chair and desk needs to be set up with this in mind. The height of the desk needs to be at elbow level so that when you are sitting correctly and you are close to the desk, you can comfortably rest your elbows on the desk without raising or lowering your shoulders.
The keyboard should then sit wherever your hands fall. Most people who spend a lot of time at the computer do so without their elbows on the desk. This means that the weight of their arms is being supported all day by the neck and shoulder muscles alone. This will result in neck pain, shoulder pain and headaches. If you hold your arm out to the side for a few minutes your shoulder muscles will start to ache. Eventually you will strain the joints of your upper thoracic spine and your neck, as the strain is transferred into the skeleton, and inflammation and acute pain will result. The monitor should then be placed at eye level so that your head can rest directly over your shoulders. You do not want your head forward of your shoulders as this will cause neck and shoulder pain from supporting the weight of your head.
Another cause of neck pain that occurs while sitting at the office desk is holding the phone between your ear and your elevated shoulder. Again this will feel fine while you are in this position but your body will adapt to this asymmetrical position and get stuck there. This can result in a torticollis if done often enough.
Sleeping is a common cause of back pain.
Finally, one of the most common causes of back pain, and/or neck and shoulder pain is sleeping. There are two typical presentations of pain at night.
- Pain that starts not long after going to bed.
It is very common for pain to start not long after going to bed. In this situation the bed or the position that you are lying in is not the cause of the pain. Here, the pain is worse than during the day time because inflammation and swelling is often greater at night time when your body has a chance to heal. Movement often keeps inflammation at bay and when you lie down the inflammation process increases. There are also less distractions while you are trying to sleep and this often makes the pain feel much worse because you are a lot more aware of it.
- Pain that occurs after being in bed for a few hours or upon getting up.
The type of pain that comes from poor sleeping habits will be more symptomatic first thing in the morning and will ease as the day goes on. It will present as either a stiff and painful neck (torticollis) or lower back pain. If you tend to go to bed pain free and wake up with pain, the cause of the problem is either the position that you are sleeping in, or the cause is what you are sleeping on.
The only position to sleep on that will not cause pain and stiffness is sleeping on your side and alternating between the left and right side. If you sleep on your stomach or back you will eventually wake up with a stiff lower back and you will eventually get a sore neck. When you lie on your back the lumbar spine tends to flatten and this causes the back to be stiff and painful if it stays in that position for too long. When you lie on your stomach the lumbar spine develops a greater curve than normal and this will cause pain and stiffness if it is left in this position for too long.
If you sleep on your back or your stomach, you will turn your head to one side while you sleep. If your neck stays turned to one side for too long your body will adapt to this position and get stuck there. This is the same feeling you get if you have been sitting on a long bus or train trip and you have been looking out the window for a long time. It feels stiff trying to straighten the neck. The only difference with sleeping is that you stay in this position for hours at a time. This is the most common cause of a torticollis.
If the position that you are sleeping in is on your side and you are still waking up with pain then the cause is most likely to be the mattress that you are sleeping on. An inner spring mattress that is older than 3-4 years will have lost is ability to support your weight. The springs within the mattress will only last for a few years. This is true even if you have a 10 year guarantee on the mattress. The guarantee is given on the fact that the bed will not fall apart but it will not guarantee the springiness of the springs. When buying an innerspring mattress do so knowing that you are likely to replace it in 3-4 years. The only way of getting around this is to buy a latex mattress – as a rubber material, latex will hold is shape and support for longer. Just beware of buying a mattress with a pillow top (or comfort layer) made of foam or other material that will sag. The safest option for a pillow top is one that has latex in it rather than foam which will lose its support within months of buying it. Remember just because it is comfortable in the shop doesn’t mean that it will be comfortable in six months time. The firmness of the mattress will depend on the comfort level of the individual. You don’t wont a bed that is too hard or too soft. You should be able to lie on the bed and feel level.
The other thing that will cause pain is the type and shape of the pillow that you sleep on. Good neck support is essential for a good night sleep. The pillow is not used to support the head as much as the joints of the cervical spine. If the pillow does not support the neck properly you will wake up with a stiff and sore neck. The right pillow is dependent on which position that you sleep in. As we have already discussed sleeping on your back or stomach is no good for your neck or your lower back. This means that you need to find a pillow that will support you while you are sleeping on your side. The pillow needs to be contoured so that your neck has as much support as your head. You need to lie on your side so that the pillow keeps your spine neutral. If you lie on your side and the pillow is too low you will feel like your neck is dropping to one side too far. If it is too high you will feel like your neck is propped up too high. The difficulty in finding a good pillow is in finding one that is the right height for the individual and one that is the right firmness to give proper support. For more information on good pillows check out the latex pillows we stock.
Why does my back hurt? In this next section learn about the tissues in your body that are inflamed and causing your symptoms.