Preventing back pain

David Roberts, managing director of David Roberts Physiotherapy, whose clients include Sir Ian Botham, Andrew Flintoff and Lawrence Dallaglio, offers advice on how to avoid back pain.

Put your back into it

The loose term ‘back’ describes the complex core physiological structure around which our bodies move. It’s made of discs, nerves, muscles, ligaments and bone. When an injury occurs, it’s very common for it to trigger a chain reaction as the surrounding muscles go into spasm, in an involuntary attempt to protect the injury site.

The depth of the problem

Around 80% of people will experience lower back pain at least once throughout their lifetime and half of the working population admit to experiencing low back pain each year. Each year 15 – 20% of the people in the UK suffer low back pain.

It is important to understand that there is a definite chance that you will recover from lower back pain. Research studies have shown that the majority of us that suffer from back pain return to work within one – four weeks.
Types of back pain
Prolapsed Disc (slipped disc)

More commonly (and misleadingly) known as a ‘slipped disc’, a prolapsed or herniated disc, occurs when the spinal disc becomes less elastic and can rupture. When the disc ruptures, a portion of the spinal disc pushes outside its normal boundary this is called a herniated disc. When a herniated disc bulges out from between the vertebrae, the spinal nerves and spinal cord can become pinched. There is normally a little extra space around the spinal cord and spinal nerves, but if enough of the herniated disc is pushed out of place then these structures may be compressed.

Sciatica (nerve root pain)

Sciatica pain can range from mild to severe, but it is often worse than the back pain. With a prolapsed disc the sciatic nerve is affected.  The sciatic nerve is a large nerve that is made up from several smaller ones that link to the spinal cord in the lower back. It travels deep inside the buttock and down the back of the leg.

Sciatica nerve root pain is pain that occurs because a nerve from the spinal cord is pressed by a prolapsed disc, or is irritated by the inflammation caused by the prolapsed disc. Although the problem is in the back, tingling or numbness is felt along the course of the nerve in addition to back pain. These symptoms may extend down the leg, to the calf, or even the foot.

Lumbar Spondylosis

Spondylosis is a very general term referring to the degenerative osteoarthritis of the small joints between the spinal vertebrae, facet joints and/or neural foraminae (the little holes where the spinal nerves emerge). Medical Professionals often describe this as ‘wear and tear’ and the condition is very common. In fact most people of adult age have some degree of wear.

Save your back

Staying active and undertaking regular exercise is the ideal way to maintain a healthy back. Exercise builds endurance, strength and flexibility.

Your back’s main muscles combined with the muscles of your core, need to be regularly stretched and strengthened to maintain a healthy spine. When exercising always be mindful of your posture.

In terms of getting active just five to ten minutes stretching in the morning and at night can provide significant lower back pain relief.

Try some of these exercises:

Knee roll

Lie on your back with knees bent and heels and knees together. Zip in lower abs, pressing your back into the floor. Roll knees left and right ten times each side

Knee to chest stretch
Lie on your back with your knees bent with your feet flat on the floor. Grasp behind your knees with your hands and pull your knees towards to your chest. Hold for ten seconds. Repeat ten times.

Back extensions
Lie on your front with hands in a normal press up position on the floor. Push-up through your arms, keeping your hips down causing your lower back to gently arch. Hold at the top for two – three seconds. Repeat ten times.

Piriformis stretch

Lie on your back with your legs bent and your feet flat on the floor. Cross one ankle over the opposite knee to produce a figure of four shape. Grasp with both hands behind the knee of the supporting leg. Pull your leg towards your chest until you feel the stretch in your buttocks. Hold for fifteen seconds. Repeat three times each side.

The bridge

Lie on your back, neck and shoulders relaxed with knees bent and feet flat on the floor. Zip in your lower abs, squeeze your glutes and peel up your pelvis/spine towards the ceiling as high as your knees. Hold for ten seconds. Repeat ten times.

The plank

Lie on your front with your elbows under your shoulders. Push-up so you are resting on your elbows and toes. You should contract your abs and glutes to enable a completely ‘flat plank’ position. Initially perform three times daily, holding each for thirty seconds. Aim to increase your hold up to one minute after six weeks.

Performing these exercises on a regular basis will help keep your spine in good health.

If the pain persists rather than soldier on, seek professional help. Your physiotherapist will be able to assess the problem, give you a diagnosis and advise you on the best course of action to get you back to full health.

Your back is the central platform of your physical being. Look after it.
About the Author
David Roberts is the former physiotherapist to the England Cricket Team, current head of Sports Medicine at Lancashire County Cricket Club and runs the largest chain of physiotherapy clinics across the North West. Services include specialist physiotherapy, sports and massage therapy, strength and conditioning coaching, Pilates, personal training and acupuncture.