Back ache: why to act at first signs of pain


Back pain at its worst is a crippling condition, yet it is one that until it strikes its impact tends to be underestimated or not taken that seriously. Yet we ignore twinges in our backs at our peril, as the painful risk of them becoming worse can open us to even more serious consequences.  Why? Because back pain is the leading cause of disability worldwide.

Women aged 40-80 years have the highest prevalence of back pain, while women also report more frequent and debilitating back pain compared to men – so it’s perhaps no surprise that a study uncovering the implications of back pain focused on women. What is extraordinary is that the researchers at Boston Medical Center found that frequent, persistent back pain was associated with earlier death.

In a study of more than 8,000 older women (followed for an average of 14 years) those who reported frequent, persistent back pain had a 24% increased risk of death compared to women with no back pain. However, this incredible statistic becomes more easily understandable when we appreciate the researchers also found that disability measured after back pain helped explain the association. Specifically, difficulty performing one or more basic daily activities, like walking short distances or meal preparation, explained nearly half of the effect of frequent persistent back pain on mortality.

The findings raise the question of whether better management of back pain across the lifespan could prevent disability, improve quality of life – the healthspan – and ultimately even extend life.

Use it, or lose it?

Of course, the question remains as to why this association between back pain and mortality is so strong? Theories tend to focus on the danger of back pain beginning a retreat from physical capabilities, with people ignoring the symptoms and then failing to deal with them properly as they worsen. As they fall into a trap of less movement, becoming unable to perform, or avoiding, daily activities could in turn lead to increased frailty, weight gain and development or progression of other chronic health conditions, and then ultimately earlier death.

Not just a problem for the elderly

Unfortunately, back pain is becoming ever more prevalent as a problem of modern life. Desk workers, sitting with heads tilted toward a computer screen, or anyone spending a significant amount of time staring down at a tablet or mobile phone, may be at risk of a growing problem: spinal kyphosis. This is the excessive outward curvature of the thoracic spine (upper back) – or essentially a ‘hunched back’. This can lead to decreased mobility and flexibility of the upper back, but more alarmingly to potential spinal complications and back pain.

What causes spinal kyphosis?

If the head is in an excessively ‘forward’ position – a typical pose when working in front of a computer screen or scanning a tablet or mobile phone – you are putting increased stress on your spine, forcing more curvature in your thoracic spine. With the average head weighing around 4-5kgs, every inch you move your neck forward or down you place an extra 4-5kgs of pressure on your spine; no wonder this forces it to curve excessively! Worryingly, this is also observable among kids.

How to fix it

Become mindful of posture. Learn how to ‘switch on’ your upper back muscles by bringing your shoulders back and keeping yourself upright. Squeezing your shoulder blades slightly together is vital and switching on your rhomboids (the muscles between the shoulder blades) to maintain an upright back.

It’s likely in the first instance that your chest will feel tight and you will struggle to switch on your back muscles. The answer is horizontal pulling exercises.

If you are starting to develop some minor levels of kyphosis in your upper spine, address it immediately. If you don’t it could lead to some unpleasant and unnecessary back pain in the future – and as the recent study has shown, this is a path no one should wish to tread.

Note: if you are suffering from back pain seek professional attention. Do not ignore pain.

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Alex is a registered Master Trainer and Nutritional Advisor with Level 4 qualifications in obesity and diabetes. He is also a strength specialist and a Ni Dan in Shotokan Karate.

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