SAN RAMON, CA - Low back pain strikes hundreds of thousands of people every day. Most will see their primary medical doctor, who will typically prescribe pain medications, anti-inflammatories, and perhaps muscle relaxants. Some will call their local chiropractor and receive chiropractic treatment. And then some will try to manage their pain on their own.
The medical literature is filled with case studies on low back pain. Why some people develop it, while others don't is still open to discussion. There are some risk factors associated with low back pain:
1. Obesity, or gradual weight gain in the abdomen
2. Overly sedentary lifestyle
3. History of injury to the low back
4. Type A personality
5. Smoker
6. History of playing sports
7. Long torso
If you are in one or more of these categories, you are at a high risk for developing low back pain. Let's go over the reasoning:
Obesity-- when you stopped growing, around your early 20s your skeleton stopped growing. Your long bones and vertebrae settled at a size sufficient to support a naturally lean body weight. Now, the only way to gain weight after you stop growing is to gain fat, or get pregnant. If fat settles in the abdomen, it moves the center of gravity of your stomach forward and pulls your lower spine forward in the process. The additional weight compresses the cartilage (discs) in your spine, as well as in your hips, knees, and ankles. Over time, it will cause the cartilage to develop cracks. The increased pressure and spinal arc jams the posterior vertebral joints (facet joints) together, making the vertebrae less mobile. This causes muscles around the spine to atrophy, or weaken. End result: low back pain and stiffness.
Overly sedentary lifestyle. Many of those who work at a desk for the most part of the day fall in this category. You need to move your spine frequently in order to keep your spinal discs hydrated and healthy, and to keep your spinal musculature exercised and toned so that it can support your spine from the back, the sides, and the front. Sitting and not exercising leads to weak discs and weak back muscles, which can lead to pain.
History of low back injury. If you hurt your back during high school or college, it may have healed. But healed tissue has scar tissue mixed in. Scar tissue is what your body uses to close broken muscle, tendon and ligament tissue. Scar tissue is not as strong or elastic as normal tissue, so if a previously injured area is subject to a heavy load, or sometimes a sudden movement, it can become re-injured. And this time, since you're older, it may not heal as fast as before, and may even become chronic (permanent).
Type A personality. This means that you are frequently under stress, are aggressive and are always "on the go." Type A personalities have a very hard time relaxing. Studies show that this can increase heart rate, blood pressure, and cortisol (stress hormone) levels. These physiological changes are not conducive to a healthy back.
Smokers. Smoking deprives oxygen delivery to tissues. If your job places a lot of force on your back, the cells that make up your discs, muscles, ligaments and tendons need oxygen, as their metabolic rate increases. Limited oxygen will make these structures prone to injury. Also, cigarette smoke contains at least ten known carcinogens.
History of playing sports. Not much surprise here. Any sport that requires jumping and landing will put a tremendous shock to the spine. The spine IS designed to handle such activity, but only so much. 4-6 years of this can overcome the body's engineering and cause a breakdown in cartilage and bone.
Long torso. Individuals with long upper bodies are often more prone to low back pain. The reason being is that a long torso means a long spine. With the head at the end of the spine (a 10-12 pound weight) a lever-arm is created. Gravity tends to pull the head forward, so if you have a long torso, more force (bigger lever arm) is going to be required from your lower back muscles to stand or sit erect. To help visualize this, picture holding up a a stick with a 10 pound shot put attached to the end, then tilting it forward slightly. You will notice the force required to keep it up. Now, picture holding a broomstick length stick with a 10 pound shotput attached-- you won't be able to keep it up, due to the much larger force created.
If you are aware of these risk factors, you can take immediate steps to help reduce your chances of developing lower back pain.
Dan Perez, DC
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