Low
back pain is the second most common cause of work absenteeism. If a person has
a history of low back pain, it is likely they could develop occupational low
back pain. Persistent back pain for more than 6 months constitutes only four
percent of cases. Disability is usually closely related to compensation and
litigation.
The
least amount of pressure on the discs is measured with the patient lying in the
supine position. The highest amount of disc pressure is measured while sitting
with 20 degrees of forward leaning with a 20 kg load in the arms. It is better
to keep the weight of the load close to the body. This will reduce the
compressive forces placed on the lumbar spine. Yoga activities and exercises
performed during sitting probably have less pressure being placed on the discs.
Physical
factors which lead to low back pain include the following: lack of fitness;
heavy lifting of objects; operating motor vehicles; prolonged sitting;
operating motor vehicle accidents; prolonged sitting; operating vibrating
tools; and cigarette smoking (nicotine causes disc degeneration).
There
are many sports-related activities related to low back pain. When golfing, pain
occurs as the result of twisting, bad forward bending, and most importantly
overarching the spine during the swing. After the age of 40, we lose about 50%
of our rotational spine movement. It is important to stretch and warm-up before
starting the game. Vibration caused by horseback riding increases the load on
the discs. The back muscles work constantly to keep posture straight. Caring
for horses could also be detrimental to the back due to the bending and lifting
associated with their care.
Virtually
any structure in the spine can hurt including: the facet Joints; invertebral
discs; spinal canal; sacroiliac joints; muscles; ligaments; nerves; hip joints/Piriformis
muscles; and trochanteric bursitis. Red flags for cancer include: over 50 years
of age; pain at rest and night; unexplained weight loss; history of cancer; and
bone destruction involving the pedicle is pathognomonic. Red flags for
infection include: diabetes; fever; drug abuse; urinary tract infection; and
previous surgery
Treatment
for acute low back pain, without sciatica (leg pain), involves a short period
of bed rest, anti-inflammatory medications, and physical therapy for a short
period of time. Patients will also be advised to work within the limits of
pain.
