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#015 - Backcare Awareness Week

Perhaps the concept of ‘backcare’ has flown you by. I’ll freely admit that before hearing about this awareness week I truly hadn’t given it much thought, let alone considered how incredibly important it is. To me, backs were something to be exercised and toned, or maybe given a nice massage at the end of a long day. And sure - those are great things to do for your back and your body in general, but the link between this huge and complicated bodily region and our overall health goes far beyond this. The back is so important to our overall physical capabilities – anybody who’s suffered from pain in the area before will probably be acutely aware of that fact.

I chatted a little about the subject to MAG’s resident physiotherapist, Miraj, to dig a little deeper into the topic – read on to see what I learned and ensure you’re up-to-date on the correct methods to care for your back. Not to scaremonger, but it’s knowledge that could genuinely prevent you from suffering highly-debilitating issues in the long term. “Back pain is the single leading cause of disability worldwide; I think around eighty-percent of adults will experience some form of it at some point in their lives,” Miraj begins by telling me. Working within a clinic that deals with muscular-skeletal physiotherapy, back problems are reportedly the most common ailment that he sees on a day-to-day basis. I’m aware of the fact that the vast majority of physical movements we make require our backs to some degree, so I was keen to know exactly what kind of consequences such issues can have on the lives of those who deal with them. “The number one thing is actually days off work,” Miraj states. “There are more days lost off work because of back pain than any other ailment. I read somewhere earlier that back pain actually costs the NHS about £10 billion a year. If you also factor in days off work, it winds up costing the economy a huge amount.”

Pretty gloomy statistics to be faced with, especially considering the already-precarious financial state of the UK. But what about more immediate physical consequences? I’ve been lucky enough to never truly suffer from back pain (and hopefully will remain so), but I’ve seen plenty of others who haven’t been so fortunate – and it looks excruciating. “It’s a bit of a revolving door, really – it can lead to poor health and inactivity, which then often leads to obesity and depression. You have the back pain, it leads you to be inactive, you gain weight, and you then have more back pain and you’re not able to get out of that rut; and actually you begin to become fearful of certain movements and avoid them – and become inactive – because you believe they’re the cause of your pain,” he explains. “When actually, it’s the opposite - being inactive is the cause of your pain.”

I’ve heard, as many might have, that lifting heavy objects with the wrong form can be very damaging to the human back – it was a fact one of my old PE teachers would remind the class of with a near-obsessive regularity. Whilst most of us never truly took him seriously – instead finding it pretty funny how passionate he seemed as he warned us against it (I know, kids suck) – I can now see that his cautionary advice truly was that important. It made me keen to know whether there were any other bad habits that Miraj frequently sees people practicing that’re also terrible for their backs. “Setting aside poor technique in the gym – which can lead to back pain, but which is more of a traumatic cause – the bad habits involve a lack of movement, as opposed to physical actions themselves.” This surprised me, but was somewhat relieving – I do some pretty odd torso stretches when I wake up in the morning, and it’s a relief to know they aren’t going to stab me in the back (pun definitely intended) in future. “Around sixty to seventy-percent of normal back pain is what we call ‘non-specific’ back pain; so there’s no known cause for it. When it comes to backs, there are so many muscles, ligaments, nerves – the spine and back is so incredibly complex – that we don’t necessarily say “oh, it’s this or that.” Instead, as physios, we try to fix the whole system – or at least have a positive impact upon it.”

Miraj also dispels a common myth regarding back pain; that it’s caused by poor posture. This may be true when it comes to my old PE teacher’s stern warnings; as Miraj also previously-noted, lifting heavy weights with the wrong technique can definitely cause trauma to the area. However, the idea that the way you hold yourself during low-strain activity like walking or even just standing can have a negative impact on back health is, it seems, false. “It’s a very old-school mythology that’s still in the minds of certain old-school physios. But the research shows that people with bad posture can have no back pain, and people with perfect posture can have loads of it.” So for any habitual slouchers reading this, don’t worry too much – you’ll likely be okay.

There’s a phrase in physio, Miraj tells me, that goes: “your best posture is your next posture.” Whilst a little cryptic, it’s not some veiled philosophical statement: it essentially means that it’s very important to stay physically-mobile. There’s nothing wrong with slumping in your chair, he assures me, so long as you get up every so often and do something else. To avoid back problems your best bet is to simply remain active and ensure you’re stretching the area enough (and – of course – always lift heavy things with the proper technique!). Pretty simple, really – unless you’re already incapacitated, there’s no real reason you can’t get up and have a walkabout, or do some stretching, or any of the plethora of other physical exercises you can do wherever you are.

But that’s not enough, you might be thinking. I want to get ahead of this and make sure I’m doing all I can to avoid such issues in future. Luckily, Miraj has some advice for you on that too. “The deadlift is probably the king of back exercises, and then a close second would likely be the squat. If these exercises are performed with good technique then you can absolutely, one-hundred-percent avoid back pain. I’ve seen videos of seventy to eighty-year-old women doing such exercises with perfect technique and no form of back pain whatsoever.” Any weightlifting – properly performed – is very good for your back, but these are the two specific exercises that Miraj most recommends. If you’re looking for something less intensive, yoga and Pilates-based stretching can have a fantastic impact on your back and spine. “It’s what I give to ninety-five percent of the patients with back pain that I see in the clinic to start them off and help reduce their pain,” he reports. Stretches such as Cat and Camel, Downward Dog, Child’s Pose and Thread the Needle are all fairly simple and effective – and unlike weightlifting can easily be done in almost any environment with a little open space.

Before we close, Miraj goes out of his way to clarify two more misconceptions about backcare and the back in general - and I’d like to share them with you. First off, people often refer to ‘slipped discs’ in the spine. This, it seems, isn’t actually a thing – our discs can protrude or herniate, but not ‘slip’. Miraj compares the reality to a burger that’s slightly too big for its bun, which is a fairly normal occurrence and in most cases doesn’t cause any symptoms of back pain at all. The idea that having suffered a ‘slipped’ disc means you have to avoid any strenuous activity is false. It’s the opposite, in fact. Over a period of time, our bodies can absorb the gel-like liquid that usually sits within the centre of spinal discs back into the area in which it belongs. Even if it doesn’t, it usually causes no painful symptoms and shouldn’t prevent you from pursuing an active lifestyle.

Secondly, he busts the myth that performing MRI or X-Ray scans on troubled backs is necessary to get to the root of the issue. Whilst such scans are used, they’re simply to rule things out rather than rule things in. “A physio I know said she tells her patients that having a scan done on your back is similar to having a survey done on your house; it’s going to throw up lots of things, but those aren’t necessarily the cause of your problems.” There has, Miraj mentions, also been a study on around two-thousand people which found, after they’d all undergone a scan, that every single one had some form of abnormality in their back. Even more surprisingly, not a single individual from that group actually suffered from any back pain. So MRIs and X-Rays are used by physios and medics to rule out any malevolent pathologies like cancers or tumours, but most of the time they’re not needed.

Hopefully, you now feel a bit more aware of exactly what your back needs to ensure it remains healthy and painless throughout your life. Keeping active is a brilliant lifestyle choice for a wealth of reasons, but this one ranks pretty highly on the list. The core message is this; stay mobile, ensure you stretch plenty and if you’re able – hit the weights (with proper technique, of course). If you can maintain these activities then you’ll be right on track for looking after your back to ensure that your back also looks after you.

If you are unfortunate enough to suffer from back problems, we’d definitely recommend seeing a physiotherapist such as Miraj. If you’re interested in learning more about him and what aid he can offer patients, take a look here.

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