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Researchers identify common triggers of lower back pain

3/9/2015

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Back pain is a very common problem. Most people will experience some back pain at some point in their lives. A new study out of Sydney has looked at common causes or triggers of acute lower back pain.  They looked at 999 people who had had recent episodes of acute lower back pain and asked them to report exposure to 12 physical or psychosocial factors in the 4 days before the onset of back pain.  They then created an odds ratio (OR) on the chance of injuring yourself.  I am sure you will agree that prevention is better than cure, so knowing what things may trigger an episode makes it easier to try and avoid them.  Continue reading to see what they found and what time of the day injuries are more likely to happen.
The study was recently published in the Journal Arthritis Care & Research. The physical factors they considered, included "heavy load; awkward positioning; handling of objects far from the body; handling people or animals and unstable loading; a slip, trip, or fall; engagement in moderate or vigorous physical activity; and sexual activity." The possible psychosocial triggers were alcohol consumption, fatigue, and being distracted during an activity or task.

The findings were very interesting.  Some were expected, others were a bit different.  Here are the key ones:
  • You have a 25 times higher chance of triggering an episode if you are distracted during an activity.
  • Being in an awkward postural position increases the chance by 8 times.
  • Lifting objects not close to the body increases the risk by 6.2 times.
  • Manual tasks involving people or animals can increase the risk of injury by 5.8 times.
  • Unstable/unbalanced objects and heavy loads can increase risk by approximately 5 times.
  • Vigorous activity only can increase risk by 3.9 times.
  • Moderate to vigorous activity can increase risk by 2.7 times.
  • Interestingly, alcohol consumption or sexual activity did not significantly increase the risk.

Two other interesting findings came out of the research.  Firstly, you are more likely to injury yourself in the morning between 7.00am and 12.00pm.  Secondly, age was also a factor with younger people being more at risk.  20 year olds had an Odds Ratio of 13.6 compared to 60 year olds who had an odds ratio of 2.7.

What to make of this
As I said earlier, prevention is always better than cure.  If you know what may cause an injury, you can then take steps to try an avoid injury from occurring.  Several of these findings are quite obvious and seem to be based on good lifting technique or lack thereof.  Good lifting technique involves bending knees, not using your back like a crane and having the object you are lifting close to your body to reduce the strain.  Everyone should be aware of these. What I found interesting was the distraction.  If you are not focusing on what you are doing you are significantly more likely to hurt yourself.  We really need to pay attention to what we are doing, especially when lifting is involved.

The age differences was also fascinating.  My thoughts are that older people will have better understanding of lifting and how to do it safely or are more likely to get other younger people to do the heavy lifting for them.  Younger people may also have the ‘she’ll be right’ attitude and just force through something that may not feel quite right.

Finally, the increased risk of injury early in the mornings is an interesting find.  My thoughts are that this may be due to the fact our spinal discs swell overnight and therefore you are more susceptible to injury in the mornings.  Especially if you have or have had disc problems.

3 key take home points
  1. When lifting or doing any activity, make sure you are using the correct technique. This is especially important when you are doing vigorous exercises.  Technique is paramount.
  2. Pay attention to what you are doing.  Present time awareness and mindfulness are vital.
  3. Be extra vigilant when lifting or doing exercises in the mornings.  This is the time you are more likely to hurt yourself.
By being aware of these key points, you will hopefully reduce the risk of suffering an injury.  I think your body will thank you for it.

References
  • Arthritis Care Res. 2015;67:403-410.
  • http://www.medscape.com/viewarticle/841853#vp_2 
  • http://www.medicalnewstoday.com/articles/289163.php

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