Making People Better
Making People Better
Back Pain: Prevention, Causes and Management Strategies
Use Left/Right to seek, Home/End to jump to start or end. Hold shift to jump forward or backward.
Ever find yourself clutching at your lower back, wondering if your spine secretly despises you? Let's unravel that mystery with the help of Karen Beattie shed light on back pain's complex relationship with sleep, diet, and mental health. Our revealing conversation peels back the layers of why physical strain is just one piece of the puzzle, and why your spine health is more akin to an entire lifestyle choice.
Back Care and Pain Management
Speaker 1Enjoy a moment of relaxing calm with the Vita Health Group well-being series of podcasts to make you feel good , keep you healthy , help you make changes to your life . Vita Health Group is an award-winning market leader and has been at the forefront of healthcare for the past 30 years . Vita Health Group making people better .
Speaker 2Yes , and welcome along to another of the Vita Health Group podcast . Good to have you company . I'm Glenn Thompson , and thanks for joining us , and the aim of this series of podcasts as you buy it Well , no , I'm sure by now is to raise awareness of what Vita Health Group has to offer . To do that , I'm joined on each episode by various experts in their chosen field , and today I'm very pleased to welcome Karen Beattie . Karen is speaking to us direct from Scotland , from Bolly Scotland , north of the border , in sunny Glasgow . How are you doing , karen ? Nice to have you on board .
Speaker 3Oh , thanks for having me , glenn . Yeah , very well , and , as I said , it's sunny up here today , which always makes a difference up in Scotland .
Speaker 2Now you're an MSK corporate deputy clinical lead . For the uninitiated of us , MSK meaning what exactly ?
Speaker 3MSK stands for Musculoskeletal .
Speaker 2Okay , and how long have you been working in this line of business ?
Speaker 3Oh goodness , I don't really want to admit how long I've been a physio form , but far too long . I've come in up for 20 years , let's put it that way . So I've worked across a variety of sectors in sport , private healthcare and for the last four years with Vita in their corporate services .
Speaker 2And enjoying it obviously .
Speaker 3Absolutely . Oh , it's a great job . Absolutely .
Speaker 2So do you work mostly from home with your advice , or do you get to sort of travel around a bit ?
Speaker 3Pretty much completely from home , which is absolutely fantastic and just with a setup we have it . At Vita , my job is to primarily support , train , offer clinical leadership to our corporate clinicians , so it's great to be able to do that remotely and from home .
Speaker 2Fabulous . Well , the subject of today's podcast , then , is back care and back care and back problems . There's a lot of folk that suffer with back issues lower back , you know all over . It's a very common thing , isn't it ? We'll delve into this in more detail in just a moment , but back pain in general , karen , is fairly widespread , isn't it ?
Speaker 3Oh goodness , yeah , I mean . The short answer is it's incredibly common . That even goes far to say is if you're human and have a back , you will at some point be guaranteed to experience back pain in your life . So it's incredibly common . Pretty much the most common issue that we see either in a physiotherapy or a therapy clinic , or whether we're doing our remote or virtual assessments online . So it's certainly the most common issue that we come across .
Speaker 2And what do you find that is the most common type of back pain , Karen .
Speaker 3Oh , definitely lower back pain , Glen . Lower back pain is one of the most common issues that we come across .
Speaker 2And what causes that ? I mean , is it the fact that we maybe sleep in some weird position and lift heavy things up ? I mean , taking my own experience back , probably about 10 years ago , I was in the shower and I got out and you know , when you put the towel behind your back and you sort of do the left to right thing down , you're back to dry yourself . Suddenly a searing back pain went through me . It was slow , like from one shoulder to the other , but right down to the middle of my back . I don't know what on earth caused it . It only ever happened once and I was uncomfortable for about a week and then it went . So goodness knows what it was .
Speaker 3Absolutely , glen . I'm glad you mentioned that as an example , and there'll be a lot of people out there that have experienced something really similar to that . Historically , the causes of back pain we always put down to bending , lifting something heavy , and that installs quite a lot of fear in people in terms of their back pain . But actually what we know , the causes of back pain are really wide and really diverse . Probably about two thirds of the people they actually don't know what set off their back pain in the first place , which I find are absolutely fascinating stat and actually very few people can attribute the cause of their back pain to lifting or bending . And it's such a multifaceted issue . Back pain , you know , in its simplest terms , you know the load that we put on the structures in our back has just exceeded our capacity to deal with that .
Speaker 3That's quite a simple or simplistic way of looking at it , but we know that there's so many other things that can enforce and contribute to our back pain could be things like have we had enough sleep ? Sleep has been shown in the research to be a really big factor when it comes to yeah , absolutely when it comes to back pain . What we eat , how healthy our diets are , can contribute , and even things like our mental health , really strongly associated with back pain , particularly chronic , which is persistent , and long standing back pain . If we suffer from anxiety or stress , for example , this can really amplify our feelings of pain , particularly in the back . So hopefully I've kind of . What can I basically alluded to there ? There's lots and lots of different things that can cause back pain . We can simply attribute to one thing .
Speaker 2But back pain is a little bit like your feet . I mean , we tend to ignore our feet . We're on our feet virtually all day long , most of us are and your backs are similar . You tend to just ignore it . You just get on with it . You let your feet get on with it , you let your back get on with it , but you've got to look after these areas of the body , haven't you ?
Speaker 3Yeah , absolutely . And if you think about it , our spine is absolutely integral to everything we do in our daily life , which is whether it's rolling over in bed , whether it's standing up out of a chair , whether it's going for a water-sitter spine are integral . And just to that point about just ignoring it if it's any sort of reassurance , I'm not saying necessarily ignore it , because sometimes you can't completely ignore back pain , particularly if it's really severe and debilitating . But the majority of cases of back pain do resolve on their own , usually potentially within about six weeks , and it's only if it persists beyond that point that it's important to sort of look for a bit of added support and help with it . But , yeah , absolutely , we tend to ignore it . There's nothing wrong with ignoring it , provided that we keep on moving as normally and we keep as active as possible . It's when we tend to move away from doing that , which is when the problem can persist or not improve .
Speaker 2And how important are things like exercise , maybe doing a few stretches every day in the morning . When you get up , most of us have a bit of a stretch and a yawn , don't we ? I mean , how important is it to sort of just stretch a little bit in the morning ?
Speaker 3Oh , I'm glad you asked me that , glen . So exercise and I'll use the term exercise here probably more than stretching exercise has been one of the main things that's emerged from research that that's been shown to effectively manage and potentially prevent back pain . As I said , it's a multi-faceted issue that has lots of different contributors , but exercise has been shown to be particularly helpful and that doesn't need to take the form of stretching per se . Exercise is something that should feel quite challenging to you and it should put an element of load through your body and through the spine . So stretching , yes . Motion is lotion . We've all heard that saying .
Speaker 2Motion is lotion . I love that Motion is lotion .
Speaker 3So that applies to whether , when we get up , as soon as we get moving , we get our circulation going , we get the joints lubricated and it's really valuable , but not just stretching lots of different types of exercise . There's not been one particular type that's shown to be more effective than another .
Speaker 2And Karen , if it's ongoing , if that pain is constantly there , I'm guessing it is necessary to see somebody like yourself , a specialist , to get a scan , to get an accurate diagnosis of the problem .
Speaker 3Absolutely . As I said to you already , most people in their lives will experience back pain and the huge majority of those cases are not serious . And although it may feel serious , you know that this is not to kind of devalue who bad someone's back pain feels bad , but actually , in terms of perhaps anatomically or damage , the huge majority cases are not serious . What I would say is it's important that if your pain is persisting and it's having quite a big impact on your life , then do reach out to a therapist . Therapists are really useful . We're not just assessing how well your back moves or how much load your back can tolerate . We're actually looking at you holistically and seeing all those other factors that may be contributing to your symptoms as well .
Preventing and Managing Back Pain
Speaker 3In terms of scanning , this is a question we get asked a lot as therapists . My back pain's really bad . It's really severe . Surely I must need to see a specialist or I need to have a scan . It's really easy to see why people would want that . What we know from the research is that pain doesn't equate to damage in the spine , and that's what people are fearful of . This huge amount , these huge amounts of pain , are equaling some sort of horrific damage to discs or ligaments or the joints . So I really want to reassure folk that pain doesn't equal damage and , as I said , the vast majority of episodes aren't serious . What I would say is I'll come back just to the kind of point on scans in just a second , but there are some cases I will caveat this with .
Speaker 3There are some cases of back pain which do require a scan , and this will be why sometimes , if you're having a therapy assessment , your clinician will ask you about really random things , such as your bowel bladder habits . They'll actually ask you about your sexual function . They'll ask you about any sort of numbness or pins and needles in the genital area , and these are really important questions the nerves that come out of the base of the spine . They supply your pelvis , your bowel , your bladder and your pelvic genital region . So if there is any signs and symptoms of damage , irritation , compression to these nerves , we do need to act quickly .
Speaker 3In a scan is absolutely essential because you may need to have some more radical intervention or reviewed by a specialist . But on the whole , a huge majority of cases do not warrant a scan and we actually have seen from research . They've looked at folk that have had no back pain and they have a scan and there actually are changes visible on the MRI scan . And on the other of respect , you've had people that do have back pain . We scan them and there haven't been any significant changes at all .
Speaker 3And this just simply suggests that changes to the back they are normal and they are to be expected . We call them age-related changes rather than sort of historically a rightistic . I know a really nice way of looking at it is they're kind of like wrinkles . They're maybe not great to look at on a scan , but they're actually not causing us any harm or any damage at all . So wrinkles , wrinkles is quite a nice way of looking at it .
Speaker 2It is a great way .
Speaker 3Just to reiterate , the majority of cases are not serious and actually having a scan can reiterate those feelings of fear and anxiety , all the things that can amplify your back pain in the first place .
Speaker 2And I'm guessing , karen , first of all is the GP , and then they'll , I'm guessing , recommend a specialist of some sort .
Speaker 3It could be your GP . As a physio , I would always and this is in no way to sort of downplay the valuable roles that GP have but actually speaking to a physio or a rehab therapist in the first place can be really valuable and it can cut out that need to go and see your GP and they're obviously they're kind of inundated with lots of other different things at the moment and , yeah , absolutely valid to go and see a therapist first . Obviously your GP can help with pain relief if your pain is really significant and that is important as well in terms of getting you moving and getting active . But no , absolutely approaching a physio or rehab therapist would be where I would start initially .
Speaker 2Sure , I mean , we're all sitting at computers or most of us seem to sit at computers these days , don't we ? And sit badly . Posture is important , isn't it ? I mean , if you are sitting at the computer all day long , make sure you're sat with a straight back and get up occasionally . Get up as often as you can , really Just having to walk around . But posture plays a huge part , doesn't it ?
Speaker 3I'm going to defend posture a little bit here , glenn . I think posture gets quite a bad rep just generally in terms of back pain . There have been studies that show that actually very few cases are actually directly . Certainly disc injuries are themselves are directly caused by posture . So I would say any posture , whether it's good posture or bad posture , any posture that went in for too long , really has the potential to contribute to back pain , whether it's that kind of stiffness and achiness that we can feel from being in the one position for too long . Like you said , their movement is the key . So if we can break up positions staying in any posture for too long , then that is really valuable . Going back to my saying earlier on , motion is lotion , so getting up and moving is really valuable . But having said that , having a workstation we're all working from home quite a lot nowadays Having a workstation environment which promotes movement and is comfortable for you is really , really valuable .
Speaker 3What I sometimes do and I'm a physio myself sometimes I need to just remind myself if I'm doing training or sitting at my desk for too long . I have little post-it notes . I'm a bit old school and I have put , instead of having reminders on my phone or reminders on my laptop . I have little post-it notes just stuck around saying remember , get up , stretch , move . It doesn't need to be stretching , get up and doing some squatting . Squatting is one of my favourite exercises in the world . Just getting up and moving is really , really valuable . And I think an important thing to remember is people have this concept of , or this kind of feeling that when we're sitting we're really slouched or vertebrae in our back are getting really compressed , and actually even when we're sitting in a slouched position , our vertebrae don't even fall much beyond a parallel position , so we're not squashing , squeezing , putting too much pressure on certain parts of the body . So it's important to sort of remember that as well and hopefully that reassures folk .
Speaker 2I've got a couple of friends who've got these sort of stand up desks . You know they've got a little switch underneath and they they raise up and from time to time during the course of the day they'll stand up and work and spend , sit down , and so that's quite a useful , a useful thing to have , isn't it , if you can afford .
Speaker 2I know they're quite expensive to buy those desks , but you know , if you've got a returning back pain , a niggling back pain that does occasionally come on from time to time . I get that when I get sort of flew or come down with a cold .
Speaker 3I give you the back pain .
Speaker 2You know , I sort of just move about , sort of a bit of stretching , walk around a little bit and then tends to go away . But there are some ways of preventing that back pain If you are sat at the desk . Let's not exclude other people who don't work at desks . But you know , there are ways of treating it , aren't there ?
Speaker 3Yeah , absolutely , and I think you've kind of summarizing that this whole session it's about movement and it's about keeping active and it's about improving the robustness and the resilience of our backs . And the primary way of doing that through exercise . I always kind of work by the really simple philosophy that doing something is better than doing nothing and doing more , a little bit more , is always better than doing a little bit less . So the essence of keeping your back we can never prevent back pain completely . Like I said , there's so many other facets . You could be an athlete and still develop back pain , but essentially it's keeping active , it's keeping fit and healthy , it's having a adopting a really good and healthy lifestyle , making sure that we're loading our spines . We should be fearful of loading our backs . Bending , lifting weights with historically been quite fearful of that and , like I said , if you don't use it , you lose it .
Speaker 2So you know , if I wanted to prevent back pain I've had back pain in the past and I've got it sorted a bit of therapy sorted me out how can I prevent it returning . I don't want to have that pain all over again . What's the best thing and the best way of preventing it ?
Speaker 3That's a great question , glenn . As I've alluded to already , it's such a multifaceted issue back pain I would be sort of irresponsible to sit here and say there's an absolute , definitive way of preventing back pain . What we know works is often sort of dispelling some of the myths that go with back pain . We know that fear , anxiety about movements , lifting , bending , can amplify , it can turn the volume up on pain and our appreciation , our responsiveness to pain so it's actually part of it is having a really good understanding of what causes back pain potentially and understanding that movement is healthy . All movements are healthy .
Speaker 3Glenn , when it comes to preventing back pain , exercise is incredibly valuable and I kind of refer to doing something as better than nothing and doing a little bit more is better than doing a little bit less Any exercise that you enjoy it's not specific exercise necessarily that works , which I actually find . That's a revelation . That's been great for therapists across the board . You know we used to very much stick to , you know , lying on the floor , doing ab work , but actually think of where the trunk and the spine is . Every movement that we do will work the trunk to some extent . So it's finding an exercise that you enjoy , that you find challenging and that you can commit to doing regularly , along with things like looking after yourself through good sleeping habits , good nutrition , keeping a healthy lifestyle . Those are all really valuable and helping to . I would say we're just the risk of development . We can't eradicate it completely , but we can certainly reduce the risk of it happening frequently .
Speaker 2I'm fascinated that diet plays a part in this . I mean , I know diet plays a huge part in most things with our health , but you're saying that it helps with back pain . If you've got a decent diet going on , you can alleviate the back pain .
Speaker 3I would probably wouldn't say alleviate . We know that eating a diet that is potentially quite a processed diet and again the research is still quite mixed on this but it can increase what we call low grades inflammatory responses throughout the body and we know that a kind of low , subtle level of inflammation throughout the body can amplify and turn the volume up on pain and in particular back pain . So you know , having a nice , healthy diet won't eradicate and it won't necessarily improve back pain when you have it , but it's important overall factor to consider in terms of back care and back health overall .
Speaker 2OK , great stuff , Karen . You at Vita Health can offer advice in this area , can't you ? If anybody wants more details , head over to the website .
Speaker 3Yes , absolutely . We've got lots of ways of offering this , glenn , and from the convenience of your own home as well , we can do as I mentioned before . It's a really multifaceted affair and our therapists are absolute experts in helping you get to the bottom of what's really hopefully causing this back pain . So we can do it virtually , we can do it over the telephone and we can also work through clinics as well .
Speaker 2Just , give us a bit of an example . I mean , I've got back pain . I get in touch with you guys . Do you ask me about my lifestyle ? Do you do a bit of like a consultation session , first of all , before you get stuck into the nitty gritty ?
Speaker 3Absolutely . We want to know about you . We want to know about the patients' experience of their back pain . Patients know themselves best . It's not for us to say you must do this and give out prescriptive sets of exercise , perhaps like we used to do in the past . So it will be a consultation . We want to know what's impacting you . We will obviously ask some specific questions , particularly those ones that I referred to earlier on , to try and establish whether your back pain falls into that very small bracket . That is a serious condition . But we'll ask you lots of questions throughout . We'll get a feel for potentially what exercise you like doing , any sort of underlying fears and anxieties you potentially have about management , and we will work with you to establish the program that's best suited to you . So it's not us telling the patient what to do . It's working with our patients to work out what best strategy is , covering lots of different areas .
Speaker 2I think in a nutshell , just look after yourself and don't lift anything too heavy , and I always would toss it when I was a young lad , when I worked on the farm with my dad . You know , bend at the knees . If you're lifting something heavy and come up from the knees , don't bend over , because that's the problem .
Speaker 3I actually know that that's probably not the case now . Actually lifting has been shown to actually improve the robustness and the resilience of our distal . So definitely lifting it's always not going to lift 100 kilos and the heaviest you've lifted before is about five kilos but actually lifting is shown to be beneficial and our spines are designed to bend . So actually avoiding movements like bending if you don't use it you lose it . Essentially that's a simple way of putting it and it can show to have can be shown if you don't use a movement and use it frequently , it can have a more of a detrimental effect . So lots of normal natural movement , lots of exercise in all directions and intensity , but it is a little bit higher than what you're used to . That's probably the simplest way of managing back pain or helping to prevent it in the future .
Speaker 2It's been a real education , Karen . Thank you so much . Karen Beesey is an MSK corporate deputy clinical lead at Vita Health Group and specializing in back pain . Hope very much . You've enjoyed this podcast . Don't forget to hit that subscribe button and listen to the other episodes in our series . Thanks for joining us on the podcast .
Speaker 3Thank you very much .
Speaker 1Glyn , thank you for listening to this Making People Better podcast , part of the Wellbeing series from Vita Health Group . Improving your lives , physically and mentally , drives everything we do , and getting you back to doing what you love is our priority . Vita Health Group Making People Better wwwVitaHealthGroupcouk .