Everyday Activities That May Be Hurting Your Back

By Dr. John A. Papa, DC, FCCPOR(C)

80% of all Canadians will suffer at least one significant episode of back pain in their lives.  Back pain prevention can go a long way in reducing the risk of injury.  Below are some tips on how to overcome some of the common everyday activities that can contribute to back pain.

1.    Improper lifting is a risk factor associated with back pain. There are several strategies that should be employed during lifting activities.  Maintaining the natural curve/hollow (lordosis) of your low back is important, as this is its strongest and most secure position.  Avoid awkward postures such as bending, reaching, and twisting/turning.  Whenever possible, you should square your body toward the object being lifted, turn your whole body by moving your feet, and keep the object close to your body.  Contracting your abdominal muscles during lifting, lowering, and moving activities improves spinal stability, referred to as bracing.  You should also bend at the legs and not the waist, lifting slowly and smoothly, not jerking.  Minimizing lift load and exposure, taking mini-breaks, and job rotations can be helpful.  The use of assistive devices such as dollies, handgrips, and pull carts is also recommended.

2.    The physical strain of sitting.  People who sit for prolonged periods of time may adopt a poor posture that includes losing the natural hollow of the low back, along with rounding or slouching of the upper back and shoulders.  These less than ideal positions put cumulative compression and strain on the spine.  Take 10 to 30 second stretch or posture breaks every 20 to 40 minutes to make sure weight is evenly distributed, your shoulders are not rounding forward, and you are not slouching.

3.    Working in stooped positions.  When we keep our backs in a neutral/straight position, the mechanical load on the spine is considerably lower than when your back is bent forward.  Many activities around the home and workplace cause you to bend forward and stoop.  The longer you work in these forward bent positions, the more likely you are to experience back problems.  In order to minimize the risk of injury, you should interrupt the stooped position at regular intervals before pain starts.  Trying to find alternative ways of completing tasks without stooping is ideal.

4.    Smoking contributes to an increase in spinal problems.  Smoking has been shown to decrease bone mineral density and increase the risk of osteoporosis and future fractures.  The reduced blood circulation found in smokers deprives spinal tissues of vital nutrients which can lead to premature degeneration.  Smoking may also provoke disc herniation through coughing.  Exposure to secondhand smoke during childhood may also increase the risk of developing back problems later in life.

5.   Lack of physical activity de-conditions the body.  This makes us more susceptible to cumulative spinal strain and injury.  Regular exercise increases our functional capacity to withstand occupational, recreational, and everyday stresses on our back more efficiently, thereby minimizing the risk of injury.

For some, back pain can be dramatically minimized or avoided; while for others it needs to be managed so that its negative effects on activities of daily living can be reduced.  If you are suffering from back pain, a qualified health professional can determine the cause of your pain and prescribe appropriate therapy, exercises, and back sparing strategies specifically for your circumstance.  For more information visit www.nhwc.ca.

This article is a basic summary for educational purposes only.  It is not intended, and should not be considered, as a replacement for consultation, diagnosis or treatment by a duly licensed health practitioner.

Defining Common Muscle And Joint Injuries

By Dr. John A. Papa, DC, FCCPOR(C)

Physical injury to your muscles and joints can occur with workplace, household, sporting, and recreational activities.  Common mechanisms of injury include slip and fall or collision-impact type accidents, overstretching a body part, twisting awkwardly, or performing repetitive movements.  This can cause pain, stiffness, and swelling in a joint and/or muscle, leading to injuries such as sprains, strains, and contusions.

A sprain refers to a stretching or tearing of a ligament.  Ligaments are tough bands of fibrous tissue that connect one bone to another.  They help stabilize joints, preventing excessive movement.  One or more ligaments can be injured at the same time.  Common locations for sprains are the ankle, wrist, and knee joints.

A strain refers to a stretching or tearing of a muscle or tendon.  Muscles are responsible for producing force and causing motion, whereas tendons are the tough fibrous extensions of muscle that attach to bone.  A strain injury can occur when the muscle-tendon complex suddenly or powerfully contracts, or when it is overstretched.  This is called an acute strain.  Overuse of certain muscles over time can lead to a chronic repetitive strain.  Strains are commonly referred to as “pulled muscles” or "tendinitis".  The shoulders, forearms, low back, and leg regions are common locations for strains to occur.

Contusions are commonly called “bruises”, and occur when small blood vessels in the skin, muscles, or bones are subjected to trauma. 

Sprain, strain, and contusion injuries can exist on their own or in combination with each other.  Initial conservative management and first aid of these injuries should follow the P.R.I.C.E. principle (Protection, Rest, Ice, Compression, Elevation).  This can significantly reduce swelling, tissue damage, inflammation, muscle spasms, pain, and recovery time.  With a mild injury you should experience progressive improvement within 2 to 3 days.  You should gradually begin using the injured area after this time.  Mild injuries usually heal completely without any residual consequence in 1 to 4 weeks. Moderate injuries usually require 4 to 12 weeks to heal and may require basic rehabilitative treatment and exercises.  Severe injuries will take longer to heal.  Healing times may also vary depending on a persons age, physical condition and general health.

You should seek immediate medical care under the following circumstances:  a popping sound heard during the injury accompanied by a feeling of joint instability or inability to weight bear; obvious evidence or suspicion of a broken bone, fracture or joint dislocation; or injuries at risk for infection.  For less serious injuries that do not subside, you should contact a licensed health professional who deals in the diagnosis and treatment of muscle and joint pain.  They can determine the cause of your pain and prescribe appropriate therapy, exercises, and rehabilitation strategies specifically for your circumstance. For more information on managing muscle and joint injuries, visit www.nhwc.ca.

This article is a basic summary for educational purposes only.  It is not intended, and should not be considered, as a replacement for consultation, diagnosis or treatment by a duly licensed health practitioner.

Hip Pain And Prevention

By Dr. John A. Papa, DC, FCCPOR(C)

Hip pain often limits physical activities such as walking, running, squatting, and going up and down stairs.  It can also create problems with sleeping and sitting positions.

Depending on what the source of the hip pain is, symptoms can be felt in a number of  different regions which may include:  the low back, deep in the hip joint, on the outer aspect of the hip, in the groin, at the front of the thigh, and in the buttocks.  Listed below are some of the conditions that commonly cause hip pain:

·     Osteoarthritis results from the protective layers of cartilage in the hip becoming worn over a period of time, leading to change in the composition of the bone underneath the cartilage.

·      Osteoporosis is a disease of bones that decreases bone mass and strength, making them more fragile and susceptible to fracture.  Hip fractures usually occur in older individuals after a fall injury.

·     Ligaments are tough bands of fibrous tissue that connect one bone to another.  They help stabilize joints, preventing excessive movement.  Ligament injuries (sprains) can occur when these structures become over-stretched or torn, often during activities where there is a direct blow to the hip or there is an awkward fall or twisting motion involving the hip.

·     Tendons are strong tissues that anchor muscles to bones, and these structures can become over-stretched or inflamed around the hip joint leading to tendonitis and muscular strains.

·       Bursitis can involve several fluid-filled structures in your hip that help provide more cushioning in the joint.  Repetitive hip strain and blunt trauma to the hip bursa are two common causes of bursitis.

·     Injuries and conditions in the low back can radiate symptoms into the hip region.  This includes things such as osteoarthritis, sprains and strains, disc herniations, sciatica, and spinal stenosis.

Below are some useful tips that can help individuals avoid or minimize the chance of hip pain and injury:

1.      Maintain a healthy bodyweight to decrease the overall stress on your hips.

2.    Wear appropriate footwear that supports your activities and helps maintain proper leg alignment and balance.

3.      Prepare your hips for physical activity by stimulating the joints and muscles, and increasing circulation.  This can be accomplished with a quick cardiovascular warm-up and gentle stretching of the muscles in the hips, thighs and lower legs.

4.  Choose activities that are "hip friendly" for you.  This may include low impact activities such as swimming, walking or cycling.  Remember to start slowly and build up the intensity gradually.

5.   Strength, balance, flexibility, and core exercises can train your body to better support your hips and avoid injuries.

If you have hip pain that limits your daily functioning, you should contact a licensed health professional who deals in the diagnosis and treatment of hip pain.  For additional information on hip pain and treatment of muscle and joint injuries, visit www.nhwc.ca.

This article is a basic summary for educational purposes only.  It is not intended, and should not be considered, as a replacement for consultation, diagnosis or treatment by a duly licensed health practitioner.

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Solutions for Overcoming Poor Sitting Posture

By Dr. John A. Papa, DC, FCCPOR(C)

An ideal posture allows an individual to maintain an efficient, strong, and balanced position while interacting and adapting to their physical environment.  Good postural habits can help decrease abnormal and excessive physical strain on the body, thereby minimizing the chance of injury.

Unfortunately, modern technology has significantly influenced our daily postural habits, which has resulted in having people sit more often and for longer periods of time.  Individuals exposed to these sitting positions may adopt a poor posture that includes losing the natural hollow of the low back, rounding or slouching of the upper back and shoulders, and a forward head poking position.

Less than ideal posture puts cumulative compression, stretch, and shear forces on the body.  The cumulative effects of sitting are often offset by the body’s ability to compensate.  However, even in the absence of pain, these compensatory changes may begin a vicious cycle of unbalanced motion, muscle and joint stress, and secondary areas of discomfort.  As a result, the physical consequences of chronic poor posture can lead to symptoms such as muscle and joint stiffness, nerve pain, headaches, shoulder pain, neck pain, upper and lower back pain.

Listed below are some potential solutions that can minimize the chance of postural injury, specifically as it pertains to the sitting position:

1.    Pay attention to how you sit by making sure weight is evenly distributed in your seat, your shoulders are not rounding forward, and you are not slouching.  Your head should be resting on your torso and not poking forward.

2.   Take a break from sitting with 10 to 30 second stretch or posture breaks every 20 to 40 minutes.  Some activities such as computer work, talking on the phone, and business meetings can also be done while standing.

3. The use of a properly designed workstation (i.e. adjustable chair and desk), along with ergonomic tools and assistive devices (i.e. speakerphones, foot stools, lumbar supports) can help maintain mechanically advantageous positions while working in a seated position.

4.    Avoid unnatural positions such as looking down, awkward twisting, or slouching for long periods of time as this can cause unnecessary strain.  A simple solution may be to bring your smartphone, tablet, or book closer to eye level, or adjusting your seat position to help you maintain a more natural/neutral position.

5.    Engaging in regular physical activity and exercise can keep your body strong and help overcome the effects of cumulative strain associated with poor posture.  Exercise activities can include general cardiovascular conditioning, along with postural, stretching and strengthening exercises for the neck, shoulders, upper and lower back regions.

Prolonged sitting and poor posture can undeniably cause real physical change and breakdown in the body.  If you have ongoing pain as a result of postural strain, you should contact a licensed health professional who deals in the diagnosis and treatment of these conditions.  For more information visit www.nhwc.ca.

This article is a basic summary for educational purposes only.  It is not intended, and should not be considered, as a replacement for consultation, diagnosis or treatment by a duly licensed health practitioner.