The Physical Strain Of Sitting

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

From smart phones to computers to video games, modern technology has significantly influenced our daily postural habits and caused us to sit more often and for longer periods of time than ever before.  As a result, our increased exposure to sitting has contributed to rising levels of inactivity, and chronic ailments such as headaches, neck pain, and back pain.

People who sit for prolonged periods of time 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.  This can eventually lead to painful symptoms as these less than ideal positions put cumulative compression, stretch, and shear forces on spinal tissues such as joints and discs.

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.

Structural changes can also result from poor or prolonged sitting habits.  For example, aside from providing anatomical support, ligaments also function as neurological sense organs to the spine and influence reflexes that help muscles fire.  When an individual is exposed to prolonged sitting postures, they load their spinal ligaments which results in a delayed reflex action of muscles.  As a result, when this individual moves, the muscles may not fire quickly enough to protect the spine and this can lead to episodes of neck and back pain.  This is known as the biomechanical principle of CREEP, which stands for Continuous or Repetitive Elongation of the Elastic Properties of tissue.

Scientific research has also identified changes in muscle tissue associated with inactivity and prolonged sitting.  Over time, muscle tissue will accumulate fatty infiltrations that make it weaker and less capable of providing support for physical activity.

Below are some useful tips that can help overcome the physical strain of sitting:

1.    Proper posture is key:  Make sure weight is evenly distributed, your shoulders are not rounding forward, and you are not slouching.  A lumbar support can also be used to help maintain the natural hollow of your low back and proper spinal alignment.  Even slight slouching to the side, backward, or forward can put undesirable forces on biological tissues.

 

2.    Take a break from sitting:  Take 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.   Consider ergonomics:  The use of a properly designed workstation, along with ergonomic tools and assistive devices can help maintain mechanically advantageous positions while working in a seated position.

4.    Engage in regular physical activity and exercise:  Exercise strengthens our muscles and joints, while inactivity and poor posture weakens them.  Regular exercise can help overcome the effects of cumulative spinal forces, compensation, CREEP, and fatty infiltrations associated with poor posture and prolonged sitting.

Sitting can undeniably cause real physical change and breakdown in the body.  Chiropractors are well positioned to effectively evaluate and treat the effects of poor posture and prolonged sitting.  This may include symptomatic treatment, the prescription of appropriate exercises, and ergonomic advice 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.

The Reality Of Neck Pain

By Dr. R. Greg Lusk, DC

Neck pain is a common complaint in healthcare offices.  Whereas 8/10 people will experience low back pain throughout their life, up to 70% of people will experience neck pain.  Thankfully, only 1/10 neck pain sufferers report that it is serious enough to limit their ability to work or enjoy other daily activities.  However, like low back pain, neck pain will commonly recur.  In fact, between 50% to 85% of people will experience neck pain again within 1-5 years of the initial episode and how quickly symptoms improve is variable with each episode.

Due to the global impact of musculo-skeletal complaints, The United Nations and World Health Organization had an initiative from 2000-2010 titled "The Bone and Joint Decade".  A component of this was a Neck Pain Task Force that screened an enormous amount of research, nearly 32,000 citations, on its way to including 552 papers in a summary of best evidence with respect to neck pain.  As stated by the Task Force, "...the most productive use of this review is to inform and empower the public - more specifically people with neck pain or who are at risk of developing neck pain.  The most valuable outcome and contribution will be a change of attitudes and beliefs about neck pain and its prevention, diagnosis, treatment, and management."

Starting with cause, neck pain most often comes out of nowhere and does not involve trauma or a specific mechanism.  In these cases, there are multiple factors that can contribute to developing neck pain.  There are things you cannot change, such as being female, the genetic make-up you inherit from your parents (i.e. if there is a family history of neck pain), and getting older, all of which increase your risk.  However, there are things that increase your risk which are modifiable.  These include smoking, exposure to environmental tobacco, prolonged sedentary positions, repetitive work, and work that is very precision oriented.  Having degenerative changes in the neck, which are often seen on x-ray and are not modifiable with conservative measures, had no supporting evidence as a risk factor for neck pain.  This reminds us that structural changes shown on medical imaging, which are common with many painful conditions, need to be interpreted carefully and not easily scape-goated as the cause of pain.  As for protective factors for neck pain, physical activity participation had a positive influence.

If you have neck pain, how quickly you recover is also dependent on many factors.  Younger age was helpful.  In contrast, poor overall health, a history of neck pain, and poor psychological health were associated with a poorer prognosis.  With respect to the psychological aspect, worrying or becoming angry in response to neck pain, avoiding any activity that causes pain, and receiving only passive treatments were associated with a slower improvement.  Optimism, being confident in your abilities, and taking an active role in therapy, on the other hand, help you resume normal activities more quickly.

Non-surgical treatment options found to have benefit include educational videos, mobilization, manipulation, manual therapy, exercises, low-level laser therapy, and acupuncture.  Manual techniques combined with exercises are superior to hands on only approaches.

As you can see, there are many options which can be used based on appropriateness and personal preference.  Either way, due to its recurring nature, management of neck pain should involve therapies that are effective at managing your symptoms, empower you to take a role in self-management, and aim for prevention.

This article is for general information purposes only and is not to be taken as professional medical advice.