Watch your back!
With all the sitting we do these days, lower lumbar spine pain is common
William Jones, 44, was in the garden, “lifting something I probably shouldn’t have been”, when he felt his back “give way.” After the first excruciating ping in his lower back, an hour or so later, he thought it had eased up and that he’d had a narrow escape. But the following morning, when he passed out trying to get out of bed, his wife had to call for paramedics.
“I was at once incredibly embarrassed and grateful that they were there,” he says. They suspected a herniated disc and offered to take him to hospital for further checks. “I didn’t want to go as I didn’t see what good it would do, but they gave me gas and air and took my weight while I moved around, getting some movement into my spine,” he says.
Lower back pain is a common problem for many midlifers, affecting about one-third of the U.K. adult population each year, according to Arthritis Research U.K. A paper published in the British Medical Journal reports that most instances occur in people in their 40s and increases with age. “I treat a wide variety, and lumbar spine pain is the most common,” Darren Chin, physiotherapist at the Centre for Health and Human Performance, confirms. “This is due, in part, to the lumbar spine having the least structural support while enduring the most strain, therefore being the most frequently injured region of the spine.”
As Jones found out, after the initial pain, the referred pain down his buttock and leg — sciatica — was debilitating. He couldn’t sit or stand for more than about five minutes at a time, couldn’t get himself dressed and was unable to lift up his young daughter.
Chin estimates that 90 per cent of sciatica cases are the result of a herniated disc, such as the one Jones experienced, as the disc pinches the sciatic nerve. “Frequently, the term ‘sciatica’ is confused with general lower back (lumbar spine) pain. It’s not a condition; it’s a symptom caused within the lumbar spine, and usually felt within the buttock and/or down the back of either leg.”
The most common cause is our age: “Sciatica is found most frequently in people aged between 30 and 50 and is caused by spinal degeneration resulting in a gradual loss of normal function and structure,” Chin says. “The spine at this stage shows normal signs of wear and tear as the discs dry out and shrink (hence why we get shorter as we get older), placing pressure on the spine.”
But the problem is also thanks to sitting down more than we’re meant to: a symptom of today’s desk-bound office worker: “Sitting or living a sedentary lifestyle can make you more likely to develop sciatica than an active person,” Chin adds.
Jones initially tried to get treatment on the NHS but was frustrated by the waiting times between appointments. When he did see an NHS physiotherapist, they prescribed a series of exercises, instead of manipulating the back, as he felt he needed. “I wasn’t mobile enough to do the things they were suggesting, even though I tried.”
Instead, he went to see Chin, who massaged the back to provide relief to the supporting muscles, before teaching Jones more exercises. “Just one session made a huge difference,” Jones says. “It was intense, and Darren warned me that I would feel bruised, but the next day I could move around more freely. I went back to see him again and did my exercises at home and I’m feeling so much better — but it’s taken five months.”
While Jones says that his condition has improved — although he has not managed to return to running, and sitting for long periods of time is still painful — unfortunately, Chin says that recurrence of back pain is statistically high. “It is due to insufficient rehabilitation and a return to old ways such as prolonged sitting,” he says, something many of us are guilty of.
While generations before us had more manual jobs at work and home, and also walked more, we are attached to phones, desks and, crucially, chairs. It’s estimated that we now spend more than 20 hours sitting (or lying down) per day.
Tony Riddle, who calls himself a natural lifestyle coach, is an advocate of standing more and sitting less. “Humans are the ultimate adapters: for good or bad, we will always adapt to the norms our environment presents us with; most of us have just adapted to become the sedentary modern humans our environments are facilitating.
“When we sit, our glutes switch off, and in turn our powerful pulling muscles, our hamstrings, take over, which leads to tight hamstrings and stagnant, lazy, drooped glutes, which are a modern physiological phenomenon.”
He believes in what he calls “rewilding” our bodies, by avoiding sitting. “It’s about incorporating it into normal activities, for example, during a Netflix marathon, avoid the chair and sit on the floor or even do stretches. Or while you’re brushing your teeth, use that time to do foot exercises, or stand on one leg. Mashing up new and old habits mean you’re more likely to stick to them.”
Jones has now purchased a standing desk, performs a stretching routine three times a day and has been monitoring how much he moves with his Apple Watch. He is also still completing treatment with Chin: over the coming weeks the physiotherapist will reintroduce running on a treadmill along with back strengthening exercises.
“It’s been a wake-up call,” Jones says. “I took my back health for granted but having something like this completely wipe me out for months means that I’m going to be extra diligent going forwards. I’ve been warning everyone else to watch their backs — it’s just so vital.”