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Back Pain: Common Causes and Treatment Strategies


Back pain is one of the most common of all injuries seen by healthcare practitioners. The most common causes are poor posture, injury and overuse. In this article, Mark Adshead, specialist physiotherapist at Physio2go St. Albans, reviews the common causes of back pain in the home gardener. Mark reviews choices in treatment, and how back injury may be prevented.

Back attack

The comedian Leonard Cohen wrote “I ache in all the places I used to play!” Back pain, especially lower back pain, is no laughing matter. Back pain, one of the most common orthopaedic complaints in the 45-65 age group, is often due to a combination of aging joints and a relatively sedentary lifestyle, coupled with an intense burst of activity. The activity may be springtime tennis, a new golf swing or moving the sofa.
What hurts and what to do
Most back pain originates from simple muscle and joint strains, although structural damage, such as slipped discs can occur. As our spinal columns age, the spongy moist discs that cushion our spinal vertebrae become dryer, flatter, and less able to protect our back from sudden movements. If you can identify a specific movement, heavy lifting or a fall as the cause of an acute back pain, it is most likely that you have sustained a muscle sprain. If no specific event has triggered the pain, the cause may also be general wear and tear osteoarthritis.
When back pain occurs there are some simple steps you can take to help yourself. Doing some gentle back exercises to prevent the joints and muscles from stiffening up may help. Try bending forward, backward and side to side, but only as far you feel you are able. Do not force these movements. Take your normal off the shelf type pain killers if required.
Use a heat pack or hot water bottle wrapped in a towel on the affected area, this will not cure the problem but will help relieve the symptoms. Most back pain will start to resolve fairly quickly, usually in the first 48 hours. If your symptoms persist or they get worse, then this is the time you should consider contacting a health professional for advice.

Back pain: When to seek professional help

You should also contact a health professional in the following circumstances:
• if your pain is constant in the back, legs or feet
• if you experience constant pins and needles in both feet
• if you experience any weakness in the legs or feet
• any numbness in the saddle area
• night pain that wakes you or is affecting your sleep
• if you have a history of cancer / other serious illness
• any changes in bladder or bowel frequency, i.e. any retention of bladder/bowel or any lack of control
If you happen to fall whilst sustaining your back injury these same simple rules also apply. Most back pain, if managed correctly, will resolve in six to twelve weeks. In the vast majority of back problems, despite the pain being debilitating in the early stages, there is normally no need for X-ray or MRI scan. What it does require is correct assessment, advice and treatment if necessary.

Heave hoe!

In the springtime, when people are venturing into their gardens for the first time since the autumn, they are faced with a multitude of jobs that lie ahead. This can be for some especially hazardous with tasks such as digging, mowing, weeding and pruning. In my experience, by making a few small changes in the way you would normally perform certain tasks, even long term back pain sufferers can still enjoy gardening.
For gardeners some of the hazards include:
• Sustained bent postures – (weeding)
• Overstretching – (pruning)
• Repetitive movement – (digging)
• Lifting heavy loads in awkward position – (wheelbarrow)

Pace and prevention

General prevention activities include core strengthening exercises, such as Pilates, to build strong abdominal and back extensor muscles to support your back. Maintaining a healthy weight and active lifestyle will also go a long way in preventing chronic back problems. As you head out to the garden, plan the tasks ahead and be sure that they are achievable within your physical limits and time frame! Treat gardening as a sport; warming-up and stretching works for the runner, the same precautions will work for the weekend gardener in preventing injuries.
Make sure you wear appropriate loose fitting clothing, gently stretch the muscles of your back for a few minutes prior to starting. Avoid repetitive or sustained positions. Some jobs, such as digging an area of garden, are repetitive. Break the task down into smaller chunks so as not to over exert yourself.
If there are heavy objects to shift either break the load down to smaller manageable amounts, use a long handled wheelbarrow or get someone to help. Take regular short breaks, this will help stop you overdoing it.
If you are a person who suffers from chronic or intermittent back pain you are potentially at greater risk of injury. There are several ways you can help yourself:
• Have the right tools for the job; many injuries are caused by using tools not appropriate to the specific task. Garden tools come in many shapes, sizes and weights. Go for the ones with either long or telescopic handles, this will reduce the risk of being in sustained compromised postures and repetitive bending.
• Make the design of your garden work for you. The type of gardening you do and the design of your garden can have an impact on back pain. For example if you have very wide flower bed these should be narrowed to reduce the amount of bending and reaching.
• Raising the height of flower beds can also be a great advantage by reducing the need for bending.
• Use a coiled hose for watering to reduce the need for carrying heavy watering cans.
• Pace yourself and appreciate your physical endurance and limitations.

And finally…

If despite your precautions you do sustain back pain which does not subside quickly it is important to get quick professional advice. Physiotherapists are specifically trained in the comprehensive assessment and diagnosis of back pain. When appropriate, physiotherapists provide a wide range of treatments to not only relieve pain but to promote movement and restore normal function. Treatment could include specific hands on approach with joint manipulation/ mobilisation / soft tissue massage and specific exercises for mobility and strengthening.

For further information please contact:
Physio2go Ltd.
York Lodge,
St. Peters St,
St. Albans,
AL 1 3HD
Telephone: 01727 850925