22 December 2012

Rwanda: Sitting Position a Major Cause of Low Back Pain

Low back pain is one of the most common complaints amongst the working class in our society. Back pain is itself a symptom and not a disease. It is an indication that something is wrong either with some part of the spine itself or with the nerves and muscles in the back.

Low back pain is the most complaint in our society that has been diagnosed without an underlying physical illness. Some people have learnt about the use of movable chairs as a solution of back stress that enables them to change sitting position adequately.

Modern or soft material made chairs have replaced wooden or desk chairs that used to inflict problems to many people.

Sitting on a metallic or wooden chair all day puts a person at a great risk for low back pain or injury. For most people this position is more natural than standing or even sleeping. Here you realise that there is high need for change of sitting position that can be either upright or slight bending.

Low back pain is still a major problem to people having office work due to long hours of continuous sitting. This is because when you sit, your lower back supports more than half your body weight.

Though we admit that sitting position can damage the back in a variety of ways, the main cause of the low back pain stems from the fact that the back is pulled out of its natural position when the legs are at a 90-degree angle to the hips.

However, the hips stop rotating after the first 60 degrees of descent and moving the legs in final 30 degrees into position makes muscles of the back of the thigh pull the bottom of the pelvis forward to cause a major neuro-muscular complaint. Neuro-muscular related illnesses are those that involve skeletal muscles and nerves. Skeletal muscles are muscles that have attachment or relation to bones.

Persistent low back pain or generalised back pain is one of the major indications for physical therapy. It is strongly believed that low back pain is linked to weak muscles and tight hamstrings.

Low back pain can be caused by the inability to activate certain muscle groups, especially those involved in active movement of the body. When muscles have not been actively used or involved for some time, they become lazy. Therefore, use of these muscle groups should come from an understanding by an individual. A person should know their health benefits.

In our daily language or lives we know very well that if you have a valuable commodity that you do not put to use, you risk losing it. Likewise this applies to our health when it comes to understanding of our physical make up.

People should also know that a tighter spine or strong back with health skeletal bones that consists of well supported muscles and ligaments is healthy. This is because the stronger the muscles that secure the spinal column, the better the body will be able to move.

For physically fit individuals, sitting straight on a chair is good. However, slouching is dangerous because it strains the ligaments. For unfit individuals, sitting in an erect position can strain the muscles around the spinal column and this puts stress on the disks of the spine.

Now people have to understand how to use their body in order to avoid the occurrence of persistent low back problems. For example, sitting for lengthy periods, then springing up quickly can lead to an injury that involves either skeletal muscles or nerves. Some elderly people with weak skeletal support can develop vertebral disk displacement but that is rare.

You should also avoid leaning forward from the chair to stand up because this might cause shear compression on the spine. But instead hinge from the hips as the hips and the torso function as one unit.

Another good habit is to raise the seat or desk surface to a supportable height because it puts the hips at a better angle and allows the spine to remain in its natural shape without any added stress.

Proper exercise is ultimately the best solution to help lower back pain. Exercise and movement will develop tonicity and certainly strengthen core muscles. This also helps to hydrate the disks around the spine and to alleviate pain caused by lack of fluid. Exercise actually pumps fluid into the disks in the spine or vertebral column. Exercise can help rehabilitate painful back muscles and can act to protect and prevent future injury of the back.

The author is a doctor at the Rwanda Military Hospital 

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