Low-back pain at work – what really does prevent it happening?

Well, I’ve banged on about it enough to my patients and now, as always, I’ve been proved right.

Firstly, you have got to understand that you are built on the design brief of Palaeolithic Man. In this massive design brief slapped down by God (or what ever supreme deity you want, such as ‘The Force’) there was no chapter on sitting on your butt and peering into a computer for 8 hours on the trot and there was no annex that that covered ‘Future proofing’ the structure. No, the main pages would have covered: ‘Running fast for a short distance to avoid predation’ and ‘Walk/Running for a long distance to improve chances of killing mammoth’.

So, your work posture is a real challenge to your body as it is a demand that is wildly outside the design brief, similar to using your car to climb trees, so no wonder it hurts.

The next point is that no manner of fancy chair, desk height re-alignment is going to make THE difference – yes, it will be less-bad for you than a really crappy one but you’ll still be in the region of bad and it will never be the answer. (And the best would be a height changing desk that allows you to stand at the thing every now and then – search the web). So, get a decent desk, a decent chair (IKEA £50 is what I am using) and save the money on some of the ‘orthopaedic products’ out there.

Why do I say this? Well look at this bit of really solid recent research:

The paper is called:
High-quality trials on preventing episodes of back problems: systematic literature review in working-age adults

It was produced by Bigos SJ, Holland J, Holland C, et al. from Department of Orthopedic Surgery at the University of Washington and published in the serious Spine Journal in 2009; 9: 147-168.

The study looked at clinical or educational approaches (exercise or education), personal appliances (back supports or shoe inserts), ergonomic equipment (lift assists etc.), changes in physical activities or work duties and administrative or social interventions such as work policies or social changes. All trials included had high quality scores, 90% investigated workplace settings, and 50% involved health care workers and, eventually, 20 prospective controlled trials were included and evaluated. Of these 20 rigorous trails 5 measured objective outcomes and the remaining 15 measured only subjective outcomes.

At the end of the day exercise was the only intervention found to be effective. 7 out of 8 exercise trials reported statistically significant reduction in back pain and 5 of the 7 successful exercise programs included 45-60 minutes of supervised exercise, twice per week for 3-12 months (most also encouraged additional exercise without supervision).
The exercise techniques included McKenzie (Google that one), active and passive back extensions, core stabilization, “Williams” exercises and Mensendieck trunk exercises (again, Google).

NO other intervention was found effective in reducing back pain.

And, negative results were found in all studies on ergonomic/back education, stress management, lumbar supports, shoe inserts, and programs for reducing lifting tasks.

So, the story is that the exercise that your Palaeolithic ancestor did is exactly the stuff you need to do to survive doing strange things with your back to prevent it going wrong. No wonder we advocate core stability, rehab and sports therapy at C1. We can get you right but you must keep yourself there.

So stop putting your faith in futuristic looking mesh back multi adjustable seats and desks made from dolphin-friendly ethically resourced wood and get some core stability into you and then go for a run.

Makes sense, yes?