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Jan 09

The battle against backache…

A combination of poor diet, bad posture and lack of exercise can lead to chronic spinal problems

An estimated 70-80% people will suffer from significant backache at some point in their lives—and more and more youth are now beginning to suffer from it.

That’s what Mihir Bapat, consultant spine surgeon at Mumbai’s Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, says. It’s an opinion that’s shared by several doctors and orthopaedic surgeons, on the basis of anecdotal data.

Having a spine, a character virtue, unfortunately can also lead to health issues. A combination of careless diet, poor posture and lack of exercise has made backaches an increasingly common, and disturbingly unconnected-to-age, trend.

Raison d’être: Muscle imbalance is the basic source of pain in the back.

Raison d’être: Muscle imbalance is the basic source of pain in the back.

Though there are no known studies in India specific to back problems, doctors use data from other countries when estimating the high number of people likely to be affected by them. For instance, a New York Times article, Sit Up Straight. Your Back Thanks You, in June said up to 80% of Americans experience back pain at some point in their lives.

It’s the long hours at work, mostly spent in front of a computer, and the natural tendency of the human body to bend forward, that leads to a poor posture. The hunched slouch of James Dean in the poster of the 1955 film Rebel Without a Cause might look cool but it does the back no favours. Muscle imbalance is the basic source of pain in the back, shoulder and neck, says Abhishek Srivastava, consultant, centre for physical medicine and rehabilitation, Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute. “It leads to more stress on the spine, the disc comes out, leading to nerve compression,” adds Dr Srivastava.

Dr Bapat says the second reason young people, some still in their teens, are falling prey to spinal problems is poor diet, and the fact that they don’t spend enough time outdoors. There are two outcomes of this: overweight and calcium/vitamin D deficiencies.

Abhay Nene, a consultant spine surgeon at Mumbai’s Hinduja Hospital, says up to 80% of the people who come to the hospital with aches and pains are deficient in vitamin D. A survey by doctors at the hospital in early 2011 found that 77.5% of 561 males and 72.68% of 443 females who had come to the hospital for routine health check-ups were deficient in vitamin D, a surprising statistic for a city that’s predominantly sunny. For the sun is the best source of vitamin D.

“Vitamin D and calcium deficiency is an urban epidemic,” says Dr Nene. “It leads to poor muscle tone. That’s because we are not exposed to sunlight enough. Even an hour outside a day is not enough because we are anyway mostly covered up.” Dairy products, Dr Nene adds, are good sources of calcium, though major deficiencies can be addressed with supplements.

An improper diet, doctors say, also increases weight, which puts a constant load on the spine. “Controlling your weight is most important,” says Dr Bapat. “Particularly after the age of 25, you need to maintain your muscle strength as well.”

Some back problems are inevitable, like disc degenerative diseases (as the spinal vertebrae naturally degenerate over time). For the rest, there’s hope.

… And ways to win it

You are what you eat

There is a reason why women suffer from backache during pregnancy—too much weight adds a constant load on the spine. It’s also the reason men with potbellies would have a similar problem. In addition, calcium and vitamin D deficiencies weaken the bones. Cod liver oil, milk products and eggs are good dietary additions, besides supplements which can augment your diet.

Get some sun

The urban lifestyle keeps people indoors—in air-conditioned offices, cars and homes. That Goa beach holiday would be timely; alternatively, just sun yourself in the balcony. Dr Nene suggests taking regular breaks from the city to take to the outdoors.

Sit right, sit tight

Dr Nene says that while sitting, the back should form a convex rather than a concave form, which means your lower back should be curved inwards towards your front rather than the other way around, with shoulders pushed back. Long hours on a desk or in front of a computer can lead to slouching.

The centre of the computer screen should be at eye level, at least 20 inches away, and the desk height should allow your forearms to rest comfortably at a 90-degree angle. Keep your feet flat on the floor and your back against the chair. Use a cushion at the bottom of the spine if your chair is not well-designed – or while driving. Get up and stretch every hour; sitting for long periods puts pressure on discs and fatigues muscles. Roll your shoulders backwards 10 times and tilt your neck up and down and sideways in both directions 5-10 times.

Exercise

Prescribed: Yoga helps prevent and reduce backache.

Prescribed: Yoga helps prevent and reduce backache.

Former Australian cricketer Matthew Hayden, in his 2011 autobiography ‘Standing My Ground’, quotes his mantra: “The pain of disappointment is much more than the pain of discipline.” Sure, it’s a drag to get to the gym or do 20 laps in the pool or walk among noisy cars and bikes on busy roads. But these activities will get your heart rate up, keep your weight in check and get you those precious moments under the sun when outdoors.

Dr Nene says a gentle use of musculature, like brisk walking, is enough, so you don’t have to necessarily grunt under a barbell. Dr Bapat says it’s best to start easy, with 40-minute walks for three-four months, before increasing intensity as desired. This year, like every other year, make that resolution to exercise, but this time, ensure you stick to your plan.

Yoga is great at preventing and controlling back pain as it has specific exercises aimed at improving core strength—abdominal muscles and lower back.

The good news, if it can be considered that, is that just 5-10% of the people with back problems will need surgery. In most cases, say experts, an understanding of the problem, and rehabilitation (physical exercises targeted specifically at the back) will do the trick. “Rarely do we intervene as surgeons,” says Dr Nene. “These weekend ailments (occasional, and therefore treatable) can be managed.”

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