Common Chronic Back Problems

Chronic back problems are among the most common medical problems faced by Americans, affecting four out of five individuals in the United States at some point in their lifetimes. Back pain is one of the most prevalent reasons for doctor visits and is the single highest reason for lost work time for individuals 45 years old or younger (Harris). As a result, its economic ramifications are truly devastating; the cost of back pain to the American economy—taking into account factors such as medical bills, lost wages, and reduced productivity—has been estimated to be anywhere from $30 billion (Harris) to $100 billion (NCCAM) each year. Educating Americans everywhere about chronic back problems—specifically, about its risk factors, prevention, and treatment—is of imperative importance if these costs are to be reduced.

The extremely high incidences of back pain in the United States are likely first and foremost related to the sedentary habits pervasive in offices across the country. For countless Americans, the majority of the working day is spent sitting, usually both at a desk while at the office as well as on a car, train, or bus on their way there. This combination, which medical writer Liesa Goins has termed “commuting and computing,” often cuts off blood circulation to the intervertebral discs of the spine. Additionally, a sitting position puts more stress on the spine than an upright standing or reclined position. The cumulative stress on the spine resulting from hours of continuous sitting, in addition to the drastic reduction in blood circulation to the intervertebral discs, results in long-term damage to the back and spine, and is often a precursor to chronic lower back pain (Goins). Secondly, poor lifting technique and strenuous activity can also have deleterious effects on lower back health. Back injury caused by pivoting, twisting, or turning while lifting heavy objects (often as a result of insufficiently strong core and stabilizer muscles) or by improper lifting form (most frequently characterized by holding the object too far away from the body or lifting with straight knees and not employing the legs; both of these practices dramatically increase stress on the back). Failure to engage the abdominal muscles when lifting heavy objects prevents the back from receiving the support needed to prevent injury (Goins). This can result in strains or sprains in the muscles and ligaments supporting the spine, or more severely, the prolapse of an intervertebral disc onto a nerve (Harris). Lastly, excess bodyweight can put additional stress on the spine as well as the muscles and ligaments of the back, further increasing an individual’s risk for chronic back problems (American Obesity Association).

Preventing chronic back problems before they occur is essential if their cost to the economy is to be reduced. As is the case in preventative methods for nearly all problems, the suggestions presented here are most effective if integrated continuously as lifestyle changes; they are not quick fixes that can reverse years of bad habits. The long-term nature of these preventative measures makes an emphasis on early awareness and education even more important. First—and perhaps most importantly—frequent exercise is essential, as it strengthens and stretches the core muscles, which help stabilize the back and prevent injury. Weaker muscles, especially in the core area, result in more strain on ligaments and intervertebral discs. Secondly, when moving heavy objects, focusing on lifting them with proper technique can prevent strains and sprains associated with many acute back pain problems. The United Postal Service has established a few basic guidelines to be followed by its employees, who must safely lift many heavy objects over the course of a work day. These include bending the knees and keeping the back straight, without bending at the waist; keeping the object held close to the body; ensuring that the object is held at the mid-section of the body at all times, between the knees and shoulders; and lastly, that extraneous movements—such as changes in direction, twisting of the body, or pivoting of the waist—are eliminated (Goins). These principles, taken together, ensure that the muscles of the abdomen are recruited to provide the back with the support needed to lift an object safely. Lastly, practicing good posture—both when sitting down and standing up—by keeping the head up, shoulders level, and spine straight will help alleviate pressure on the intervertebral discs (Cooper).

However, when prevention fails and individuals develop symptoms, they are fortunate to have a myriad of treatment options available. Chiropractors employ a variety of techniques when treating back pain, including spinal manipulations, mobilization, and massage therapy. Chiropractic adjustment via spinal manipulation is one of the more common remedies for lower back pain, and involves a manual adjustment of dysfunctional vertebrae, resulting in an improved range of motion in the back as well as diminished nerve irritability (NCCAM). Similarly, spinal mobilization also seeks to enhance range of motion and joint function in the back, but instead employs slow movements (Yeomans). Depending on the patient’s symptoms, massage therapy may also be an appropriate remedy, reducing stiffness and improving circulation in the affected area.

The current state of chiropractic care offers patients new therapeutic methods that are setting new standards for efficacy, safety, and patient comfort. However, education about the causes of lower back problems remains as important as ever. Prevention truly is the best medicine when it comes to lower back health, and widespread adoption of the preventative measures discussed here are essential—the economic consequences of today’s back pain epidemic are simply too profound to ignore.