Health – The spine: fragile or robust?

At any given time around 20 percent of adults in the workforce suffer from back pain. In addition, a survey of 3000 working-age Kiwis found a nine percent rate of absenteeism from work due to lower back pain.

According to ACC statistics, the building and construction industry has had the highest number of accident related claims year on year. As a physiotherapist we frequently see people in our clinics presenting with acute or chronic low back pain because of injury or overuse.

With this in mind, it is easy to believe that the spine– specifically the lower back – is fragile and easily injured. However, this is not entirely true. As part of undergraduate training, physios attend labs at Auckland Medical School. This includes several lessons in the cadaver labs. It was in these labs that I came to realise just how stable and robust the human spine truly is. The solid, brick-like bones carefully protect the spinal cord. Meanwhile, rubbery cushioned discs in between each vertebra allow for movement and shock absorption. This is before we have even considered the barrel of muscle helping to protect and move you. We have abdominal muscles at the front, oblique muscles on the sides, a diaphragm on top, and pelvic floor underneath. The lower back is literally encased in muscle from all sides.

However, despite this the lower back has one of the highest associations with stress, anxiety, and chronic pain. It is as though we have forgotten how amazingly robust the spine is.

Managing acute lower back pain is crucial in order to prevent it from becoming a chronic condition. The key is movement. The spine is designed to move freely, without bracing, rigidly blocking or avoiding movements. Not all pain is harming you – sometimes it’s just the body needing to be able to work back into an activity. Moving into painful ranges of movement may not be advised early on, but even simply getting out walking after a lower back injury can make all the difference. 

When pain levels are more under control, strength exercises become crucial to recovery. A cartoon that I once saw on the wall of a doctor’s office summed it up well – the forlorn patient was being told, ‘Well your back’s out because your front’s out’!

The best thing that you can do to ensure a healthy spine is to stay active and strong, and maintain a healthy body weight.

If you are unlucky and end up with a lower back injury, just remember – movement is medicine!