28 Mar 2024

Is there a fix for back pain?

From Afternoons, 1:25 pm on 28 March 2024

We talk about the effect of stress on hearts but not enough about its relationship to musculoskeletal pain, says physiotherapist Antony Bush.

Feeling stressed can lock our bodies into a state of 'freeze', he tells Jesse Mulligan.

"If we can't fight, we can't run away, we freeze up and we get really tight. That adds loads on our joints."

Physiotherapist and fitness counsellor Antony Bush

Physiotherapist and fitness counsellor Antony Bush Photo: Total Fitness

Antony Bush has 30 years' experience in spinal pain and musculoskeletal injuries. His new book is called The Back Fix.

The Back Fix book cover

The Back Fix book cover Photo: Supplied from PR Gill Hughes

As we age, gripes in our back are as normal as wrinkles, Bush says.

"We think that pain is something sinister and ir's not. For 95% of us, back pain is just a normal part of the human highway of life."

Persistent back pain can be scary, he says, but it's rarely dangerous.

Unless your pain is determined to be the result of a fracture, cancer, or a significant disc herniation causing loss of strength, bladder or bowel control, then lifestyle factors are probably playing a big role.

"It's about our workload and our environment, our activity levels, whether we're sleeping well, fatigue, general health...

"Are you working long hours? Are you tired, stressed, fatigued, rundown? That's where your back pain is coming from, not some pathology in your back."

Back pain is often the result of how we are and aren't using our bodies, Bush says. Most of us spend prolonged periods in one position every day.

"if you looked at another animal that sits staring at the wall all day or an animal that has a highly repetitive activity all day, we would think that animal in the zoo was sick. Our scope of existence has reduced and we're not moving around as freely and as often so there's sort of different types of back pain. But if we look upstream, it's our lifestyle that's causing a lot of our back pain."

Joints don't like sitting in one position for a long period of time, he says, and will respond by becoming tired and sore.

"We're looking at screens, most of us are, on average, nine hours a day, I think. And joints don't like point-loading in one position, they like to move freely through their range of movement.

"You can sit in the best position possible - up dead-straight - and that will give you pain if you sit there all day."

Bush recommends people get up and move around for at least 20 or 30 minutes during the day.

"Go for a walk, put your desk up, stand for a while. Put it back down again, sit. You just need to keep these joints moving through their range of movement."

Too much time living in our heads isn't working out well for our backs, Bush says.

"We've lost our relationship with movement. We're not moving around enough. 1000 years ago, we were hunter-gatherers on the African plains. We were walking for three to six hours a day.

"We are a self-healing animal and I think we're victims of our own technology, really. Our scope of existence is really reduced. We're sitting inside, we're not moving around enough. We just need to be moving in a well-paced way and a bit of back pain is okay and it doesn't mean we need to stop everything."

Walking is a really good activity for back pain, Bush says.

"Like opposable thumbs, walking upright is one of the things that defines us as human.

"We need to be walking more on our breaks, not sitting down having a cup of coffee or sitting down to lunch, we need to be walking around the block."

Strengthening our muscles is also essential, Bush says, especially via squats, aka "the king of the exercises". 

"Do some squats. move your joints and in multiple planes. Don't just sit there in one position all the time.

"You do want to be doing some strengthening and some movement and staying fit and able because strong muscles equal strong joints. It's not all about just tightening your tummy muscles. And in fact, those people that have chronic back pain often clench their muscles and that can give them pain 'cause they stay too stiff and they don't bend."

Looking after your back involves staying active, staying strong and keeping moving, Bush says, all in "a well-paced way".

"It's the one-offs that get us [hurting our back]. It's helping somebody shift house and moving a 100-kilogram fridge when we haven't been going to the gym and doing squats."

If you have chronic back pain,  disregard the old advice to 'Bend your knees, not your back', Bush says.

"Bend your back normally, don't hold it stiff."

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