If you ask a reputable physiotherapist the real cause of back pain, his quick answer is gravity. What is gravity? Gravity is a force that naturally acts vertically and holds us down the earth. Without gravity we will fly off into space. We would jump and just keep going. That might sound like fun. We could not live very high up. For one thing, we need to breathe air. The higher you go, the less air there is. Therefore we need gravity to keep us down on earth.
From the moment we are born, our bodies are at mercy of gravity, a force that continuously created pressure and stress on all of our muscles, bones, joint and ligaments.
By far, the part of the body that is affected most by gravity is the spine. The combination of gravity and muscle imbalances shove the vertebrae together, pressing on the discs.
The inner core of your spinal discs consists of jelly-like material that acts like a shock absorber system, providing flexibility and cushioning when you are sitting, standing or exercising.
During your normal daily activities, gravity caused fluid to squeeze out of your disc into adjacent soft tissue. With less space between the discs, you lose some height. When you sleep, some – but not all – of the fluid soaks back into the discs.
During a typical day, you can lose as much as ¾ inch in height! And because there’s only a partial recovery at night, the average person loses ½ inch to 2 inches in height by their senior years (i.e. old age). Insufficient distance between the vertebrae can result in nerve root pressure, which in turn causes pain.
To make matters worse, very often pressure on the discs is not distributed evenly. Your discs were not designed to cope with such uneven pressure, and sooner or later it will be too much for them to withstand. The disc will bulge, herniated or slip, causing spinal nerve root compression and damage likely, a life with chronic pain.
Even the slightest increase in spacing can be enough to allow a herniated disc to pop back into place or relieve pressure from a compressed nerve. This requires a labour-intensive measure carried out by a skilled physiotherapist who is knowledgeable in anatomy and biomechanics of the human back. Gradually with dexterity, he will cause the ‘slipped disc’ to pop back and the nerve decompressed and you will be free from pain.
The spine is the main weight bearing structure of the body and houses the central nervous system (CNS). The more you move the more wear and tear the spine takes. Therefore pain and injury are extremely common.
More than 80 percent of the world’s population will experience lumbar pain at one point over a life-time. Lumbar pain is the number one reason for visits to primary medical physicians and number two reason for work absence.
You cannot avoid the effect of gravity, but you can minimize the effects of wear and tear. How? As a dentist is to tooth decay, a physiotherapist is to musculo-skeletal disturbances that might commonly involve muscle imbalance and spinal degeneration.
Exercise; this is not just a recommendation, it’s a must. The body is designed for activity, you therefore must remain active. Low impact activities such as stretching resistance training and swimming are great ways to minimise the effects of wear and tear of the spine and reduce pain. The experience and observations of a skilled physiotherapist will help enhance the health of your spine by tailoring your need.
Start a low impact exercise program today and let it be done daily, be proactive in your back wellbeing by practicing good body mechanics in your daily activities. Don’t wait for back pain, that’s like waiting until your teeth hurt to brush them.
Talk to your doctor for referral to reputable physiotherapist with sound interest and skill in back pain matters. Do not be in hurry for non-conservative options which outcome might be unpalatable and full of regrets and of course would be irreversible, because of their high rate of failure! Be rational in your options and make thorough enquiries before embarking on the choice.

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