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LBP Among Doctors... Lawyers Get It Too!

This article first appeared in E-Berita March 2023 issue, the monthly magazine of the Malaysian Medical Association.  Copyright © 2023
Reprinted with permission from the Malaysian Medical Association
Low back pain ("LBP") can be described as self-reported discomfort in the spinal region (pain between the lower costal margins and gluteal folds) that persists for at least one day over 12 months and may or may not radiate down the leg to the knees or below.
If a person experiences variable or persistent LBP for more than three months, they are said to have chronic LBP.  Acute (short-term) back discomfort can last from a few days to a few weeks.  There is typically no long-term loss of function and with self-care, will resolve on its own within a few days.
Studies have shown that physicians are more likely than other health workers to experience LBP, which is more common than any other musculoskeletal disorders.  Physicians are also susceptible to twisting bending, maintaining awkward postures for a long time, and lifting heavy loads.
General Risk Factors for LBP
As we get older, LBP episodes may become more frequent, often with the first episode occurring between the ages of 30-50.  People with less physical fitness tend to experience back pain more frequently because their muscles may not be able to support the spine as well.
Having a large body mass index ("BMI"), being obese, or rapid weight gain can strain your back and make it hurt.  Some back pain reasons have a genetic component such as ankylosing spondylitis (a kind of arthritis that affects the spine).
Sitting at a desk all day, especially when combined with poor posture or being seated with insufficient back support, can also cause back injuries.  Other job-related factors include jobs that require heavy lifting, pushing or pulling, twisting or vibrating the spine, or heavy lifting.
Stress and anxiety can create muscle tension, and melancholy, mood swings, and anxiety can affect how employees perceive back pain.  Smoking can reduce the amount of blood and oxygen getting to the discs, thus hastening their deterioration.
Signs and Symptoms of LBP
These could start slowly or appear suddenly. Sometimes pain develops following a specific action, like bending to pick something up.  Sometimes, the root causes are unknown.
The bottom or the back of the legs may be affected by pain that is either severe or dull and achy (sciatica).
Moving or straightening the back could be challenging.  When getting out of a seated position, it could take some time, and we might feel like we need to stretch or go for a stroll.  Our range of motion might be reduced.
Remedies for Back Pain

Rest, ice, and over-the-counter painkillers are typically effective treatments for lower back discomfort. Pain treatment may include nonsteroidal anti-inflammatory medicines ("NSAIDs").  Several “hands-on” techniques can help to loosen up tense muscles, lessen pain, and enhance alignment and posture.  Depending on the underlying source of the problem, we may require osteopathic treatment or chiropractic adjustments.  Back pain reduction and function restoration are additional benefits of massage treatment.
Medication (steroids) is injected with a needle into the painful location.  Some illnesses and traumas may call for surgical intervention utilizing minimally invasive methods.
Recommendations for Maintaining a Healthy Back

Some simple tips include:
  • Steer clear of motions that jolt or strain your back.  When exercising, opt for low-impact exercises for the lower back and abdominal muscles.
  • Keep a healthy weight and consume a balanced diet to encourage the creation of new bones.  Use furniture and tools that are ergonomically built.
  • To ease stress, frequently switch postures while sitting and take short breaks to stroll around the workplace or gently stretch your muscles.
  • Use low-heeled footwear.
  • Sleep on your side with your knees up in the foetal position to lessen the curvature of the spine.  This can aid in opening up the joints in the spine and alleviate pressure.  Always snooze on a solid surface.
  • Avoid using your back to lift anything overly heavy.  Keep your back straight, and use your legs to lift by bending your knees and bringing the object closer to you.
  • Stop smoking as smoking lowers blood supply to the spine.  This speeds up spinal disc aging and worsens recovery while raising the risk of osteoporosis.