The Impact of Low Back Pain in The UK.

The Prevalence of Low Back Pain in the UK

Low back pain is one of the most common non-life threatening health problems in the UK. It not only creates a huge personal inconvenience and hindrance to individuals, but it also affects the UK financially and as a national community.

According to a survey published back in 2000, almost half of the adult population in the UK reported occurrences of low back pain lasting for a minimum of 24 hours during the year. Two further reviews were conducted, one of which focused on the elderly and the other on adolescents, both of which identified high numbers of these populations suffering with low back pain. It appears from the research that the number of people with back pain increases with advancing age, starting in school children and peaking in adults of 35 to 55 years. Additional findings suggested that back pain was just as common in adolescents as in adults.

From these studies it can therefore be estimated that four out of every five adults will experience some form of back pain at some stage in their life. It can therefore be predicted that in industrialised countries such as the UK, up to 80% of the population will suffer with back pain at some stage in their life.

Causes of Low Back Pain

In the majority of cases it is very difficult to identify a single cause for back pain. As many as 85% of back pain sufferers no clear pathology can be identified.

However there are a number of factors which have been suggested to contribute to some forms of back pain. These include:

• Having had back pain in the past
• Smoking
• Obesity
• Physical factors (heavy physical work, frequent bending, twisting, lifting, pulling and pushing, repetitive work, static postures and vibrations)
• Psychosocial factors (stress, anxiety, depression, job satisfaction and mental stress)

Back pain is, in most cases, a self-limiting condition and 90% of people with acute back pain will recover within 6 weeks. However, up to 7% of people with acute back pain will develop chronic back pain. These chronic patients have considerable discomfort and account for approximately 80% of the social and health care costs.

The Cost of Low Back Pain to the UK

In most cases back pain is confirmed as nothing serious and can often disappear spontaneously and as quickly as it came on. The problem is the vast number of the population affected with low back pain. It is this that makes the condition very costly and imposes a considerable burden on the individual and society in general. According to the Health Executive figures (2005/2006) 3.7 million working days are lost per year due to episodes of back pain. In addition to this over £1 billion of public money is spent annually by the health service on back pain related costs, with an additional £565 million being spent in the private sector. This brings the healthcare costs for back pain to a total of £1.6 billion per year.

This is where the money is spent in the health service:

£512 million on hospital costs for back pain patients.

£141 million on GP consultations for back pain.

£150.6 million on physiotherapy treatments for back pain.

Back pain is the second highest reason for long term sickness in much of the UK. In manual labour jobs, back pain is the highest reason for long-term sick leave. Nearly 5 million working days were lost as a result of back pain in 2003-04. This means that on any one day 1% of the working population are on sickness leave due to a back problem.

The role of the Personal Trainer in the Management of Low Back Pain

Simple and easy measures can be taken to reduce the chances of developing back pain and thereby reducing the impact of existing back pain – all of which can be offered to clients though preventative, prescriptive advice. In addition to this physical exercise is known to be a very effective method to reduce the pain and discomfort that long-term pain sufferers experience, with much research suggesting that staying active is important when experiencing back pain as opposed to bed rest. Therefore with the appropriate qualifications Personal Trainers can offer their services specifically to those with low back pain.

As a PT, you should ensure your prospective low back pain clients have checked with their doctor that they should exercise. Once a client has been referred you can then carry out a postural assessment. Things you would look out for include:

• Left to right imbalances – mothers carry children on one hip, people often carry a bag on one shoulder
• Front to back imbalances – for example lordosis and kyphosis
• Leg length discrepancy
• Hip hitching
• Rounded shoulders from work/driving ergonomics

These imbalances that arise as a result of imbalance can often trigger pain in the back, hips, knees, and shoulders.

Once imbalances have been identified you can then suggest life style changes and exercises to help correct current imbalances and possibly prevent future ones.

Lifestyle change suggestions:

• Take regular breaks and work and move around
• Stretch daily/after exercise
• Use an ergonomic chair at work and get advice on how to sit correctly
• Ensure the car seat is in the correct position for you ergonomically
• Use left and right sides equally (holding a child/bag)
• When standing dissipate weight equally through both legs
• If you must cross your legs, cross them at the ankles only

Exercise examples:Continue reading below…

• Lie supine on a carpeted floor or mat. Rest your legs on a chair so that the legs from the heels to the back of the knees are fully supported. This technique mimics sitting in a chair/car seat but displaces the pressure on the back.
• Lie prone on a stability ball and let your body mould to the sides of the ball.
• Lie supine and hold your knees in to your chest.
• Perfect and perform sets of squats. With an improved ability to squat, there is a reduction in pain and improved ability to do functional activities things like go up and down stairs and sit to stand from a chair.