If you continuously do a desk job, you are likely to spend your majority of day with your neck pitched forward, your shoulders slumped and eyes on a screen.
Over time, this posture can take a toll on your neck and shoulders, warns Dr Fahad M Shaikh, consultant orthopaedic surgeon at the Masina Hospital, Mumbai.
Back pain is a chronic problem affecting a large part of the population across the world.
Approximately 18% of the total world population is suffering from back pain due to various causes ranging from postural acute back spasm to debilitating spinal instability requiring operative management.
Back pain is endemic to any given population, mostly the geriatric age group or those involved in heavy lifting professions. But in the pandemic, a new trend of work from home has resulted in increased cases of upper and lower back pain.
This is especially because office-goers are working from home and are deprived of work desk and chairs.
While some have turned their dining tables to work spaces, others continue to use their couches and beds for the same.
There is an increase in the number of back aches due to poor posture.
Shutting down of gyms and staying indoors has also resulted in inactivity and lack of exercise leading to increase in cases of back problems.
Understanding the types of back pain
There are various ways to classify and identify back pain.
Depending on the duration, it can be classified as acute and chronic.
Acute back pains are usually less than a month old, while those continuing over a month would be categorised as chronic back pains.
These can be further divided into recurrent (which come and go) and persistent (continue without cessation).
Depending on location of pain they are categorised as:
- Upper back pain (includes neck and shoulder),
- Mid back pain (dorsal spine and related structures) and
- Lower back pain (lumbar-sacral spine with or without radiation to legs).
Another way to classify back pain is -- whether back pain is associated with nerve involvement or not.
Whenever back pain is associated with radiation down either of the limbs and associated with heaviness or pins and needles sensation, there may be a nerve involved.
The treatment differs and intensifies requiring higher investigations including MR scans and nerve studies.
What is a good posture?
A good posture helps in maintaining the alignment of the entire spine, where the bones are optimally placed and supported by the muscles without stress on either.
The head is held vertical over broadened shoulders without stooping forward, which is maintained over the dorso-lumbar spine without side curvatures.
Any other way of sitting can cause back pain and spine related issues.
The right way to sit and how to place the computer
- Sit with a back support which keeps the lower spine concave outwards (lumbar lordosis)
- Back should be supported during long hours of seating
- Upper back and shoulder should be squared and not hunched.
- Elbow supported on the side of the body.
- Cervical spine should be straight.
- The screen should be brought to eye level rather than looking down.
- Seating height adjusted to a level where the hip is flexed at 90 degrees with feet touching the floor.
- Soft comfortable cushion preferably with a coccyx support on the chair.
- If you have a sedentary lifestyle, remember to exercise every 2 hours or so to rejuvenate the muscles.
What is bad posture?
Any posture that deviates from good posture is considered bad posture.
Due to work from home and staying indoors for long durations, the working population, especially those involved with long duration of computer use, have resorted to use any available home furniture.
When you do this every day, it gets uncomfortable. If you are unable to maintain good posture during long working hours, it could result in back pain.
Similarly, teenagers, and also adults spend an unusually large amount of time on handheld devices, on social media and the Internet watching online series, chatting and messaging each other.
Lying in bed with laptops on their sides or in their laps or holding cell phones for long durations grossly deviates from good posture.
Many of them end up with acute upper back, neck and shoulder spasm, which when neglected results in exacerbation of symptoms leading to complete debility for even weeks adding to their pandemic woes.
The warning symptoms
Symptoms may differ from patient to patient as it is subjective.
The usual presenting symptoms are:
- Pain in upper or lower back with or without radiation to any of the limbs.
- Back discomfort after few minutes of standing
- Unable to hold posture or balance for a long time
- Headache
- Gluteal pains
- Pins and needle sensation in the hands or feet
Importance of Vitamin D
Vitamin D helps in assimilating the calcium into the bones which helps in making the bones stronger.
It is also responsible for maintaining good tone of the muscles, deficiency of which can cause hypotonia, as it helps in maintaining the integrity and quality of both muscle and bones. This vitamin plays a vital role in strength and function.
Vitamin D levels can be quantified by blood test which can be reviewed with a physician or orthopedician and doses can be prescribed as per the test results.
Prolonged deficiency of vitamin D causes Osteopenia (softening of bone) causing bone pain.
As vitamin D is synthesised in the skin with exposure to sunlight, many of us are deprived of daily sunlight due to our clothing, work patterns, busy schedules and 'stay indoors' policy due to Covid.
This makes it necessary to either get enough sunlight exposure or take recommended vitamin D supplements.
Treatment
One can avoid and reduce back pain by making small changes in daily habits along with regular exercise and conscious posture corrections.
Warm packs and some rubificient ointments or gel may further help.
Be informed of the correct posture while sitting, sleeping, working and performing daily tasks.
Always sit with your back straight and supported with the screen at eye-level.
Whether you are in office or working from home, exercise every few hours to stretch and strengthen your muscle.
The following exercises can be performed once or twice a day to keep the spine healthy:
1. Shoulder Shrugs
If you continuously do a desk job, you are likely to spend your majority of day with your neck pitched forward, your shoulders slumped and eyes on a screen.
Over time, this posture can take a toll on your neck and shoulders.
If you want to strengthen your shoulder, neck, or upper back, or if you wish to improve your posture, consider to add shoulder shrugs to your daily routine.
2. Shoulder abduction
This involves rotating the shoulder joints in such a way that you move the arm straight out and away from the body.
3. Upper back strengthening exercises
Hunching over a laptop, sitting at desk all the day can hurt your upper back.
Stretching and strengthening exercises can help restore and maintain flexibility, promote a range of motions and also improve blood circulation, all of which can help alleviate pain.
You can do neck side bend and rotation, shoulder roll, overhead arm stretch, chair rotation, thoracic extension, etc.
4. Static cervical spine exercise
Press your palm against your forehead and resist with your neck muscles. Hold for 10 seconds, relax and repeat 5 times.
Do this again by pressing on the side of your head, relax and repeat 5 times then switch sides.
Do this again by pressing on the back of your head, relax and repeat 5 times.
5. Interscapular exercise
One of the simple exercise is to stretch your arms out in front of your body.
Clasp one hand on top of other and gently reach out so that you feel your shoulder blades stretching away from each other.
Gently bend your head forward and hold for 10 seconds repeat 5 times.
6. Static lower back exercise
Lie on your back on a mat, knees up with feet flat on mat, pull the abs in and push your low back to the mat. Repeat 10 times.
Lie on your back on the mat, draw one knee to the chest while maintaining the abdominal draw in and do not grab the knee with your hand. Repeat 10 times each leg.
7. Lower back bridge exercises
Lie down on your back, knees in full flexion and feet flat on the floor and close to buttock. Then lift your hip off the floor towards the ceiling/sky as high as possible.
Other forms of exercises that can benefit the spine are hip girdle exercises and hamstring stretches.
Please note that all these exercises need to be learned and performed under the expert care of a qualified professional physiotherapist before you try them at home.
In case of severe pain or recurrent and persistent back pain is recommended to meet an orthopaedic specialist to identify and treat the cause.
You may be advised to get an X-ray or MRI scan done before you're offered an expert line of treatment.
