Back Talk - An Owners Manual for Backs
Contents
1. Lumbar spine Sacrum C Q D un Fes gq cr un cr S O cr g O m lt O og Q 2 NU Back and side view of the spine Vertebrae The spine is composed of boney blocks called vertebrae that are stacked on top of one another and separated by shock absorbing discs The neck has seven vertebrae The chest has twelve vertebrae each carrying two ribs There are five vertebrae in the low back or lumbar area The remaining fused vertebrae create a solid base called the sacrum and the coccyx or tailbone Discs Discs act as cushions between the vertebrae They have a very strong tough outer casing with a firm jelly like substance inside Discs are firmly attached to the vertebra above and below and can withstand considerable compression A disc can never slip out but can be ruptured causing the jelly like substance to protrude As people get older their discs become degenerated This is a normal aging process and for most people it does not cause any problems Facet joints Facet or apophyseal joints connect adjacent vertebrae and allow the vertebrae to move on each other Vertebra Disc Facet joint Lumbar disc and facet joint Muscles Back abdominal and buttock muscles add stability to the spine and help maintain proper posture Abdominal muscles Muscle systems of the back buttocks and abdominals Spi2. It is particularly important to seek professional advice if you experience any of the warning signs described on page 10 In most cases back pain is not caused by serious injury or disease People who remain active and get on with their lives despite feeling back pain tend to do better than people who avoid physical activity If you have back pain you can expect things to improve within a few days or weeks However some back pain may last longer Also when you ve had one episode of back pain you may have another in the future This does not mean it is a serious problem Episodes of back pain generally settle down with time and in between episodes life is normal You may need to rest for the first day or two but try to resume your daily activities as soon as you are able In the past back pain was treated with long periods of bed rest but bed rest has been found to be harmful to people with back pain Staying active even while experiencing some pain will help keep you fit and speed up your recovery yoeq Sulpueysiapun gt Surgery is rarely required for back pain X ray CT or MRI scans are not typically needed to understand back pain They may be useful if someone is considering surgery but clinical examination is the best step to decide if surgery should even be contemplated Some of the terminology used in medical reports may sound scary For example degeneration is a very common finding but it isn t as bad
3. Fax 604 232 1946 Courtenay 801 30th Street VON 8G6 Phone 250 334 8765 1 800 663 7921 Fax 250 334 8757 Kamloops 321 Battle Street V2C 6P1 Phone 250 371 6003 1 800 663 3935 Fax 250 371 6031 Kelowna 110 2045 Enterprise Way V1Y 9T5 Phone 250 717 4313 1 888 922 4466 Fax 250 717 4380 Nanaimo 4980 Wills Road V9T 6C6 Phone 250 751 8040 1 800 663 7382 Fax 250 751 8046 Nelson 524 Kootenay Street V1L 6B4 Phone 250 352 2824 1 800 663 4962 Fax 250 352 1816 North Vancouver 400 224 Esplanade Ave W V7M 1A4 Phone 604 276 3100 1 888 875 6999 Fax 604 232 1558 Prince George 1066 Vancouver Street V2L 5M4 Phone 250 561 3700 1 800 663 6623 Fax 250 561 3710 Surrey 100 5500 152 Street V3S 5J9 Phone 604 276 3100 1 888 621 7233 Fax 604 232 7077 Terrace 4450 Lakelse Avenue V8G 1P2 Phone 250 615 6605 1 800 663 3871 Fax 250 615 6633 Victoria 4514 Chatterton Way V8X 5H2 Phone 250 881 3418 1 800 663 7593 Fax 250 881 3482 Head Office Richmond Prevention Information Line Phone 604 276 3100 1 888 621 7233 621 SAFE Administration 6951 Westminster Highway Phone 604 273 2266 Mailing Address PO Box 5350 Stn Terminal Vancouver BC V6B 5L5 After Hours Health amp Safety Emergency 604 273 7711 1 866 922 4357 WCB HELP RO6 06 Printed in Canac
4. BACK TALK AN OWNER S MANUAL FOR BACKS 1G TO MAKE A DIFFERENCE Re worksafebc com About WorkSafeBC WorkSafeBC the Workers Compensation Board is an independent provincial statutory agency governed by a Board of Directors It is funded by insurance premiums paid by registered employers and by investment returns In administering the Workers Compensation Act WorkSafeBC remains separate and distinct from government however it is accountable to the public through government in its role of protecting and maintaining the overall well being of the workers compensation system WorkSafeBC was born out of a compromise between B C s workers and employers in 1917 where workers gave up the right to sue their employers or fellow workers for injuries on the job in return for a no fault insurance program fully paid for by employers WorkSafeBC is committed to a safe and healthy workplace and to providing return to work rehabilitation and legislated compensation benefits to workers injured as a result of their employment WorkSafeBC Prevention Information Line The WorkSafeBC Prevention Information Line can answer your questions about workplace health and safety worker and employer responsibilities and reporting a workplace accident or incident The Prevention Information Line accepts anonymous calls Phone 604 276 3100 in the Lower Mainland or call 1 888 621 7233 621 SAFE toll free in British Columbia To report after hours and week
5. ad work with a partner Get mechanical assistance for heavy loads Know your own strengths and limitations Use proper lifting bending and sitting techniques on the job to help avoid low back injuries in the workplace un Q A gr go ga ga Q Q Suke Safe lifting technique Many people who have back pain are afraid that any exercise will cause further damage The fact is most backs benefit from exercise Strong flexible muscles are essential to a healthy back They support the spinal column and determine posture which is the key to a healthy back If your muscles are weak or tight back injuries are more likely and recovery is more difficult Exercise is the only way to keep your muscles healthy Exercise to Build strength and endurance for more efficient support and better posture Stretch shortened muscles that are causing imbalances Maintain mobility of joints When you have an episode of back pain you may find exercise more difficult Try to stay as active as possible to promote recovery from your back pain episode m X go Q T g D gt eL lt O n og A O N Exercises Stay fit by exercising regularly to maintain a proper balance of flexibility strength and endurance On the following pages you will find exercises designed to improve and maintain the overall fitness of your back Cardiovascular exercise such as walking
6. al curve allowing the muscles to relax The feet should be supported The height of the seat should place the knees level with or slightly higher than the hips Stand up regularly at least every 45 minutes and walk around If you sit at a computer try raising the screen to eye level and adjusting the chair so you don t have to lean forward Good posture lying down Lying on your side with hips and knees bent may relieve back pain One or both legs may be bent If only the top leg is bent place a pillow under the knee to prevent twisting If lying on your back with your legs straight leads to low back pain try bending your knees There is no perfect mattress or pillow that will resolve back pain A good mattress for you is one that allows you to sleep well and awake refreshed There is no one perfect posture You may find it helpful to change your posture frequently and determine for yourself the most comfortable position It is particularly important to stay healthy and prevent injury to the lower back when you are on the job Good ergonomic design in the workplace is important as are the rules for safe lifting and oa Always follow these rules even for lifting light objects Place your feet apart for good balance Bend your knees Hold the object as close to your body as possible Lift smoothly and slowly Pivot with your feet don t twist the back gt Push rather than pull a load Share the lo
7. as it sounds Degeneration of bone and tissue is a normal change that comes with age Discussing these medical terms with your doctor will help you understand what they mean How can I prevent my back pain from becoming chronic The risk of back pain becoming chronic is linked to the way people view their pain and the extent to which they remain active For example if you view back pain as a serious medical condition you are actually increasing your risk of developing chronic pain On the other hand if you think your back pain will get better even though it s a nuisance you reduce your risk of developing chronic pain Hurt does not always mean harm One of the most important things to do is to play an active role in your recovery rather than looking for a prescription or specific treatment as the answer People who are off work for more than a month increase their risk of chronic pain and disability People who reconnect with work even if they have to modify their activities for a while are more likely to recover If you notice you are starting to withdraw from others or are feeling blue this is a warning that you could be at risk of developing chronic pain If you cannot manage these feelings on your own talk to a friend or a professional Spine The main functions of the spine are to Support the trunk and the head Allow flexibility of the body Protect the spinal cord Cervical spine Thoracic spine
8. control You may need to take the painkillers for a few days or you may need to take them for a week or two Heat or cold Heat or cold may help relieve pain and relax muscles In the first 48 hours try a cold compress on the sore area for 5 10 minutes at a time You don t need a special cold pack a bag of frozen vegetables wrapped in a towel can do the trick Some people prefer heat such as a hot water bottle a bath ora shower Massage Massage is one of the oldest treatments Many people find gentle rubbing eases the pain and relaxes muscles Spinal manipulation Spinal manipulation such as that provided by chiropractors osteopaths physiotherapists or other qualified health care practitioners may help early on with back pain The benefits of spinal manipulation should be felt within a few sessions If you do not feel better after a couple of weeks you may not be one of the people helped by manipulation Other treatments Many other treatments such as electrical stimulation acupuncture or alternative medicine may be suggested to treat your back pain There is no quick fix for back pain If you can stay active you ll have a much better chance of recovery a u O 3 M N Very few back problems are the result of disc injuries however when a disc is strained beyond its limit the outer casing can tear or rupture If the inner substance touches a spinal nerve pain may be felt in the leg This leg
9. cycling or swimming has been shown to help control low back pain This information is not intended as a substitute for medical attention If you are receiving professional care do only the exercises you have been instructed to perform At the end of this book is a chart for your health professional to write recommended exercises and the number of repetitions you should do Start with five repetitions of each exercise Progress slowly to 10 repetitions but use your own judgment and don t advance too quickly A minimum of 20 minutes should be set aside daily for doing your exercises Ifthe exercises cause an increase in pain consult your health professional 1 Pelvic tilt Lie on your back with your knees bent feet flat on the floor and arms at your sides Tighten your stomach muscles and flatten the small of your back against the floor without pushing down on the feet Hold for five seconds and then slowly relax q x lt D un go un 2 Knee to chest Lie on your back with your knees bent feet flat on the floor and arms at your sides Grasp your right knee and gently pull toward your right shoulder Hold for five seconds Return to the starting position and repeat with the left leg This is one repetition 3 Knee raises Sit upright on the edge of a chair with your back in a neutral posture maintaining the curves of the spine Tighten your abdominal muscles to brace your spi
10. end accidents and emergencies call 604 273 7711 in the Lower Mainland or call 1 866 922 4357 WCB HELP toll free in British Columbia OPPORTUNITIES AT worksafebc com careers Work SAFE BC WORKING TO MAKE A DIFFERENCE BACK TALK AN OWNER S MANUAL FOR BACKS WORKING TO MAKE A DIFFERENCE worksafebc com WorkSafeBC publications Many publications are available on the WorkSafeBC web site The Occupational Health and Safety Regulation and associated policies and guidelines as well as excerpts and summaries of the Workers Compensation Act are also available on the web site WorkSafeBC com Some publications are also available for purchase in print Phone 604 232 9704 Toll free phone 1 866 319 9704 Fax 604 232 9703 Toll free fax 1 888 232 9714 Online ordering WorkSafeBC com and click on Publications follow the links for ordering 1987 2003 2007 2010 2011 Workers Compensation Board of British Columbia All rights reserved The Workers Compensation Board of B C encourages the copying reproduction and distribution of this document to promote health and safety in the workplace provided that the Workers Compensation Board of B C is acknowledged However no part of this publication may be copied reproduced or distributed for profit or other commercial enterprise nor may any part be incorporated into any other publication without written permission of the Workers Compensation Board of B C 2011 edi
11. f the following signs or symptoms Pain that spreads down your leg especially below the knee and is accompanied by weakness tingling or numbness Severe pain that worsens over several weeks Problems with urinating or bowel movements Numbness especially in the area around your anus or groin Fever Unintended weight loss When back pain occurs What you need to do depends on how your back feels At night you may stiffen due to inactivity and feel worse in the morning You may need to get up alittle earlier to give you more time to work out this stiffness before starting your regular morning activities Here are some things you can do Use some measure to control pain see below Modify your activities for a short time if necessary Most importantly stay active and get on with your life If you think back pain is caused by your work the Occupational Health and Safety Regulation requires you to report it to your supervisor or first aid attendant Measures to control pain Painkillers Acetaminophen for example Tylenol is the simplest and safest painkiller You can also add anti inflammatory medication such as ibuprofen for example Advil or aspirin These simple over the counter painkillers are often the most effective for back problems It is important to start with the full recommended dose and take them regularly every 4 6 hours as you need them It is important not to wait until your pain is out of
12. nal cord The spinal cord is the bundle of nerves that leads from the base of the brain to the level of the second lumbar vertebra The lumbar spinal nerves join to form the sciatic nerves which run down the back of the legs Spinal cord Sciatic nerve Spinal cord Spinal nerves Between each two vertebrae a spinal nerve branches out from the central spinal cord and carries commands to the organs and muscles These nerves also send messages relating to touch temperature and pain to the spinal cord and the brain If anerve is pinched by a protruding disc you may get leg pain Cauda equina Pia mater Dura mater Nerve root Branch to facet joint Branch to body Branch to muscle Branch to disc Nerve Spinal nerves Ligaments Ligaments are bands of tough tissue between the bones that keep the vertebrae in good alignment and help keep the spine stable F Posterior ue pu longitudinal avum ligament Supraspinous ligament Anterior longitudinal Interspinous ligament ligament Ligaments yoeg Most back pain does not indicate any serious injury or damage Back pain may be called a sprain or strain Often we don t know the cause What we do know is that most back pain improves within a few days or weeks given the proper care Warning signs There are a few warning signs that you should pay attention to Consult your doctor as soon as possible if you have back pain and Feel any o
13. ne Slowly raise one knee up and move your foot off the floor without moving the rest of your body or pushing down on your other foot Hold for about five seconds before slowly returning your foot to the floor Repeat the exercise using the opposite leg 4 Cat stretch With hands under your shoulders and knees under your hips tighten your abdominal muscles to brace your spine Move your back down and up in a comfortable range of motion Repeat 6 10 times 5 Side bending With your feet shoulder width apart drop your head and shoulder while sliding your hand down your leg Bend sideways slowly as far as you can Hold for five seconds and repeat on the other side This is one repetition 6 Trunk extension Lie on your stomach Push up with your arms Keep your hands on the floor Let your stomach muscles relax and your back sag Be careful not to bend back too far Hold for five seconds Return to the starting position 7 Bridging Start with your back shoulders and arms flat on the floor and your knees slightly apart Squeeze your buttocks together and slowly raise them off the floor keeping your abdominal muscles tight Slowly return to the floor 8 Wall squat Lean against a smooth wall with your feet pointing straight ahead heels about 45 cm 18 in from the wall Slowly slide down the wall until your knees are bent to 90 Hold for five to ten seconds and slide back up As yo
14. pain is called sciatica Most disc problems improve without surgery Disc protrusion pressing on nerve Disc protrusion Proper spinal curves produce proper posture which will result in comfort normal spine is shaped as a double S curve with two curves to the front and one to the back These curves balance each other so that the head is supported on a pillar Neck or cervical lordosis forward curve Chest or dorsal kyphosis backward curve ne r F gr Q D 3 gr all F lt og D O N Low back or lumbar lordosis forward curve Proper spinal curve Poor Good Poor posture posture posture Forward Forward head head Rounded shoulders Balanced upright posture Flat Weak back abdominal muscles Good posture standing Good posture when you are standing is straight vertical alignment of your body from the top of your head through your body s centre to the bottom of your feet If you have back pain from standing in one position for too long try any of the following for relief Walk around from time to time Raise and rest one foot on a block about 15 or 20 cm 6 or 8 in high Crouch periodically to relax your back Ifyou have been bending forward stretch and bend backwards You might be more comfortable with your pelvis in a neutral position To do this the spine should be supported along its natur
15. r shower followed by stretching exercises Find the most comfortable position If you find heat or ice helpful don t apply it for more than 20 minutes at a time When the pain starts to ease do the following Stretch gently gt Walk around the room Walk around the house Walk around the block Keep moving a little further every day Swim cycle and exercise your back Other tips Maintain a balanced posture while standing sitting and sleeping Get on with your life this will help you cope and assist with recovery Do what you can following a back pain episode Stay fit and avoid overeating Keep a positive attitude Those who cope best know that the pain will get better Stop smoking Smoking is linked to back pain Don t rely on painkillers alone Connect with work as soon as possible You may need to modify your activities or job duties It s normal to have twinges aches or pains for some time after you are back to normal activity Exercise chart n zA pu VU Q YU Exercise Repetitions v M YU da 7 x Wi WorkSafeBC offices Visit our web site at WorkSafeBC com Abbotsford 2774 Trethewey Street V2T 3R1 Phone 604 276 3100 1 800 292 2219 Fax 604 556 2077 Burnaby 450 6450 Roberts Street V5G 4E1 Phone 604 276 3100 1 888 621 7233 Fax 604 232 5950 Coquitlam 104 3020 Lincoln Avenue V3B 6B4 Phone 604 276 3100 1888967 5377
16. tion National Library of Canada Cataloguing in Publication Data Main entry under title Back talk Richmond B C Back talk an owner s manual for backs Feb 1975 Irregular Issues for 1981 have subtitle An owner s manual for backs ISSN 1207 1501 Back talk Richmond B C 1 Back Care and hygiene Workers Compensation Board of British Columbia Il Title Back talk an owner s manual for backs RD768 B34 617 5 6 C97 800583 X troduction 2 Understanding Dack Damian 3 Understanding the structure of your back ssc 5 Back paipa oni 10 PES Srania a 12 Posture ane a healthy BaCk eniami aiina 13 Sale bending iting and CANYING dis amsn 18 Exeradse and your BAR end e 19 EXO ES ano AE attu 21 miperoryo ur Dac Kosasi eee rire mer re ere 32 Ferde Gha R R T 33 A go a n mr O Q c O O Our back is one of the strongest anatomical structures of our body Despite this about 80 of the population will experience back pain at some stage in their lives Even though back pain is common and may cause some people considerable pain serious or permanent damage is rare Fear and misunderstanding are two important factors that can delay recovery The information and advice in this booklet will help you understand the structure of the back and show you how to care for yourself during episodes of back pain This booklet is not meant to replace your health professional
17. u become stronger increase the time you hold the squat with your left foot and then slowly step back down with your right foot Do one set starting with one foot then another starting with the other 10 Partial sit up Lie on your back with your knees bent feet flat on the floor and arms at your sides Slowly raise your head and shoulders off the floor Slowly return to the floor 11 Bird dog With hands under your shoulders and knees under your hips tighten your abdominal muscles to brace your spine Slowly raise and lower your arm while keeping your back still Repeat the movement and then switch sides Slowly raise and lower your leg while keeping your back still Repeat the movement and then switch sides Progress to doing these exercises together when you are able to consistently control movement in the back O un at lt O ex pa 2 A Healthy diet Excess weight places an unnecessary strain on the spine The remedy includes developing good eating habits that provide you with enough nutrition without causing you to put on extra weight Have your doctor or dietitian recommend a proper diet that suits your needs Recovery from back injuries During an episode of back pain what you do early on is very important Resting more than a day or two usually does not help and may prolong your recovery If you have back pain you may want to take a hot bath o
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