מתוך medicontext.co.il
By Suzanne Rostler
WESTPORT, CT (Reuters Health) – Individuals with lower back injuries can actually exacerbate their pain if they avoid using the painful back muscles. Other muscles, including those in the abdomen, contort to compensate, leading to greater pressure on the spine and disc injury, explain researchers from Ohio State University in Columbus.
"We have often suspected that patients guard their trunk muscles but this [study] has shown for the first time how this results in increases in spine loading that can lead to secondary back injuries," lead author Dr. William S. Marras told Reuters Health. "This is important because second back injuries are often more serious and expensive."
In the study, published in the December 1st issue of Spine, researchers asked 22 adults with lower back pain and 22 adults without injuries to lift various objects using identical postures and then to lift objects in whatever position was comfortable or natural.
The investigators then measured the electrical activity of participants' muscles and compared spine loading and lateral shear measurements.
Adults with lower back injuries used more muscles in the back when lifting, creating greater pressure on the spine. Injured patients experienced about 26% greater spine compression, a 75% increase in lateral shear, and used significantly more muscle activity for 10 muscles than noninjured adults, the report indicates.
Additionally, people with lower back pain weighed more than their uninjured peers, a factor that significantly increased pressure on the spine.
"Excessive body weight, or a protruding stomach, is like always holding a box in front of you," Dr. Marras said in an interview. "One must counterbalance the weight with more activity in the back muscles that aren't as far from the spine. It is like a see-saw where the back muscles are not as far from the fulcrum as the weight of the belly."
The results of the study underscore the need for people with lower back pain to trim down, and suggest that physical therapy for certain types of back injuries aim to teach patients how to use their back muscles appropriately, the authors note. Typically, physical therapy focuses on strengthening the trunk muscles.
Additionally, workplaces can make simple changes that would help reduce lower back pain among employees with lifting jobs. For instance, Dr. Marras suggested that lifting be done from waist level instead of from below the knee.
"This would significantly reduce the loads on the spine even though the weight of the object has not changed," he explained.
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