College students spend a long time sitting in class, reading, or working on computers, and a sizable number of students experience back pain throughout their academic careers. This can end up being a huge problem for students as they get older. Studies have shown that low back pain is one of the leading causes of disability (University of Illinois Mckinley Health Center, 2010). It occurs in similar proportions in all cultures, interferes with quality of life and work performance, and is the most common reason for medical consultations. Few cases of back pain are due to specific causes; most cases are non-specific. Acute back pain is the most common presentation and is usually self-limiting, lasting less than three months regardless of treatment (University of Illinois Mckinley Health Center, 2010). Cross-sectional data demonstrate that initial onset of lower back pain is expected to occur around the mean age of 30, and peaking in occurrence between the ages of 45 and 60 years. However, lower back pain is common in both older and younger adults, especially active students (Brennon, Graham, & Shafat, 2007). Lower back pain is ranked first as a cause of disability and inability to work, and is expected to affect up to 90% of the world’s population at some point in their lifetime. The annual first time incidence of lower back pain is roughly 5%, and the annual prevalence (i.e. those suffering at time of questioning) is between 15 and 63%. Prospective studies demonstrate that low back problems do not display a six-week spontaneous recovery pattern, as was once believed. The condition is regularly seen to worsen over time, becoming a chronic disorder, influenced by both physical and psychosocial factors (Brennon, Graham, & Shafat, 2007).
“The social determinants of health are the circumstances in which people are born, grow up, live, work, and age, as well as the systems put in place to deal with illness. These circumstances are in turn shaped by a wider set of forces: economics, social policies, and politics" (Thurston Arthritis Research Center, 2014). Your socioeconomic status controls how you live your life. This is your education, occupation and income. This will determine the food you eat, the place you live and what social activities you are going to get involved in. All these factors will determine your health. From the chart in the Australian Institute of Health and Welfare (2002), arthritis has 3 leading causes: tobacco smoking, lack of physical activity and obesity. Student age affects many health outcomes. College students tend to have tight budgets and not a lot of time to prepare meals. This often leads them to make food choices that are quick and inexpensive, such as fast food, which doesn’t have many necessary nutrients. Students also carry extremely heavy backpacks with textbooks and laptops. Routinely carrying too-heavy backpacks at a young age can cause stress fractures in the back, back and neck strain, inflammation of growth cartilage, and even nerve damage in the neck and shoulders. Pain results when the weight of a backpack pulls students backward, causing them to arch their back or bend forward to stay comfortable. These positions compress can the spine and cause further pain (Brody, 2012).
Along with the traditional medical approach of surgery and medications, there are many other forms of intervention for chronic back pain. They include but are not limited to: diet, exercise, and alternative therapies. Diet is an important part of living a healthy life, however, it is even more important when you are dealing with an illness such as back pain. A poor unbalanced diet could result in chronic diseases that adversely affect other parts of the body such as the back. Balanced diets high in calcium, vitamin D, and other nutrients contributes to strong, healthy bones. Conversely, tobacco and alcohol use can compromise the health of your bones and muscles, as well as your general immunity (National Osteoporosis Foundation, n.d.). Diet and exercise always go hand in hand together. There are many forms of exercise that can be done to reduce the pain and symptoms of chronic pack pain, such as stretching, weight training and cardiovascular exercise. The importance of any form of exercise, especially ones that target your core abdominal muscle group and back muscles greatly decreases your likelihood of having low back problems. Exercises that focus on posture are especially effective, such as the Standing Back Bend shown in Figure 1 (National Osteoporosis Foundation, n.d.). In addition to exercise and diet, there is also the emergence and popularization of alternative medical therapies that can help reduce back problems. Therapies such as massage therapy, acupuncture and chiropractic aim to decrease the pain that is caused by a plethora of issues. In a randomized controlled study, treatment for low back pain was more effective for patients who received acupuncture than patients who did not (Brinkhaus, et al., 2006).
Squatting is a fantastic functional movement that will help undo the damage of sitting and if done correctly, will help to strengthen the lower body and parts of the back and core muscles (Rifkin, 2013). Push ups and pull ups will aid in strengthening the upper portion of the body so as to help with the pushing and pulling of objects while helping to keep posture strong and stable. The core is important for many reasons but for the purposes of protecting spinal health it aids in keeping the anterior upright which reduces load and stress on the spine.
Strengthening these muscles will help to protect the body from any physical trauma associated with extracurricular activities such as sports and intramural as well as help to keep everything in proper position (National Institute of Neurological Disorders and Stroke, 2003). Lugging a heavy bag around is strenuous for a weaker body and can lead to poor posture habits while a strong body will be able to endure such a task with ease. Making use of the already existing workout facilities to help strengthen the student body is a cost effective way to prevent back pain. Providing incentives to students who workout is a must (University of Texas Health Science Center, n.d.). Incentives such as extra credit, Credly badges, and opting out of small homework assignments, for example, would provide reasonable reason to workout out apart from the “its good for health and longevity” spiel that everyone has heard a million times.
Without the muscular system the skeletal system would fall to the ground in a pile of disarray. Muscles are very important in pushing the bones into position. If there are any mobility challenges caused by a variety of issues, then the skeletal system will suffer, thus sending pain signals to the brain. Sitting is the biggest perpetrator to bad posture and poor muscle health and it happens to be the activity that students do the most (National Institute of Neurological Disorders and Stroke, 2003). A simple, cheap, and effective method to increasing mobility and help to repair the damage from sitting would be to break lecturing up every twenty or thirty minutes and spend around five minutes doing simple stretches will casually conversing with the students (Rifkin, 2013). The cost for equipment is nonexistent since active, passive, proprioceptive neuromuscular facilitation stretching and static stretching can all be done without equipment. The only cost would be in educating the professors in simple stretches and providing them with a routine to do which would still be fairly minimum. Breaking up the lecture will reduce time partitioned for presenting information but studies show that breaking up study time will help to increase focus and information retention (University of Texas Health Science Center, 2008). This gives the professor a chance to speak with the students a little bit more formally and improve relations.
Low back pain that starts as an acute condition and worsens with age into a chronic condition is a major concern for health care professionals. Treatment can be difficult due to the behavioral changes required in diet, exercise, and substance use. In addition, there are many ways in which our culture promotes sitting and many people do not have the opportunity to move their bodies in school or work environments. Interventions within schools to promote stretching breaks, backpack weight awareness, and access to healthy, inexpensive meals could help students start good habits while they’re young. Hopefully they will then carry those good habits through adulthood, decreasing the prevalence of chronic low back pain in our country.
Standing Back Bends
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| Figure 1 Source: National Osteoporosis Foundation |
Purpose:
To stretch your spine and muscles for greater flexibility and movement.
Directions:
- Stand with your feet shoulder-width apart and your buttocks against a counter or heavy table that won't move.
- Place your hands at your waist. Pinch your shoulder blades back as if you are trying to squeeze a pencil between them. Then lean back slightly but stay comfortable.
- Your head should stay in its normal position. The underneath part of the chin should be level with the ground. Your eyes should be looking straight ahead.
- Hold for a slow count of 5.
- Relax back into your normal posture.
- Repeat 5 times.
- Repeat several times daily.
References
Australian Institute of Health and Welfare. (2002). Chronic disease determinants. Retrieved November 20, 2014, from http://www.aihw.gov.au/chronic-disease-determinants/
Brennan, G., Shafat, A., Donncha, C. M., & Vekins, C. (2007). Lower back pain in physically demanding college academic programs: a questionnaire based study. BMC musculoskeletal disorders, 8(1), 67.
Brinkhaus, B., Witt, C. M., Jena, S., Linde, K., Streng, A., Wagenpfeil, S., ... & Willich, S. N. (2006). Acupuncture in patients with chronic low back pain: a randomized controlled trial. Archives of internal medicine, 166(4), 450-457.
Brody, J. (2012, April 23). Heavy backpacks can spell chronic back pain for children. Retrieved November 13, 2014 from http://well.blogs.nytimes.com/2012/04/23/heavy-backpacks-can-spell-chronic-back-pain-for-children/?_r=0
National Osteoporosis Foundation. (2013). Food and Your Bones. Retrieved November 20, 2014 from http://nof.org/foods
National Osteoporosis Foundation. (n.d.). Posture Exercises. Retrieved November 20, 2014 from http://nof.org/articles/16
National Institute of Neurological Disorders and Stroke. (2003). Low back pain fact sheet. Retrieved November 30, 2014 from http://www.ninds.nih.gov/disorders/backpain/detail_backpain.htm#260493102
Rikfin, B. (2013). Squats and lower back posture. Retrieved November 30, 2014 from http://www.livestrong.com/article/380644-squats-for-the-lower-back-posture/
Thurston Arthritis Research Center. (2014). Social determinants and health outcomes. Retrieved November 20, 2014 from http://www.med.unc.edu/tarc/research/callahan-team/social-determinants-and-health-outcomes
University of Illinois Mckinley Health Center. (2010) Back pain: overview. Retrieved on November 20. 2014 from http://www.mckinley.illinois.edu/handouts/back_pain.htm
University of Texas Health Science Center. (n.d.). 10 things helps to increase retention. Retrieved November 30, 2014 from http://som.uthscsa.edu/StudentAffairs/10Things.asp
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