The Lancet: Low back pain is the leading cause of disability in the world. Sitting, standing or lying down, which one hurts the back the most?

"Doctor, help me take a look, my low back pain is dead."

Xiao Zeng is a 30-year-old office white-collar worker who needs to sit in front of a computer for a long time to work. Recently, Xiao Zeng found that his waist was often sore and painful, especially after sitting for a long time, the discomfort was more obvious.

She went to the pharmacy to buy some plasters to apply, and also went to the massage shop for a few massages. Each time the symptoms were relieved a little, but they recurred again and again after a while.

Finally, Xiao Zeng couldn't stand the pain, so he had to take leave to go to the hospital for an examination, only to find out that he had chronic lumbar muscle strain.

1. The Lancet: Low back pain has become the leading cause of disability in the world

How is your waist? Sedentary, women's menstrual period, physical labor, strenuous exercise... These are all causes of low back pain.

Low back pain is so common that many people overlook its seriousness. A review of 165 studies in The Lancet shows that low back pain has become the leading cause of disability in 126 countries, and the incidence of low back pain is increasing with age, with 40-69 year olds The incidence of low back pain was 28% to 42%.

In China, nearly 80% of the people may experience low back pain in their lifetime, especially the people aged 65-69 have the highest incidence.

So, specifically, what factors are related to low back pain? Clinically, it is a common method to judge the cause of low back pain according to the time of low back pain.

If there is no pain in the morning, and the pain becomes more pronounced in the evening , it may be caused by lumbar disc herniation.

If the pain is the most painful when you get up in the morning, and the pain is gradually relieved after activities, it may be a rheumatic immune disease.

If it hurts to fall asleep or even wake up, it may be osteoporosis or bone cancer.

If there is no obvious relationship between the occurrence of low back pain and time , it may be an organ problem, such as kidney and ureter disease, chronic pelvic inflammatory disease, etc.

The pathogenesis of low back pain is complex. If low back pain recurs, or sudden severe pain, it is recommended to go to the hospital to clarify the cause.

2. Sitting, standing or lying down, which position hurts the waist the most?

Improper posture is closely related to low back pain, and different postures have different pressures on the lumbar spine. In 1976, Dr. Nachemson's article published in SPINE magazine used a picture to show the waist force in different postures.

Among them, the load on the lumbar spine is the smallest when lying down, about 25kg, the load on the lumbar spine is about 75kg and 100kg when lying on the side and standing, and the load on the lumbar spine when the upper body is upright is about 140kg when sitting. It should be noted that, whether standing or sitting, when the posture is leaning forward, the load on the lumbar spine will be greatly increased.

· When lying flat, there is minimal pressure

"I don't want to sit, I'll lie down?" In fact, although the lumbar force on the lumbar spine is minimal when lying flat, the World Health Organization has put forward some definitions, physical activities with an activity intensity of less than 1.5 MET are considered sedentary .

And our common lying watching TV, sleeping, sitting watching TV, typing, riding a car, etc. are all less than 1.5MET. So even lying down is another kind of "sedentary".

Among them, especially Ge You lying down , although it is very comfortable, the damage to the waist is fatal! Ge You's lying position will make the lumbar spine in a suspended or flexed state without supporting force. At the same time, the cervical spine is flexed forward and the central axis of the body is moved backwards, which will cause soreness and fatigue in the waist. Over time, lumbar muscle strain, lumbar disc herniation, Spinal deformities, etc.

· Stress increases when standing

When standing, the load on the lumbar spine is about 100kg. Especially for people who are overweight, standing for a long time will cause more damage to the lower back . In addition to easily causing joint damage in the lower extremities, it may also cause peripheral vascular diseases such as lower extremity varicose veins. , and may even damage the heart.

A University of Toronto study found that people who work standing up for long periods of time have an 80 per cent increased risk of heart disease in women and a 39 per cent increased risk in men than those who work while sitting.

· When sitting, stress is greatest

Sitting still for a long time puts more pressure on the lumbar spine than standing still for a long time. The reason is that when sitting for a long time, the weight of the body is mainly concentrated on the intervertebral disc, which can easily lead to the herniation of the intervertebral disc.

Stretching the back muscles for a long time is also easy to fatigue, causing lumbar muscle strain. The correct sitting posture should be to keep the hip and knee joints at 90°, the backrest vertical, or add a small cushion at the waist to keep the spine in a normal physiological curvature, and change the sitting posture every 1-2 hours.

3. Low back pain, how to relieve it?

People who often have low back pain, or who often sit and stand for long periods of time, can be prevented or relieved through the following aspects.

1, strengthen the exercise

Many people think that bed rest is necessary for low back pain, but it is not true, especially for patients with lumbar disc herniation, proper strengthening exercise is more conducive to recovery.

If it is the first two days of low back pain, you can reduce your activities. After that, if there is no special discomfort, you can gradually resume your daily activities. After 2-3 weeks, you can perform aerobic exercise or muscle training.

2. Avoid sitting and standing for a long time

Sitting, standing and lying down for a long time may cause damage to the lower back and cause lower back pain. Therefore, we must learn to combine work and rest, stand up and move about every hour of sitting, and do not lie down for a long time, playing with mobile phones, reading books, etc.

In addition, pay attention to adjusting the correct posture when sitting, adjust the chair to the appropriate height, bend the knees 90°, and make the thighs parallel to the ground. Also, don't cross your legs.

3, sleep can not be casual

The bedding and sleeping position are also very particular. Try to choose a mattress with moderate hardness and softness, and there is no obvious sagging of the waist when lying on it. Do not sleep on your back for a long time. Lying on your side can slightly reduce the pressure on your waist. When lying on your side, it is best to clamp a pillow between your legs.

4. Exercise the strength of the lower back muscles

Perform low back muscle function exercises, such as Xiaoyan Fei, glute bridge exercises that can enhance the strength of the low back muscles.

The waist is located in the middle of the human body, and it has an important impact on personal posture and health. In daily life, we must pay more attention to protecting our waist, and don't wait until the waist hurts to regret it!

References

[1] "Low back pain makes people crazy! Try these 6 methods →". The Third Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine. 2022-10-21

[2] "Sitting still hurts the waist the most! "Lumbar Spine Precision User Manual" to learn about". People's Daily Online Health. 2018-12-02

[3] "Back pain in the morning or back pain at night, orthopedic doctor: different reasons...". Life Times. 2022-08-19

Reproduction is prohibited without the author's permission