Edited by Fabio Grossi and Michela Verardo
The alterations affecting the spine represent some of the main health problems of our society and affect up to 80% of the European population. In recent years, many studies have highlighted the negative role of prolonged static postures, frequent bending and rotation of the trunk, lifting loads, and poorly adjusted daily movements for the spine.
A rather innovative approach for some pathologies (cervicalgiee, postural lumbago, etc.) can come from the postural study of the subject suffering from these problems. The purpose of a postural observation is to stimulate the person suffering from back pain not to underestimate the problem and to undertake - together with their doctor - a real therapeutic path, which in most cases can lead to the solution of the problem .
The structure of the vertebral column that more than any other undergoes an alteration, due to incorrect positions, is the intervertebral disc . In the various positions of our body (standing, supine, sitting) the intervertebral discs undergo a different pressure which is distributed over their entire surface, thanks to the liquid contained in them.
The Swedish researcher Alf Nachemson has carried out important and in-depth studies to know the pressure values that occur in particular on the third lumbar disc, in the different positions we assume and in the movements we perform in everyday life. The third lumbar disc, in the light of these studies, seems to undergo a load of 30 kg when the human body is in the supine position, 70 kg when in a sitting position, 210 kg when the body lifts 20 kg with the back flexed and the knees straight .
These scientific assessments, together with the constant need to maintain the physiological curves of the spine, suggest a useful way to keep the spine efficient - in order to avoid wear on the intervertebral discs and prevent the onset of pain - an adequate and personalized sports activities ; you should choose the positions and movements that cause less pressure on the intervertebral discs and (if the working conditions do not allow this choice) perform compensatory movements.
To allow the intervertebral discs to regain their original thickness and maintain their efficiency and elasticity it would be necessary to sleep a sufficient number of hours on a valid bed consisting of a mattress - preferably in natural latex with high elasticity and breathability - and a customizable support in staves.
The most frequent causes of back pain are to be found in work activities considered at risk (workers, painters, tilers, hairdressers, truck drivers), in inadequate sports activities, in incorrect postures during domestic activities, in emotional tension, in traumas in gender.
Back pain on a postural basis is nothing but the consequence of incorrect movements, physical efforts, and recurrent incorrect postures during daily activities.
Some suggestions on the use of footwear concern the sole - which must be in leather - and the tip of the shoe, which should be wide. With rather high heels you can reach a weight pressure of 80-90% at the level of the metatarsals.
In particular, some studies on videoterminal workers have highlighted the presence of disorders in the vertebral column in a higher percentage compared to a control group and to that found in porters or laborers, thus demonstrating in fact the negative role of fixity in front of a video terminal.
The cervico-dorsal column during the day is clearly subjected to greater stress as it is subject to continuous flexion-extension movements. The work activities most at risk for this part of the body are those of precision - art, graphologists, orologists - or painters, cleaners, farmers, as well as behaviors such as watching television in bed or using unsuitable pillows .
The lumbo-sacral tract of the column is stimulated above all by fixed postures prolonged in an upright static position (housewives when ironing, traders working at the counter, dentists, etc.).
Some useful tips to reduce low back pain caused by fixed postures could be:
- take long walks whenever possible;
- practice simple extension and flexion exercises;
- sleeping on your side with your knees bent or lying supine with a pillow under your knees;
- during the standing static position use a support package for the lower limbs on which to unload the weight of the trunk, alternatively;
- adapt workstations according to ergonomic criteria.
Other subjects at risk for the lumbosacral area are truck drivers, commercial agents, taxi drivers, and anyone who uses the car as a work tool.
It should be emphasized that a comfortable night's sleep is important in order to lighten the workload that the intervertebral discs suffer during the day. Avoid the high pillow, as it forces the cervical tract of the spine into a flexed position and can therefore cause cervical pain and headache.
The shift of weights represents a rather critical moment for the lumbosacral column, so it would be necessary to teach the correct modalities of movement to the subjects who perform these functions for work.
Pregnancy, especially after the sixth month, leads to a lumbar hyperlordosis and therefore represents a risk factor for the lumbar region; but it is above all the period of puerperium that is the most dangerous, due to the greater commitment of the mother in caring for the newborn: even the gesture of raising a child can represent a significant risk for the spine.
The excess weight ( obesity or in the worst cases) causes a significant incidence of low back pain, given that it causes an important increase in pressure on the intervertebral discs, and the correlation of lumbar pains due to reduced oxygenation of the muscle structures now seems certain. -articles of the spine caused by cigarette smoke .
The competitive physical activities are often harmful because the spine is subjected to considerable workloads; this contrasts with the widespread opinion that sporting activity improves health and can prevent the appearance of back pain . Different discourse for recreational activities (skiing, swimming, biking, etc.) and physical exercise in the gym that can prevent - if performed in a personalized, physiological way, with adequate intensity and volume - the onset of painful vertebral episodes .