WHY ME?

If you or someone you know suffers, or has suffered from back pain, you are by no means alone. Back pain is very common. Almost half of all adults suffer from back pain that lasts for at least a day each year.

HOW COMMON IS IT?
Back pain is the second common medical complaint, after the common cold. Back pain is so common that it is highly likely that the majority of us will suffer from it at some point. It been estimated that 60-80% of people are affected by back pain at some time in their lives. Back pain is one of the main reasons for absence from work, and each year millions of working days are lost due to back pain.

Low-back pain is the most common cause of limitation of activity in the young and middle-aged and is one of the most common reasons for seeking a medical consultation Every year about 5 million people see their GP because of back pain.

CHANGING TRENDS IN BACK PAIN
Back pain is becoming a bigger problem than it once was. But why is this? Many possible explanations have been proposed.

• We are more aware of our health and well-being than we used to be. If we have a problem we are more likely to seek medical help than suffers in silence.
• We expect more from our health services. When we go to see the doctor with back pain, we expect them to be able to do something about it.
• We work longer hours than we used to and are under more stress in our everyday lives.
• Changes to our diet and the popularity of convenience foods (coupled with our reluctance to exercise) means we are more overweight than we used to be.
• We lead increasingly sedentary (or inactive ) lifestyles. We drive for longer periods, take less exercise and spend hours sitting in front of the television or computer.

WHO GETS BACK PAIN?
Whilst we are all at risk of experiencing back pain, some people are more susceptible than others. Back pain becomes more common as we grow older and is most common between the ages of 35 and 55. Even so, children increase their risk of developing back pain by spending too much time hunched over a computer, or by lugging heavy school bags to and from school. Some 30% of children carry school bags that weigh over 10% of their own body weight.

Whether or not (and how frequently) you experience back pain depends on:

• how active you are (your mobility)
• mechanical causes
• underlying diseases
• your job
  

BACK PAIN AND IMMOBILITY
There are many reasons why we are less active than we used to be. Cars, television and computers may make our lives easier, but they are also causing us many health problems. By becoming less active (as well as eating more 'junk' food) we are becoming heavier and in some cases obese and our muscles and bones are becoming weaker. These are all risk factors for developing a back complaint.

Adult obesity rates have almost quadrupled in the last 25 years.

CALCULATE YOUR OWN BODY MASS INDEX (BMI)
It's very simple to work out your own BMI, to see whether your weight has put uyou at risk of back pain. Grab a tape measure, bathroom scales and a calculator. Follow these two steps.

• Measure your height in metres. Multiply this number by itself and write down the answer.
• Measure your weight in kilograms. Divide it by the number you wrote down in the first step. The number you get is your BMI.

For example: if your height is 1.80 metres, when you multiply this by itself you get 3.24. If your weight is 80 kilograms, divide 80 by 3.24 to give 24.7

As a general rule, for adults aged over 20:
- less than 18.5 underweight
- 18.5 ideal weight
- 25 overweight
- 30 obese
- 40 very obese

Remember though that your BMI is only a broad indicator - it is affected by your body style - people with a very muscular build will have a higher BMI but may not be unhealthily fat. Your age and gender also affect your BMI. Some experts say that men can have a slightly higher BMI before they are at risk, probably due to the fact that they are usually more muscular than women. However, it is best to stick to the guidelines above - they are internationally accepted boundaries for both genders. The BMI scale does not apply to children though, or during pregnancy.

BACK PAIN AND DRIVING
People who drive over 25,000 miles a year take about 22 days off work every year with back pain, compared with 3 days for low-mileage drivers.

Our fondness for driving goes hand-in-hand with our tendency to shy away from exercise . Often, we will hop in the car, rather than walk down to the shops or to school or work. Whilst this may save us time, in the long term it may also increase our chances of developing back problems and other health problems. It is well known that people who lead active lifestyles are less likely to die early, or to experience major illnesses such as heart disease, diabetes and colon cancer.

Unfortunately for some people, spending long periods of time sitting in a car is unavoidable (eg. taxi drivers, bus drivers, sales people). The constant vibration of the wheels on the road , hunching over or gripping the steering wheel, sitting in the same position and stretching to depress the clutch or see out of the mirror, all take their toll on your back. It's not just the driver who can stiffen up in a car either - passengers care often seated for long periods of time in a fixed position.

If you do spend a lot of time in your car there a number of things you can try to make yourself more comfortable:

• bring your seat forward so that you can depress the clutch without having to stretch
• adjust your mirrors properly
• take regular breaks, ideally once an hour
• try to avoid twisting when getting into or out of the car
• keep a small cushion in the car to support your lower back
• choose a car that is suited to your needs

CHOOSING THE RIGHT CAR
The Praying Test - Place both hands together, pointing forwards. You should be pointing straight at the centre of the steering wheel.

The First Test - Make a fist with your left hand, keeping the thumb to the side of the index finger. If you have sufficient headroom then it should be possible to insert the first on the crown of the head.

The Look Down Test - Place both hands evenly on the steering wheel and look down at your legs. You should be able to see equal amounts of both legs between the arms.

The Right Leg Test - After driving the car for a short while, look down and examine the position of your right leg. Your right foot should still be roughly in line with your right thigh.

The Kerb Height Test - Swing your right leg out of the car as though you are getting out, and place your right foot on the ground. The surface of your right thigh should be slopping downwards (not upwards) towards your right knee.

THESE TESTS SHOULD ONLY BE PERFORMED WHEN THE CAR IS STATIONARY AND CAREFULLY PARKED.