Back problems have become a common disease. Over sixty percent of the German population has currently or has had to deal with back pain in the past. Almost 200,000 people are treated for slipped discs every year, while 70,000 to 80,000 are operated for it.
Office workers and truck drivers are occupational groups that will most likely suffer from a slipped disc.
The age of those affected is also decreasing. Whereas a few years ago those affected by back problems were mainly people between thirty-five and forty, they are now even as young as thirty.
The number of days of incapacity to work due to back problems is around 15 to 20 percent, which means more than 71 million days of incapacity to work. This disease, which is referred to as a widespread disease with good reason, costs the German economy almost 50 billion euros a year.
And this is also related to the way we move – or more precisely – don’t move in our everyday working lives.
What exactly is the intervertebral disc?
The intervertebral discs are cartilaginous, flexible fibrous bands between the individual vertebrae. They consist of two parts. A nucleus pulposus and an annulus fibrosus surrounding it. The nucleus consists of glycosaminoglycans and is able to store plenty of water. This puts the annulus fibrosus under tension.
The function of the intervertebral discs is to act like a shock absorber, absorbing or reducing pressure on the spine and distributing the pressure remaining evenly.
These extremely stressed fibrous brands only have a low level of metabolic activity. They are almost exclusively passively nourished by the outflow and inflow of extracellular fluid from the annulus fibrosus, which has small blood vessels. The nucleus pulposus is free of blood vessels.
To ensure the proper supply of nourishment to the intervertebral discs, it is necessary that they are repeatedly exposed to sufficient pressure throughout the day. This pressure is created by movement and strain on the spine.
If the intervertebral disc is pressed, squeezed, and strained, the outflow of fluid from the nucleus of the intervertebral disc is triggered. As a result of this process, the discs in between become up to one millimetre thinner over the day. Therefore, the height of the body can be reduced by up to two and a half centimetres in the evening. At night, while the spinal column is relieved of pressure, fluid flows into it again, so that the intervertebral discs are fully regenerated and ready for use the following day.
Having difficulties moving more
Intervertebral discs wear out faster when they are not well nourished. However, the only form of nourishment is to replace outflowing fluid with new incoming fluid that carries nutrients. This means that it is necessary to make the intervertebral discs work well by switching between movement and relaxation. The more fluid flows back in, the better the supply and the slower the wear.
Wear, in turn, means that the nucleus pulposus can no longer absorb as much fluid and becomes brittle. In addition, the annulus fibrosus becomes more fragile and riddled with fine cracks, so it can no longer adequately withstand the pressure that is exerted on it. This can then lead to a slipped disc. A slipped disc means that the annulus fibrosus tears or breaks in one place and the nucleus pulposus leaks into the surrounding tissue. The symptoms can vary in intensity depending on whether a nerve is affected or not. They range from extreme pain and paralysis or numbness to a complete absence of symptoms.
A bad sitting posture that affects the back for several hours a day can become a problem for the intervertebral discs in the long run.
As we age, the intervertebral discs wear out more and more. All it takes then is to put excessive or incorrect strain on them. Then, the nucleus pulposus can slip and either bulge the annulus fibrosus due to one-sided pressure (this is called a bulging disc) or break it (this is then a slipped disc).
There is also a risk of a slipped disc for young people who are overweight and do not move much, or who put the wrong weight on their spine or overload it. This can happen, for example, by lifting heavy loads incorrectly. If you bend forward and lift a load with a crooked back, you put a lot of pressure on the intervertebral discs of your lumbar spine. If you lift loads with a straight back, you will be more gentle on your spine.
Sitting on an office chair for long periods of time, especially in a static position, is just as damaging. It exerts greater pressure on the intervertebral discs compared to standing, for example, and prevents them from being relieved. By sitting still for long, muscles become cramped and can even shorten. But sitting for long periods is actually worst for the intervertebral discs and joints. They need constant strain and relief throughout the day to stay fit. That is why people who work in an office or as a trucker are particularly at risk of suffering a slipped disc.
In case the intervertebral disc has slipped in the area of the lumbar spine, severe back or neck pain occurs frequently. This pain can spread either to the leg or arm. It can appear suddenly, for example when lifting a load. The pain is made worse by any movement, including coughing or sneezing. Muscles get hardened. To protect the affected area, they harden as a reflex. Once the sciatic nerve is affected, the pain radiates into the leg or bottom. Depending on the seriousness, it may lead to neurological deficits. The leg tingles or becomes numb. Leg muscle paralysis can also occur.
If a slipped disc occurs in the area of the cervical spine, pain is felt in the neck. Often the neck is held crooked in a protective posture. The pain can radiate to the hands, arms, or the back of the head. Neurological deficits can also occur here, which are felt as tingling or numbness.
In case of slipped discs, which narrow the vertebral canal and the spinal cord running through it, a spinal paraplegia can arise. This manifests itself as paralysis or numbness of the skin. Incontinence of urine and faeces can also occur. Such massive incidents are very rare, but they are considered an acute emergency and must be operated on immediately.
A slipped disc that does not cause any discomfort because it does not constrict a nerve does not need to be treated. Slipped discs often do not come suddenly but rather announce themselves in advance by low back pain that may already radiate into the arms and legs.
Since the slipped discs need movement and long periods of sitting is damaging to them, the best way to prevent a slipped disc is to move. By a strong back musculature, the spinal column is relieved.
Especially back-friendly sports can be chosen, such as running of any kind, swimming, especially backstroke, and cycling with raised handlebars and in an upright sitting position.
In the office
If your job requires you to sit for several hours a day, you should get up every hour and walk around for at least two or three minutes. Walking to the kitchen or to a colleague is sufficient to start with.
You should also change your sitting position often. When doing so, one should definitely also loll, stretch as well as relax in a comfortable position. After all, moving around a lot while sitting is better than static, motionless sitting. This principle is called dynamic sitting and is really important.
Ergonomic office chairs provide better sitting postures. Models with a movable seat are helpful because you are always making small movements to keep yourself balanced. Alternating between an office chair and a kneeling chair can also provide relief.
Height-adjustable desks that allow you to work both sitting and standing are also highly recommended for the health of the spine. These desks also have other positive effects. For example, the ability to perform and concentrate increases when standing. However, you should not exclusively work in a standing position. Experts recommend applying the rule of 60/20/10. In concrete terms this means: 60% sitting dynamically, 20% working standing up and 10% walking around actively
In today’s world, we are often forced into a lifestyle that is not good for our backs and intervertebral discs. In order to compensate for this, we should get enough exercise and also make sure that our daily work routine is more active. This means getting up more often, walking around and doing tasks standing up. All these things can relieve the strain on the intervertebral discs and preserve them.