The nature of some people’s work, like sitting at a desk all day, or carrying heavy loads, is likely to create complications in the long run. One could develop compressions which may affect the nerves and muscles, eventually altering the position of the back. Experts say many people complain about lower back pain, which is a result of occupational hazards. At Physique Clinic in Remera, in a day, out of 20 patients attended to, 18 of them have issues related to back pain cause by oversitting. Under the Occupation Health and Safety ACT, occupation illness hazard is a condition that results from exposure in the workplace to a physical, chemical or biological agent to the extent that normal physiological mechanisms are affected and the health of the worker is impaired. CAUSES AND DETECTION Sheila Wibabara, a physiotherapist at Physique Clinic, says physiotherapy is the best treatment for back pain and some other related complications. She explains that the patient is first and foremost made aware of their condition, most importantly, why it’s happening. Many people are occupied with their work and only seek medication help when they have a fever or pain, she adds. Back issues happen gradually and in some cases, without one’s awareness, and if one is not cautious about their health, the issue gets worse and pain escalates. “Physiotherapy includes educating one on what should be done to prevent the issue and of course, treatment,” she says. When sitting in a straight position, sometimes people shift their weight to one side, changing the shape of the back and causing problems. Overtime, subconscious habits form and make it easy for people to increase postural stress leading to back pain because of putting additional stress on their bodies. When a patient comes in with back pain, Wibabara says the best thing to do is to first assess the muscle strength and the range of movement in the joints. Thereafter, techniques and exercises to be done are recommended in order to keep the joints working as well as possible. “Assessing the patient to understand where the backache is coming from is paramount. It could be due to the lifestyle one is exposed to, the kind of work they do, or from an injury or a condition they were born with and so forth,” she says. Knowing the problem and the cause of the pain helps a physician design a plan for treatment, depending on the underlying cause. Vincent Rwamamara, a Kigali-based physiotherapist, says one can be helped if they have hypermobile joints, where the range of movement is beyond normal. Rwamamara says this is the reason why it’s important to treat each problem depending on a condition one has after the assessment. When the problem persists without seeking help, it can lead to other health problems, he says. “The second supposition is that all back pain leads to a neurologic consequence. There is a chance this new pain could be caused by a more serious and surgical pathology, that if left untreated, could lead to serious medical consequences,” Rwamamara says. TREATMENT Esther Jolie Nandatwa, a physiotherapist at Physique Clinic, says the healing period with physiotherapy services depends on the condition, how it was before, and the patient’s discipline She says discipline comes first, adding that one is supposed to adhere to the full treatment and the advice given by their physician. For instance, she says, patients are advised to continue with some exercises even while at home and avoid oversitting or standing, which all bring about the problem. She says the treatment part is normally done in two ways; there is a particular session, for instance, where they deal with the problem depending on how it’s presented. She notes that back pain can sometimes irritate a nerve, and when this happens, traction is used mainly to reduce the pain on the lower back. Traction is a manual technique designed to reduce pressure on affected vertebral discs that are causing pain. It is a manual stretching of the spine, which reduces pressure on the discs and therefore reduces the individual’s pain. Apart from this, when it comes to physiotherapy to relieve back or any other kind of pain, mobilisation is also part of the treatment. Mobilisation involves massaging the muscles, offering exercises, and applying heat to relax the muscles. “All this is done because the treatment is meant to take the pain away and align the spine. But the moment one goes back to the habit of oversitting or standing, the back will suffer complications again,” she observes. Wibabara notes that the treatment has to be managed continually, when the session is completed and the pain is gone, a patient is advised to only sit for an hour and half maximum then stand up to relax or stretch in order to break that tension in the back. She says that it’s important for one to stand up for a few minutes, then sit down again or even work while standing if possible depending on the kind of job one does. Alternatively, she says walking around every one and a half hours is ideal. Drinking a lot of water throughout the day is also important. Swimming is also important to prevent back pain which, according to her, it’s vital to maintain a healthy and strong back. Rwamamara says swimming is an excellent form of low-impact aerobic conditioning that is easy on one’s back and spine. This is because the buoyancy of the water supports the body’s weight, reducing stress on the joints and spine and allowing for a greater range of motion. The buoyancy of the water, Rwamamara says, takes the stress off the joints. At the same time, swimming and other aquatic exercises can strengthen back and core muscles. PHYSIOTHERAPY VS ORAL MEDICATION Rwamamara says when it comes to physiotherapy treatment, one can also be given painkillers and neural care for the pain, especially for people who are experiencing severe nerve pain. The medication is meant to relieve the pain. However, he adds that the medication is only given when one has severe pain that makes even the exercises recommended hard. However, even with medication, physiotherapy is still recommended. Wibabara explains that this is because medication won’t completely stop the pain, rather, it will numb it and once the dose is done, the pain will come back. “Physiotherapy is a more permanent approach, especially if one sticks to the advice given to them by a physician, unlike medication which temporarily relieves the pain,” she says. There are some people who can’t work or sleep and so they are given painkillers to manage the pain so that they can carry on with their daily activities. Before doing any exercise, people with back pain should first seek medical advice. This is because some exercises aggravate back pain, therefore, avoiding them is important. Depending on the problem one has, physicians should come up with an exercise plan that suits each individual. Dr Daniel Gahungu, Practitioner at Galien Clinic, Kigali *********************** Identifying the cause of the back pain is important because it directs one on how to go about the treatment. A poor sleep position can also aggravate the pain; lying on the side can help prevent this. Dr Celestine Karangwa, Physiotherapist *********************** It’s advisable for people to avoid things that can make them get stressed. When the body is stressed, it can lead to severely tight muscles in the back that will eventually cause pain. Dr Janvier Rusizana, General practitioner at Clinique La Nouvelle, Remera *********************** Dietary such as caffeine, alcohol and too much sugar can also lead to back pain. Staying away from such foods is important and maintaining a balanced diet will help keep health conditions at bay. Paul Muvunyi, Medical student - University of Rwanda, College of Medicine & Health Sciences editor@newtimesrwanda.com
