Pandemic Back Pain

Mark: Hi, it's Mark from Top Local. I'm here with Wil Seto, Insync Physio in Vancouver, many time winners of Best Physiotherapists in Vancouver, Best Physiotherapists Clinic, and will himself has one Best Physiotherapists in Vancouver as voted by his customers. And of course, today, we're going to talk about something that's a little bit different pandemic back pain. What the heck is pandemic back? 

Wil: Yeah. Yeah, they basically you know, with this pandemic that we're all living through right now, it's just a lot more people working at home and trying to set up whatever they think is you know, sort of a workstation or an office it can be ranging from like super great ergonomics to really poor. And I still see the people that have the great ergonomics. To especially the people that have poor ergonomics, you know, back pain. 

And so the other thing that's also important to understand with how this pandemic back pain is also the history behind each individual. Like I can say right now before the pandemic, like I used to see maybe like 25, 30% of this in the clinic on my caseload, and it's jumped from like 25 to 30% to more than 75% of everybody, if not more, like they have some form of this pandemic back pain. So someone comes in for, yeah, it's my shoulder and they're trying to stay active, but then they also work at home a lot.  But then my, yeah, my neck and my back also hurts too. 

And so a lot of it is posture related. So when we talk about pandemic back pain, it's really just the postural insufficiencies. And if you have a preexisting injury, or co-existing injury and that can actually contribute to that pandemic back pain even more. And so obviously, you know, that's a huge factor, but then if you've never had any history and you start getting this pandemic back pain, then that's also another can of worms.

So, you know, if you're doing a lot of sitting and I've said this to a lot of people before and sitting is like the new smoking. It's basically, so horrible for your body. And when you're sitting, especially if you're doing a lot you know, that's all you do 8, 10 plus hours a day. Your hip flexors will get really tight and everything just stiffens up and you get obviously lack of blood flow in your whole body and the muscles.

And then you get all this compression in certain areas in your spine. Then what happens is that your body learns that. And then you start to develop a new normal for your range of motion and your mobility. And then also the muscle extensibility, you know, so the joint mobility, joint range of motion and the muscle extensibility, all that starts to adapt to your new way of working and how we've been working mostly from home now, a lot of people.

And so someone that doesn't have a previous history, now this is the thing that I want to talk about today, because this is the thing that really has been on rise with the whole pandemic. And so I started to see all these muscle imbalances. So the biggest thing is really when you have a lot of imbalance happening in your hips and like, I see people like they wanted to try and get a running a little more, but then if their hips are super tight, then they're going to start having issues in their lower back. Like your hip flexors are really tight. It can change the alignment. And the positioning of your pelvic bones and then cause more compression in your lower back. And it can increase your what's called your lumbar lordosis, which is a natural curve in your lower back.

And so there's like, you know, a few main hip flexors, muscles that make up your hip flexors. And so when you're sitting all day long, you know, those hip flexors will just shorten. And then if you're not doing things that augment that by trying to switch up your position, stand a little bit, sit a little bit, then that will start to be adaptively more sore.

And even with standing, you know, someone comes in, I had a client that came in , I stand all day long. I don't know why my back hurts. Well, you know, it's that long position. And if your hip flexors are tight to begin with, and you're standing all day long, then now your back is going to have that increase a lordotic curve even more. And then you're getting even more compression in certain areas. 

So they did some research studies where they looked at even just the imbalances that are happening in the hips and if certain areas are less flexible or less mobile, and then you have weaknesses in certain areas, then, you know, when you go to walk or you go to run, you know, that's going to be accentuated.

And so then you're going to start to have the sort of repetitive strain and what we call running related injuries. And I treat a lot of runners. We treat a lot of runners in the clinic and we have like a treadmill to look at, the biomechanics and to really assess, you know, the mechanics of running.

And it's interesting to see before we even get them on the treadmill. It's like, you got all this going on and just by looking at alignment and movement, we can already do a lot of things to help with that. 

Mark: So the answer isn't having a standing desk like I have here, it's a standing and has sitting desk because I have listened to my good friend Wil and I don't stay in one position all the time. I like to talk standing up though. I feel more natural with that, but it's switching between the two on a regular basis is really important all day long. 

Wil: Yeah. As a ergonomic strategy yes. And then if you're like looking into getting into something that you haven't really done before, if you're doing a little bit more of, or if you're doing a lot more sitting now, and then you're still maintaining your sport of running or whatever it is. Looking at making sure that you have that mobility in your hips. Have that mobility and the strength to be able to compliment you to keep doing, or to start that new sport or activity that you want to do.

Mark: Yeah. So what's the treatment protocol? What's the prognosis for somebody with pandemic back pain? 

Wil: Yeah. So with someone that has never had a trauma or anything like that, and it's just sort of creeping up on them. And the most common thing that I find is all these muscle imbalances. So we want to start to correct that. We want to basically start to get areas in the hip, areas in the back even to be more mobile. So it's about the mobility of the joints. The mobility of the whole segments around the back so it's also the upper back. So if it's lower back pain that you're getting, then you want to make sure everything above there is moving well. And then the hips and pelvis are moving well. 

And then the supporting strengthen core stabilization. And so there's a lot of different things that we can do in the clinic, obviously, that kind of help facilitate that from doing a lot of like soft tissue release techniques that, even getting in there with some IMS with some dry needling kind of thing, and then very specific exercise rehab stuff to really kind of facilitate that process.

Mark: And typically what's the more of a normal treatment course. 

Wil: Yeah, it ranges like it can be someone like, you know within a session or two they're like, wow. It's from like, you know, an eight out of 10 pain to like now it's like a one to two out of 10 pain. And just one or two sessions to like, it takes them up to like maybe even four or five sessions, depending on how chronic and how long you've left it for or they left it for. Yeah to basically up to maybe even eight to 10 sessions and be like, I'm totally 100% better. 

Mark: Well, let me ask you a little bit of a wild card question here, because I bet you see this a lot. People come in, they feel better, they got some exercises, they kind of started doing it. And over time a month, two, three months later, they're not doing those exercises anymore. Is that a really good way to do things? 

Wil: Yeah, obviously not. And I think the biggest thing is that a lot of the times, once it becomes out of sight then becomes out of mind. So the pain goes away and then you think you can let it slip. And then once the imbalances start to come back and you may not even be symptomatic, I may not have pain, but once those imbalances that to creep up, then it's a lot harder to try and rectify that. But you can, you definitely can because you know, it just takes a little bit of work. But then sometimes it gets to the point where now you're in this pain and this function, and then, you know, it becomes desperate. But yeah, it's definitely not ideal. 

Mark: So, if you're desperate with back pain, the guys to see your Insync Physio. We highly recommend that you don't wait until you're desperate and go and see Wil because they'll get it fixed up really quickly and get you on an exercise program that will keep you fit and healthy and surviving this whole pandemic hoo-ha in a much better way.

So reach them at their website insyncphysio.com. You can book online for both of their offices right there. Or you can call. For Vancouver at the Cambie Street office is at (604) 566-9716. Or in North Burnaby, you can call (604) 298-4878. Get yourself booked. Get in there. Get feeling better. Let's survive this thing. Wear a mask.

Thanks Wil. 

Wil: You bet. Thanks Mark.