There are many health days in the year, but hardly any is probably of as much interest in physiotherapy as the Back Health Day.
are among the most frequent reasons for consultations in the family doctor’s practice. The clarification of the causes is decisive for a successful treatment. In addition to relieving the pain as quickly as possible, a chronification of the pain should be avoided. For non-specific back pain, a multimodal treatment approach with medical, physical, occupational and behavioural therapy components is useful.
This can be done in specialised outpatient pain clinics or on an outpatient basis in cooperation with physiotherapists. Especially in cases of persistent pain, physiotherapy can be used, preferably with educational measures according to behavioural therapy principles. GPs should also inform their patients early on that physical rest is counterproductive. In addition, it is important that the progress of the measures is regularly monitored and, if necessary, modified by a doctor if the effect is unsatisfactory.1
Diane Slater and her co-authors discuss the current research findings regarding posture and spinal pain in their article “Sit up Straight: Time to re-evaluate” from the Journal of Orthopaedic and Sports Physical Therapy (JOSPT). Pt – Zeitschrift für Physiotherapeuten has compiled the points, one or two of which will certainly surprise you, in German:
- There is no one “correct” posture: Contrary to common belief, there is insufficient evidence for the one “correct” posture that is optimal. Moreover, there are no typical incorrect postures that cause back pain.
- Differences in posture are normal: every person has an individual spinal curvature. There is no curvature shape that is specifically associated with the occurrence of pain. If pain occurs, it should not be directly associated with “non-normal” curvatures.
- Posture reflects emotional state: Posture can say a lot about a person’s emotional state, thoughts and how they feel about their own body. It can be helpful to analyse the reasons behind certain attitudes.
- It is not dangerous to adopt a more comfortable posture: Postures that are perceived as comfortable vary depending on the person. Trying out different postures – even those that are often avoided – and changing the usual posture can help to improve pain symptoms.
- The spine is robust: it is a sturdy, adaptable structure that can be moved and loaded in a variety of ways.
- Sitting is not harmful or dangerous: Sitting in one and the same position for more than 30 minutes is not dangerous or harmful. Nevertheless, it can be useful to move around in between and otherwise be physically active.
- There is not one universal solution for all: screening postures and movements in the workplace does not help to prevent pain. Certain lifting techniques are preferable due to the natural curvature of the spine. There is no evidence for the frequent advice to adopt a special posture or for bracing the core. 2