Staff absenteeism due to back pain and mental illness like stress is becoming a major concern in Scotland. active-x clinics in Edinburgh provides osteopathic help for low back pain sufferers but will also provide preventative care including nutritional advice and a personal trainer. Not an HR professional? Feel free to pass this on to your HR department.

2. About this guide
This free guide has been provided by Clinic Director and Osteopath Gavin
Routledge from activex clinics in Edinburgh. If your work involves sitting for
long periods at a desk, lifting heavy objects or you are just prone to back pain
there is a lot you can do to help yourself.
Your employer has recognised the importance of helping you
manage your health and has provided you with a copy of this
guide.
If you have any questions about low back pain or any other kind
of pain that you need answering please check with a registered
professional.
This is one of 10 guides that will answer all the questions you
have about back care health. Feel free to pass it on to anyone
you know who might find this information useful.
For more help you can visit our blog
http://www.active-x.co.uk/blog
Connect on our Facebook Page
http://www.facebook.com/pages/Active-x-Edinburgh/170138959667634
You can also follow me on Twitter
http://www.twitter.com/cityoestopath
Edinburgh Clinic
0131 221 1415
or 0845 2601520
activex clinics
14 Stafford Street
Edinburgh
EH3 7AU
Mon-Fri: 8.30am-8pm
Sat: 8.45am-4pm

3. The 10 Guides Included in this series are:
1. How does my lower back work?
2. What is the cause of my pain?
3. Dos and Don’ts of back pain
4. Best positions for sitting, standing and lying down
5. I’m overweight – how does that affect my back pain?
6. What’s better for the pain – heat or ice?
7. Should I wear a back support?
8. Differences between Osteopaths, Chiropractors and Physiotherapists
9. Exercise – you have got to be joking!
10. Useful back pain advice to follow

4. How does my lower back work?
We will consider your lower back to be from the bottom of your ribs right
down to the bottom of your pelvis.
Your lower back is made up of
 Bones
 Muscles
 Nerves
 Blood vessels
 Bones
The bones in the lower back are the five lumbar vertebrae, the sacrum and
coccyx, and the two hip bones. These bones provide your body’s framework
and where they meet one another are the ‘joints’. (see figure 13 below)

5. Muscles
Muscles cover all these bones. The function of the muscle is to contract and
when it does so, it pulls its two ends closer and the result is movement. It can
also remain tense ensuring that the two ends do not separate (to hold you as
you stand) or lengthen slowly in a controlled way (as you bend forwards your
muscles elongate to control this movement)
Nerves
Nerves – like electric cables - transmit impulses along never fibres – like
electric wires. Where a never fibre starts and where it ends determines what
effect it has. The never fibres we are interested in are of two types:
 Motor: end of a muscle, making it contract or just tighten, or relax
 Sensory: end in your brain providing sensation
A nerve is made up of thousands of never fibres, some motor and some
sensory.
So nerves like the sciatic nerve have a motor and a sensory function, it sends
messages to the muscles to tighten or relax, and it keeps you updated of the
changes going on in your leg.
Blood vessels
Blood vessels carry blood – fresh blood goes along the arteries to the various
tissues (bone, disc, muscle, ligament etc) from the heart and lungs; used blood
goes back to the heart and lungs along veins.
Without a good blood supply your tissues will not get a good supply of all the
nutrients they need, including oxygen. Also, there will be a build up of lots of
waste products such as carbon dioxide (CO2) and lactic acid.

6. This changes the balance of chemicals with the following results:
Low level of oxygen Damaged tissues recover more slowly
or not at all. Muscles tire more quickly
and find it difficult to relax
Low levels of building blocks for Damaged tissues rebuild more slowly
repair of damage.
Increased acidity through high CO2 Nerves become sensitised and are
and lactic acid therefore more likely to send pain
signals. Muscles prone to cramp and
tiredness
Movement is essential to maintain good circulation – particularly drainage of
blood. People frequently move less when they are in pain – particularly lower
back pain – the result is that part of you which is moving less has poorer
circulation of blood (and lymph – a tissue fluid)
Any of the tissues that have been mentioned may be damaged by acute injury
leading to pain – this damage is usually tearing of fibres, whether they are
muscle, ligament or disc fibres.
Damage to tissues normally results in inflammation which is part of the healing
process, but inflammation is painful. However, the sensation of pain is there
to warn you that you have damaged something and that you should take
things a bit easier but NOT to give in entirely.
Sometimes, if the damage is bad enough, you may suffer muscle spasms. You
will almost certainly suffer a tightening of the muscles around the damage.
This tightening restricts the flow of blood and lymph and can lead to the
vicious cycle shown in the image below. The best way to deal with this
situation is
Use it or lose it but don’t ever Abuse it!

7. The vicious circle of pain
Summary
When you are suffering from lower back pain there are many ways you can
help yourself (we go into those in future guides) and the most important thing
to remember is to KEEP MOVING.
Your muscles will tighten sending messages from your brain to your nerves and
you will experience pain. That pain may cause you to want to lie down and that
is fine for short periods but will cause a slow recovery. Moving to ensure blood
is being pumped around your body will help you recover more quickly