Every September 8 is a significant date on the global calendar. It is set aside to celebrate World Physiotherapy Day with the goal of raising awareness about the profession and its role in enhancing physical health. This year’s edition of the World Physiotherapy Day was centred on Low Back Pain—one of the most common conditions treated by physiotherapists as statistics by the World Physiotherapy reveals that “Low Back Pain is the leading cause of disability globally. 619 million people experienced it in 2020, that’s 1 in 13 people. It can be experienced at any age, and almost everyone will experience it at some time in their lives…”
As the World Physiotherapy Day was being observed, Citypeople reporter, Jamiu Abubakar (08085185886), got the Lagos Physio Expert, Mariam Sanni-Ibrahim who is the Head of Physiotherapy Department at Orile Agege General Hospital, to talk about Low Back Pain and how it can be avoided.
Mrs. Sanni is a MRTB and HCPC license physiotherapist with over 10 years of experience in helping individuals recover from injury, manage pain and regain mobility. She has expertise in orthopaedic rehabilitation, sports injuries, chronic pain management, Manual Therapy and Neurological Rehabilitation. She strong proponent of adopting holistic approach to treatment, combining hands- on therapy, personalised exercise programs and patient’s education to achieve long-term health outcomes. Below are the excerpts from the engaging and instructional interview:
Can you tell us why September 8 is significant in the Physiotherapy Department of Orile Agege General Hospital?
We are celebrating our World Physiotherapy Day, which is a three-day program from our own end of the hospital. Because there are other hospitals that are celebrating it, but some are using three days and other days. But we decided to use three days for our own program. And the theme of this year’s World Physiotherapy Day is low back pain, which is a pandemic disease around the world.
The issue of low back pain, just like you said, is a pandemic, why is it so?
So the thing is that because we are not always conscious of the way we sit, our posture mostly. We are not always conscious of our posture. The way we sit, the way we stand, the way we carry our things. In short, our daily activities, we usually take the wrong posture in doing them. And this posture, when it takes a long period of time, it leads to back pain. Which can be the low back, mid back, upper back, any part of the back.
How does it affect daily life?
This low back pain that we are talking about, it depends on what causes the pain. Sometimes it can be mild, sometimes it can be slightly severe, and sometimes it can be severe. But the thing is that most of the time, when we have pain like that in this part of the world, we take it for granted till it becomes very severe. And it causes harm that affects our daily activities. We don’t always take notice of it until when it affects our daily activities. That is why we are taking it as an awareness. People will not have this pain to the extent that it will start affecting their daily activities. Normally it is not meant to, but when it becomes chronic, it can affect daily activities.
What is the proper way one is expected to sit?
We have a lot of patients that have this same issue. They will complain that their job requires them to sit a lot and everything. So we always advise them, if you know that your job requires you to sit a lot, take breaks in between. When you have a choice to sit for 30 minutes, if you can’t take breaks within that 30 minutes, try to be moving your feet. Your knees, move them at intervals. If you have the opportunity to stand, stretch your body, move from one end to another before you go back to sit. So we always advise them. For those people that drive, that maybe they’re in traffic, and they’re limited to the way they can move, at least they should be trying to move their knees, their ankles, at intervals. So that creates circulation from the lower part back to the back. And they should try to sit as much as possible in the aligned position, the normal position, which is our upright position. So that is, at least, what I can use to prevent as much as possible.
Aside from the sitting posture, what are the other things we do that could led low bback pain?
Like I said before, our daily activities. Sometimes, when we stand, we’re not even conscious of it. We tend to move towards the right leg. We put more weight on our right leg, more than the left, which tends to make us tilt to the right side. That is one. When we are carrying stuff, or when we want to sweep, which is the way we normally sweep in this part of the world, is against the normal autonomy of the back. We are not meant to bend. That’s why we always advise people that anytime they want to pick things from the floor, or they want to sweep, they should go squatting. Instead, they should bend their knee instead of the back. Because when you bend the back, over time, it causes pain, because you are going against the normal anatomy of the back. So, over time, it affects the back, which can cause back pain.
What is the major sign to look out to know there is a problem?
Sometimes, when you are seated, you just feel like a mild pain, like a tingly sensation at your back. Some people feel pain, but it’s not severe, just a small pain. Maybe, I just feel, ah, a small pain, that after stretching, you feel like it has reduced you. At that point, the normal thing you are meant to do is come to the hospital to complain. So that, even though, if we can help you with, like, little exercises that you can use to help yourself, that will strengthen those muscles that are getting weaker, over-activated, they will educate you on the normal and proper posture to take when you are doing it, because we target job-specific postures. That’s why we are asking patients, what type of job do you do? What do you do as, even, like, a trader? That’s the reason why we went to the marketplace today, because we noticed that traders and this, like, that, they always have this issue, like, reoccurrence, when they go, they’ll come back again, because those that are causing it, they’re not avoiding them. So when you treat them, they’ll still come back and do that same thing, and they’ll still come back to us. That’s why we try as much as possible to educate them, like, these are the things that are causing it. If you don’t eliminate the thing that causes this pain, you will still come back with this pain. So that’s why the education is very important. So when they detect it very early, once we educate them and they are able to sustain that, I’m sure most of them, they always feel like, ah, this pain has really reduced immensely with the exercise that we give them.
How do Physiotherapists solve the problem of Low Back Pain?
We have some modalities that we use here. The reason why we call physical therapy means; treatment using things that you can see, that you don’t have to undergo surgery or anaesthesia or drugs. So it’s things that we can see, things that you can touch, things that you will feel. So we have modalities that we use to help patients to treat low back pain or any other pains. Then, apart from that, like I said, we have exercises that we give to patients. Then we have education, which is very important, educating them. Because we don’t have an issue of treating a patient. After we’ve done all our best, and we’ve put in all our efforts, and the patient goes and says, ah, there’s no more pain, after some months, the patient comes back and tells us that, this thing is back again. So we emphasize on this education, which is called, we give them home programs, things to be doing that will lead to education they want.
Do you also have any plan of taking the campaign to schools because student also sit for a long period in their classes?
The thing is that, it’s not even only about the parents. Young children should have low back pain. That is, this thing is becoming so common that even the children now are having low back pain. Before, we always had low back pain, so the elderly. We, they call it rheumatism. But now we are not seeing that. Secondary school, primary school children too, they’re having low back pain. This thing being that, most of the time when they’re in school, their bag pack is always overfilled with books that are too heavy for their back, which can cause pain. Another thing is that, most of the students, instead of distributing the backpack on the two shoulders, they tend to use only one arm, which makes them to tilt to one side. And all these things are things that contribute to having low back pain. So before, before we decided to go to the market, we were intending going to schools to give education and sensitisation, but we noticed that this same week that we want to do that, it’s the same week that the students will be resuming. So we thought, most of these students, they may not even be in school. Because it’s the first week of the assumption. That’s why we decided that we should, instead we should go to the market, but we still have plans to still go to schools, maybe later, because we always have different things that we do in the hospitals that we may decide to involve schools to give them education.
Aside from the pain itself, what other health complications it can lead to?
Do you know that low back pain can lead to inability to walk at all? I’ve seen patients that, it’s low back pain that they have, but they’re not able to walk. Like, they will be paralysed. Just because of low back pain. Because most of this, I’m not talking about the back. Everything is from the neck. The back starts from the neck. So everything from the neck goes down to the toes. If anything affects especially the midpoint, which is the back. The back is at the midpoint. If something affects the back, it can affect the lower limbs. It can even affect the upper parts. So, issues like, ah, mommy, I was first feeling back pain. Before I knew it, I could not move my legs. I could not move the other leg, too. And now, the person is on wheelchair. We’ve seen it. So, low back pain can really disturb a lot of things. That’s why we have to take it as a serious illness in our society.
How often is someone expected to visit a physiotherapist check?
Because physiotherapy is a professional discipline. The thing is that most of the time, not only in this part of the world, even other parts, we are not the first contact that patients see. It’s the general practitioner that patients see as first contact, and then they want to come for general check up. It’s when they now get to that point, as an expert that knows all the departments, when this is a patient’s complaint with the other tests and everything, the doctor is meant to know the right channel to refer to. So, from there, we will now be the one that says, okay, with your condition, our fight has won. You can be coming to this as frequent as this. Or you need other investigations to aid us to do this. Because there are some issues that, especially when you come, they will be referred to us, but it’s not really our job. So, we have to refer back to the right channel. As a total thing, I would just advise people in general, the populace in general, that as long as they are feeling something odd, that their body is not feeling right, they should try as much as possible to come to the hospital to make complaints. Even if you are feeling fine, just come to the hospital to tell the doctor that you just want to be sure you are fine. Because some people go, they are having pain, they don’t even know they are having pain. I’ve seen issues like that. What I have noticed that when people have pain, they always assume that maybe it’s weakness and everything. They say it is stress. And they start massaging, like, with force and everything. Then some people too, maybe, because of the way we are, they will just say that, it’s just exercise. Let’s go to the gym and do exercise. And exercise is like drug prescription. There’s dosage for each exercise that we give. So, as patient is improving, they will be increasing the dosage or reducing the dosage. So, you just don’t load anyhow. it’s a professional thing. So, I always tell patients and people generally that, early thing, still come to see the professionals. Don’t assume or don’t prescribe yourself.
What are major tips to avoiding low back pain?
One of the things I would say is and the main thing is still our posture. Our posture is very, very important. Because if our posture is right, I believe there will be nothing like low back pain. So, getting the right posture. If possible, let’s go and google it. Right posture of doing things from a physiotherapy perspective. Let’s go and get it. So that we know that this is the way to do this, this is the way to do that. And I can tell you, there’s nobody that will tell me that he’s not a victim of this posture. I’m so sure of it. Because even when you want to wear your shoes. You still have to bend. You still have to bend. So, what’s the proper way of wearing your shoes? You are meant to be seated. Raise your feet up. When you want to pick something that is higher, you are meant to do something to support yourself. Instead of tiptoeing. When you are sleeping, most of us when we are sleeping, just come back like that. Up. Which is normal. You are meant to try to decide. Bend your knee a little. Assist yourself with your hands. And move up. You see? That’s it. So, it’s like discomfort. You see what I’m saying? The proper posture is like a discomfort to us. And that’s why we always have this issue.
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