Managing Lower Back Pain With Lifestyle Changes " John a 53-year-old business man "

Case study ( 8251 views as of November 21, 2024 )

John is a 53-year-old business man complaining about a sore lower back. John is approximately 40 pounds overweight and sits for 8-10 hours a day. He exercises infrequently even though he knows he should do more. John smokes 10-20 cigarettes a day and eats irregularly, however, when he does eat he tends to overeat. John claims to sleep about 5-6 hours a night which he feels is not enough and complains of feeling tired a lot.

Upon examination by his physician, it is apparent his hip flexors are extremely tight, his rotation in his trunk is almost non-existent and his hamstrings are extremely weak due to sitting too much. John is referred by his family physician to a fitness program, with either a physiotherapist or a chiropractor for his lower back issues which includes a stretching program. John could benefit from going to yoga not only to improve his flexibility and back issues, but to improve his sleeping patterns. His family physician also feels John could benefit from seeing a nutritionist to learn more about healthy eating. Lastly, John has agreed to see a specialist about his smoking in hopes that he can soon quit.

Author: Mr. Jackson Sayers

Managing Lower Back Pain With Lifestyle Changes " John a 53-year-old business man "

Case Introduction

How to Manage Lower Back Pain

Presented by

Dr. Grant Lum

MD, CCFP, Dip Sport Med

Sports Medicine Physician

Treatments

Managing Lower Back Pain With Lifestyle - How Your Diet Can Help

Practitioner help from:

Erin Meloche

Registered Dietitian
Importance of Posture At The Office in Preventing Lower Back Pain

Practitioner help from:

Mr. Tim Battaglia

EMBA Candidate

Kinesiologist
Physiotherapy to Help Manage Lower Back Pain

Practitioner help from:

George Taouil

Physiotherapist

Treatments

Benefits of Yoga in Managing Lower Back Pain

Practitioner help from:

Heather Greaves

Yoga Instructor
Managing Lower Back Pain With Lifestyle - Smoking Cessation

Practitioner help from:

Tammy Maure

Pharmacist
How Your Workstation Can Contribute to Lower Back Pain

Practitioner help from:

Dr. Ashley Waggott

Chiropractor

Conversation based on: Managing Lower Back Pain With Lifestyle Changes " John a 53-year-old business man "

Managing Lower Back Pain With Lifestyle Changes " John a 53-year-old business man "

Mr. Jackson Sayers BSc., Kinesiologist, Vancouver, BC 09 December 2018

If you’re diagnosed with AS, your physician will likely refer you to a rheumatologist. Ankylosing spondylitis treatments include nonsteroidal anti-inflammatory drugs (NSAIDs), disease-modifying antirheumatic drugs and biologics. Physical therapy and low-impact exercise can also be effective in keeping the spine flexible and the joints mobile. Since having AS is linked to heart disease, it’s important to monitor and/or lower your cholesterol and blood pressure.

Reply to: Managing Lower Back Pain With Lifestyle Changes " John a 53-year-old business man "
Mr. Jackson Sayers BSc., Kinesiologist, Vancouver, BC 09 December 2018

Ankylosing spondylitis symptoms include pain and stiffness in the joints in the lower back, spine, hips, knees and shoulders. Some people experience inflammation of the tendons of the heels or feet and the eyes. Over time, the inflammation can cause permanent damage to the joints.

Reply to: Managing Lower Back Pain With Lifestyle Changes " John a 53-year-old business man "
Mr. Jackson Sayers BSc., Kinesiologist, Vancouver, BC 09 December 2018

Ankylosing spondylitis (AS) is a chronic type of arthritis that affects the lower back. While the cause of AS isn’t known, it occurs when the immune system attacks the back, causing inflammation and resulting in pain and stiffness. Similarly to osteoarthritis, the body attempts to repair your lower back by growing new bone, which often grows across the joint and may even become fused.

Reply to: Managing Lower Back Pain With Lifestyle Changes " John a 53-year-old business man "
Dr. John Wade MD, FRCPC Rheumatologist, Vancouver, BC 31 July 2018 Artus Health Centre

Vertebral joints can be affected by degenerative arthritis, causing inflammation within the joint and the growth of bony spurs on the edges of the vertebrae. The pain may be limited to the back or it can radiate to the lower abdomen, groin, leg or foot. The distance the pain travels can be an indicator of the seriousness of the injury. Symptoms such as pins and needles, numbness or a burning feeling in the leg or foot region that accompany the pain pathway are also an indication of severity and should not be left untreated. These symptoms may be a result of damage to the sciatic nerve, which travels from the low back down the back of the leg to the foot, enervating most of the leg muscles and bringing sensation to the leg.

Reply to: Managing Lower Back Pain With Lifestyle Changes " John a 53-year-old business man "
K. Michael 11 March 2016

I've recently started taking yoga classes. They are meant as more of a stretching class than hot or aerobic yoga. I find that since I started taking them my back pain has decreased.

Reply to: Managing Lower Back Pain With Lifestyle Changes " John a 53-year-old business man "
Chantal Sayers Vancouver, BC 18 December 2015

I found it extremely helpful to see a physiotherapist about my back pain. I was given a set of exercises and stretches to do on a daily basis. Sitting has made areas of my back very tight, so these exercises really have helped to loosen things up.

Reply to: Managing Lower Back Pain With Lifestyle Changes " John a 53-year-old business man "
K. Michael 05 October 2015

I was having some significant lower back pain. Upon exam my chiropractor was able to determine that I had a pinched sacroiliac joint and that it was hip pain I was experiencing and not back pain. I know do a number of stretching exercises daily to prevent it from happening again. John should definitely see a chiropractor for his back pain

Reply to: Managing Lower Back Pain With Lifestyle Changes " John a 53-year-old business man "
Mr. Jackson Sayers BSc., Kinesiologist, Vancouver, BC 31 August 2015

I agree with Michael in thinking that stopping smoking might be crucial in managing low back pain. I John is trying to use exercise to get the low back stronger. I cannot think of anything harder than trying to be motivated and go to the gym and still be smoking.

Reply to: Managing Lower Back Pain With Lifestyle Changes " John a 53-year-old business man "
K. Michael 31 August 2015

John may find that quitting smoking helps him to start an exercise regime and lose weight

Reply to: Managing Lower Back Pain With Lifestyle Changes " John a 53-year-old business man "
Mr. Jackson Sayers BSc., Kinesiologist, Vancouver, BC 07 May 2015

Sitting always puts to much pressure on your low back and either getting up regularly or having either a standing desk or sitting on an exercise ball for part of the day can really help. Getting to gym and strengthening the back is the real key to getting it stronger for long term care.

Reply to: Managing Lower Back Pain With Lifestyle Changes " John a 53-year-old business man "
- K. Michael 11 August 2015
  
  My company redesigned our office with this in mind. We have less printers and washrooms so that people are encouraged to get up and walk around more frequently.
T.Brown 06 May 2015

He should ask his EAP at work for an ergonomic assessment of his workspace. If his chair or desk are not set up correctly, that could be putting a lot of extra stress on his lower back, causing pain.

Reply to: Managing Lower Back Pain With Lifestyle Changes " John a 53-year-old business man "
- Mr. Jackson Sayers BSc., Kinesiologist, Vancouver, BC 31 August 2015
  
  AS I mentioned several times sitting is potentially the hardest thing we do to our low backs. Managing Lower Back Pain With Lifestyle Changes involves the lifestyle change of looking at your sitting arrangements when doing the thing you do the most in the day. This typically is sitting at work. HCF has lots of good posture videos to help with sitting options.
- K. Michael 24 June 2015
  
  This is a great idea. There are chairs and back rests that can provide some additional support while working. Also adjustments can be made to the desk setup to prevent bad posture
T.Brown 06 May 2015

Eating irregularly is not good for health. He could set himself up for easy success by keeping some healthy food at his office, easily accessible. A bag of apples or clementines, a bag of salad. Some foods that are far easier than going out for takeout. Also, he may want to set up a routine of drinking a glass of water regularly, maybe set up an auto reminder. Any of these could help him lose a little weight and relieve some of his lower back pain.

Reply to: Managing Lower Back Pain With Lifestyle Changes " John a 53-year-old business man "
- K. Michael 22 July 2015
  
  One of the keys for changing your dietary habits is consciously making healthier choices. Once you've broken the habit of choosing salads over hamburgers or skipping the fries it gets easier to make other changes.
T.Brown 06 May 2015

Adding in some movement to his work day would likely help. Get a standing desk, take conference calls while pacing his office, have a 'walking meeting' with a colleague. Sitting for 8-10 hours is not good for anyone. And if he is completely inactive, then starting to add even a little movement will likely help him lose weight, sleep better, and get him ready for more organized activity, like yoga.

Reply to: Managing Lower Back Pain With Lifestyle Changes " John a 53-year-old business man "
Joy 05 May 2015

John's quality of sleep affects all aspects of his life. Getting a sleep study done and getting some regular, light exercise would be a great starting point.

Reply to: Managing Lower Back Pain With Lifestyle Changes " John a 53-year-old business man "
- T.Brown 06 May 2015
  
  I wonder how John is relaxing in the evenings? If he's watching TV, that doesn't help with quality of sleep, nor with lower back pain, as he's just doing more sitting. He could go for a walk, and then settle in the early evening to read a book - which will likely result in an earlier sleep time.
- Healthymama 06 May 2015
  
  Studies show that people who sleep less tend to weigh more.
K. Michael 30 April 2015

It's likely due to the smoking and excess weight that John also snores. If so he might benefit from seeing talking to his doctor about doing a sleep study

Reply to: Managing Lower Back Pain With Lifestyle Changes " John a 53-year-old business man "
- K. Michael 24 June 2015
  
  That's an interesting point about the pillows. My family recently changed to gel pillows and it's improved everyone's sleep.
- T.Brown 06 May 2015
  
  I wonder if there are types of pillows that would help him get better sleep. What kind of specialist should he see to help with that?
- Healthymama 06 May 2015
  
  He might benefit from a cpap machine.
ShirleyG 27 April 2015

Losing weight and strengthening his core will help John to alleviate some of the lower back pain. Moderate physical activity and eating right will help with the weight lose. Getting a good nights sleep is also a factor in weight lose ... too little sleep is not healthy.

Reply to: Managing Lower Back Pain With Lifestyle Changes " John a 53-year-old business man "
- Healthymama 06 May 2015
  
  Extra weight causes such a strain on the body. Losing the weight will definitely help with the pain.
Sohale Ziaei BKin Kinesiologist, Vancouver, BC 24 April 2015 Innovative Fitness (Downtown), Vancouver BC

Yes, John definitely needs to get started on an exercise routine. Because of his conditioning, a routine consisting of 2-3 days per week of moderate physical activity would be recommended. The workouts should be tailored towards anatomical adaptation and should include heart-rate based cardiovascular training. Before any exercise prescription, an FMS should be administered to identify his imbalances and functional limitations. It is also highly recommended for John to begin a proper meal plan and limit his amount/or stop smoking altogether

Reply to: Managing Lower Back Pain With Lifestyle Changes " John a 53-year-old business man "
- T.Brown 06 May 2015
  
  Couldn't he benefit from just walking? If he is very inactive, I would think that something simple may be easier to start with, than something that feels overwhelming.
- Healthymama 06 May 2015
  
  What is a FMS?
Dr. Ramesh Sahjpaul MD, MSc, FRCSC Neurosurgeon, Vancouver, BC 24 April 2015 Specialist Referral Clinic, Vancouver, BC

When a patient’s symptoms correlate with the findings on the MRI scan, in that situation surgery actually can be very helpful. And some of the typical symptoms that respond well to surgery are what is typically known as sciatica. So pain, numbness, tingling, sometimes weakness in the legs if it’s due to a herniated disc, then surgery in fact in those situations can be very helpful.

Reply to: Managing Lower Back Pain With Lifestyle Changes " John a 53-year-old business man "
- Healthymama 06 May 2015
  
  Would the person be advised to lose weight prior to the surgery?
Healthymama 24 April 2015

It really sounds as if losing the excess weight would be a huge step in the right direction. 40 extra pounds would put a lot of strain on the lower back.

Reply to: Managing Lower Back Pain With Lifestyle Changes " John a 53-year-old business man "
- Dr. Ramesh Sahjpaul MD, MSc, FRCSC Neurosurgeon, Vancouver, BC 24 April 2015 Specialist Referral Clinic, Vancouver, BC
  
  Losing Weight is the number one way to help yourself in this situation.
Joy 24 April 2015

Yoga could benefit his life in so many ways-strengthening, relaxing, meditation, increasing flexibility. Strengthening his core would provide some relief to his hip flexors and also help his back pain.

Reply to: Managing Lower Back Pain With Lifestyle Changes " John a 53-year-old business man "
- Healthymama 06 May 2015
  
  Would yoga DVDs at home be useful for him? He migh not feel comfortable joining a class.
Mr. Jackson Sayers BSc., Kinesiologist, Vancouver, BC 23 April 2015

Physiotherapy and a good trainer can really help John get back to feeling good and getting into shape.

Reply to: Managing Lower Back Pain With Lifestyle Changes " John a 53-year-old business man "
- ShirleyG 27 April 2015
  
  Diet and exercise will help John build core strength which will lower the amount of back pain he is experiencing.
Dr. Maziar Badii MD, FRCP Rheumatologist, Vancouver, BC 23 April 2015 Artus Health Centre

There is a possibility John may be experiencing early scoliosis which is an abnormal curvature of the spine, so the human spine has three normal curvatures, so just looking at you like this, my neck is curved inside. That’s a lordosis.

Reply to: Managing Lower Back Pain With Lifestyle Changes " John a 53-year-old business man "
- Healthymama 24 April 2015
  
  Could this be caused by the excess weight?