Each year, the 16^th day of October is celebrated as ‘World Spine Day’ to create awareness about the burden of spinal pain and disability around the world and also to motivate people to adopt healthy routines to make their spine strong, active and flexible. This year is however unique, with the COVID-19 pandemic and its consequent social restrictions creating an unprecedented lockdown on everyone’s routine and interests to stay active and mobile.

Work from home effects on spinal health

Also work from home has its own limitations, with the majority having insufficient or improper facilities to comfortably work from home for prolonged duration, which could have detrimental effects on spinal health and strength. As the world prepares for the ‘new normal’ and shifts gear to recover from this pandemic, it is only prudent that we give requisite care to restore and maintain our spinal health.

It is with these thoughts that the theme for this year’s World Spine Day has been aptly kept as “Back on Track”, which not only encourages people to reactivate and revitalize their bodies by stepping out but also highlights the importance of Exercise, Posture, Movement and Good self-care to ensure a strong and healthy spine.

Here are a few tips to follow to take care of one’s spine –

 Maintain a good posture:

1. Choose a comfortable seating with adequate back support. A small pillow/ rolled towel can be kept behind the small of your back

2. Neck should be straight with screen at same height as eyes while using a desktop.

3. While using a laptop, neck should be straight with eyes looking down at the screen

4. For a standing desk, Counter should be at mid-tummy level with screen at same level as eyes and weight should be evenly distributed on both legs with ankle, knees, hips, shoulders and ears in a straight vertical line. A small foot rest can be used intermittently to rest one of the feet.

See the video: Computer vision syndrome

Take Frequent breaks while working:

Maintaining a perfect posture for a long time can also be harmful, and hence it is important to take frequent breaks. Ideally, the ‘break’ should be at least for 5-10 mins every hour. It is important to move around or (if you are enthusiastic) do light stretches during this break. Whatever you do, avoid sitting again during these ‘breaks’.

Regular Exercises:

The importance of regular exercises for improving your overall spine health cannot be emphasized enough. Regular and simple exercises (Spinal mobilization and core/ Extensor strengthening) can not only keep your spine healthy, flexible and strong; but also helps to mitigate a lot of negative effects of prolonged sitting and poor posture. In essence, regular exercises can help the spine in withstanding day-to-day wear and tear and stresses to an extent that may not be possible otherwise.

Responsible lifting (Think and Plan before you Lift):

1. One of the commonest reasons why develop acute back pain is when they try to lift an object in a way they are not supposed to, either because of its weight or position.

2. Bend your knees to pick up objects from the floor.

3. Hold the object close to the body, preferably at level of waist.

4. Don’t twist while lifting.

5. Most importantly – Know your limits!

Dr. Umesh Srikantha
Consultant and Head of Spine Services,
Aster RV Hospital

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Every year October 16th is celebrated as ‘World Spine Day’ to create awareness on spinal pain and disability around the world and to exhort people to adopt healthy routines to make their spine strong, active and flexible. While the COVID-19 pandemic has changed our lives dramatically, back and neck problems are still as common as ever.

Due to the coronavirus and its social restrictions, many of us are going to be stuck with the work-from-home scenario for a little longer than we expected and due to the lack of a dedicated workstation most of us now end up lounging wherever we find space at home. Hence, lack of physical activeness is not only contributing to our laziness but it is also going to end up harming our spine!

Taking care of one’s spine and back

This year’s theme has been aptly kept as “Back on Track”, which encourages people to reactivate and revitalize their bodies and watch out for problems that may come up if one is not taking care of one’s spine and back. Being in office meant we could move about a little, be it a visit to the cafeteria or a colleague’s desk. Appropriate chairs and equipment gave comfort to our posture, but all that may not be possible while working from home.

Typically, poor ergonomics, a sedentary lifestyle, bad sitting postures and staying physically inactive are common reasons for spinal and back ailments during work from home. Also, while at home, working on laptops while lying down without much activity can also cause spinal problems as there is lot of pressure on the back muscles and spinal discs. Slouched positions can stretch spinal ligaments and strain the spinal discs can cause severe pain and other severe complications if untreated.

Pay attention to ‘early’ warning signs:

Spine is a weight bearing structure subjected inevitably to wear and tear each day and it is natural to develop degenerative changes as we age. However, if any spinal condition can be diagnosed early, appropriate preventive and corrective measures can be instituted to prevent the condition from worsening and eventually necessitating a major surgical procedure. Persistent or recurring back/ neck pain, radiating pain in the limbs, numbness or weakness in the extremities, difficulty in walking long distances or imbalance while walking should not be neglected and be evaluated at the earliest.

Measures to maintain a healthy spine in the long run

Given all these considerations, there are some immediate as well as long-term measures that one should take in ensuring a healthy spine:

1. Avoid jerks and extremes of bending and twisting,

2. Share work and take breaks often,

3. Keep walking and exercise daily and

4. Focus on stretches and less on weights,

5. Maintain a nutritious diet rich in proteins as well as salads and fruits and

6. Avoid weight gain, and

7. Get good exposure to sunlight to get good vitamin D.

To keep your back and neck healthy during the pandemic, patients should perform physical activity that helps maintain fitness and strengthens the core muscles.Physical therapy may be limited during pandemic, so people can follow exercises one finds on the internet like Pilates, yoga or cardio workouts. To stay fit, one can also use elastic bands, hand weights and/or perform isometric exercises, like planks or squats.

It’s important to avoid being sedentary for long periods of time as inactivity can weaken muscles that support the spine. This can cause back or neck pain or intensify an existing spine condition.Besides this, take frequent breaks in the middle and stretch to keep back spasm at bay. Stretching your fingers, blinking your eyes, and stretching your neck will also help you in maintaining a better posture.

Regular exercise can give your day a structure and break the monotony of staying at home for an extended time. Physical exercise gives you a positive outlook while navigating this challenging period.It is important to keep the spine healthy by knowing and respecting one’s limits. It’s best not to do things that the bodies can’t handle.

Non-surgical options are important

It’s best not to operate at least until a patient has exhausted non-surgical options because almost 90 percent of patients with back and neck pain won’t need spine surgery. Anti-inflammatory medications and physical therapy, pain management and care from a physiatrist are advisable. Most patients recover after physical therapy but if a patient returns with persistent symptoms, such as pain with weakness, gait problems, or difficulty with bowel or bladder function, then surgery can be an option.

When is surgery required

Surgery is recommended only if a patient has been suffering from symptoms for six weeks or more. Likewise, severe cases of disc herniation that may risk paralysis, and serious conditions, are corrected surgically. Care is best taken from a multidisciplinary team of surgeons, physiatrists, physical therapists and pain specialists to get back to normalcy soon.

For those who work in an office, it’s also important to customize your work space to avoid muscle imbalances and repetitive injuries. Anyone who has given up an important activity owing to back problems, it is best to seek consultation from a spine expert.The lockdown restrictions don’t have to mean that our spines suffer and a little care will help you in creating the right posture.

Dr. Umesh Srikantha
Consultant – Neurosurgery
Aster CMI Hospital,Bengaluru.

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Spine is an  integral part of the movements and  abilities  of the body. Spine is not a bunch of bones. It is instead a complex channel of nerves that ferry millions of signals between body and the brain. Bones serve the function of protection, apart from providing strength and stability to stand. They protect the spine just like the ribs protect the heart and the skull protects the brain.

spine have undergone  modifications:

Ever since humans began to walk on their legs the dynamics of the spine have undergone several suitable modifications. In animals the spine is horizontal. With evolution walking on two legs gradually evolved for the select purposes in chimps to total bipedal in humans. In the process of transformation spine had to undergo several structural and functional modifications. From horizontal  position some animals evolved to walk with a bent knee and hip to stand up. To accommodate the erect posture in humans knee and hip became straight.

As a compensation the spine got modified with suitable curves . Human spine extends from the neck all the way to the bottom . Though it is in straight line , there are many curves from front to back . The spine can be grossly divided into cervical ( neck area) , thoracic( chest area) , lumbar( abdominal) and sacral and coccyx( bottom area) . The hither too tail of the animals gradually regressed as a small remnant seen as Coccyx( tail bone). In the neck the first two bones got modified to support the head called Atlas and Axis.

The bones of the spine are called vertebrae, which has a thick part called body in the front, pedicles in the middle that has supporting joints and a ring to host the spinal cord called Lamina and the final projecting part backwards is the spinous process. Each part has a distinct function . The body is strong that gives stability to stand, pedicles have the joints that holds all the bones in alignment and the joints provide the mobility, the bony ring protects spinal cord, and finally the spinous process holds the spinal muscles on the back.

Strong muscles facilitates mobility and stability. 

The intervening discs and the surrounding strong muscles facilitates mobility as well as stability. The ligaments in front, back , around the spinal joints decides the range of movements at each level. These movements  vary  from part to part  having maximum movement at  the neck followed by the  lumbar region. There are 7 cervical, 12 thoracic , 5 lumbar , 5 sacral and 5 coccygeal bones. The sacral and coccygeal ones are united together as a single piece that supports the pelvic structures.

In reality disc between the two vertebral bodies acts like a washer and shock absorber  facilitating the movements. All these structures are prone to wear and tear causing degeneration over the time which in turn disturbs the nerve function. When the disc becomes dry it can crack and the inner jelly like structure will come out pressing the nerves causing severe pain. So it is essential to maintain the integrity of all these structures by regular exercises, proper posture, training of supportive muscles and avoiding damage to those sensitive structures.

Though there are lot of checks and balances to prevent damage ,inadvertently one can injure any of them leading to either temporary or permanent damage causing pain and difficulty in movement. The spinal nerves exit at different levels to supply various parts of the body (motor nerves), while the counterparts provide feedback (sensory nerves) to the brain respectively.  In addition fibres from the autonomic nervous system (sympathetic and parasympathetic) that control lungs, heart, blood vessels, gut, bladder and sexual organs are also located within. Thus spinal cord is essentially a large cable containing millions of delicate fibbers that provides bidirectional connections between the brain and individual parts of the body .

The blood supply to this entire cable is very critical as its ability to endure insults of any kind is poor even comparison to brain. Hence handling these nerves during surgery is a challenge—it is an art. Spinal surgery demands highly specialized training, technology and devices. General perception  is that the spinal surgery is  dangerous. But the right surgery in the right time will not only prevent damage to the nerves but also help recovering. Therefore one need not shun away from spine surgery if needed. Today we have MRI scan that can show all the problems related to any of the above mentioned structures.

BRAINS ( Neuro Spine ) hospital has an exclusive centre for the spine. Apart from CT ,and MRI scans, for diagnosis, the operating Microscope, Navigation, Intra operative 3 D imaging of spine, intra operative monitoring system, sensory and motor evoked potentials, spinal angiography, endoscopic and minimal invasive spine surgeries  and rehabilitation makes the spinal surgery safe and effective under trained Neuro Spine surgeons.

Spine can pose innumerable problems 

Unfortunately being the most used as well as miss used part spine can pose innumerable problems at different stages of life. There can be developmental defects in these bones causing many types of anomalies and deformities ( scoliosis, Kyphosis) in children. Tumors can occur at all ages causing pain, loss of sensation and gradual weakness of hands and legs. Discs and bones can wear out causing neck pain, back pain ,shooting pain to hands or legs, cervical spondylitis, lumbar canal stenosis affecting the quality of life. Inadvertent injury to these structures can cause sudden severe pain, restriction of movement and associated muscle spasm.

Therefore  maintaining the spine health  is  very important to sustain the functional abilities of the individual. Loss of spine function in any form can disable an individual in many ways therefore the aphorism” SPINE LESS”.  Spine health  demands proper posture , regular exercises , proper diet , calcium supplementation, proper support during sleep. One must avoid smoking, obesity and improper use of the spine.

Dr N K Venkataramana
Founder Chairman & Chief Neurosurgeon
Brains Hospital, Bangalore.

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