World Spine Day: Pandemic Pushes Low Back and Neck Issues to New Levels

Long before the pandemic, back pain was the second-most common cause of a visit to the doctor after the common cold. Issues with the cervical (neck) and lumbar spine also represented the top disabling health condition among adults 60 years of age and older.

Now, it’s time to commemorate World Spine Day 2021, officially on Oct. 16. The designation is meant to promote physical activity, good posture, responsible lifting and healthy working conditions.

Ronald Tolchin, D.O., medical director of Miami Neuroscience Institute’s Spine Center.

More than 18 months into the COVID-19 pandemic, and its related home-based isolation, visits to the doctor’s office because of back and neck pain are now on the rise. That’s because people are becoming more sedentary and eating more as a result of the coronavirus isolation — even as more offices and public places are opening up, explains Ronald Tolchin, D.O., medical director of Miami Neuroscience Institute’s Spine Center.

Dr. Tolchinpoints out that the tendency to become more active by walking or jogging aroundthe neighborhood — a common practice at the beginning of the pandemic — hassignificantly tapered off.

People whoare still mostly stuck at home are sitting for much too long, practicing badpasture, overeating and not exercising in a way to improve spine health. Stretchingand resistance training that focuses on core strengthening is ideal for the “core muscles” thatmake up the abdomen and lower back, he says.

“My patients are sitting for extended hours at a time, and we know from research that sitting for more than five hours really increases the risk of low back pain,” said Dr. Tolchin. “Too much sitting also increases the risk of obesity, diabetes and heart disease. But from the standpoint of low back pain, people are now spending more time sitting and they’re not getting up like they would in the workplace and moving around the workstation or moving around the office. So, they’re sitting for hours on end.”

Seif M. Elbualy, M.D., director of interventional pain management at Marcus Neuroscience Institute, says chronic low back pain is one of the most common complaints nationwide. 

Seif M. Elbualy, M.D., director of interventional pain management at Marcus Neuroscience Institute.

“It is one of the biggest causes of missed work days,” said Dr. Elbualy. “We also treat many people with chronic neck pain. Certainly, many people have sciatica or radicular types of pain as well. Radicular pain occurs when pain radiates from an inflamed or compressed nerve root. For example, pain from your back and hip that you can feel in your legs.”

Those still working from home may opt for dining room chairs or other household furniture that are not nearly as ergonomic as office desk chairs. And then, adds Dr. Tolchin, people tend to move to the sofa later in the day and watch television for a few more hours.

Briskwalking, jogging or cycling are the ideal aerobic exercises. But corestrengthening is essential for spine health. Working out core muscles cancontribute to improved spine health, offer better protection from lumbar stressfractures or other serious back injuries. When these core muscles contract,they stabilize the spine, pelvis and shoulder girdle — and create a solid baseof support. And that’s important for performing everyday activities, not justorganized sports.

SocialIsolation and the Pain Factor

“Whenwe first started with the COVID-19 pandemic, people were getting out,”said Dr. Tolchin. “They were walking more; they were going around theirneighborhoods; they were exercising. With the continuing issues of isolation, Ithink people are doing it less than they were. They started out well, but I’mseeing a tapering off of exercising. Gyms are limited, in terms of their hoursand new space restrictions, and people may be also scared to go back to thegyms because of the risk of virus transmission.”

Back andneck pain can affect people of all ages, but people older than 60 tend to alsohave issues with degenerative spinal issues that are common with aging.Additionally, the social isolation from the pandemic is increasing their backpain.

“Socialisolation enhances the pain factor,” explains Dr. Tolchin. “They mayhave had underlying degenerative disc changes or spinal stenosis or the commonthings we find in the elderly age group. However, they’re not getting out now,so they’re isolated socially and they’re not seeing their families — and theirfamilies are a bit still afraid to go visit them.  This can increase feelings of anxiety ordepression which can heighten the pain experience.  So, they feel isolated and start reflectingmore on that pain. You start to somaticize a little bit more on the painbecause you’re not going anywhere and you’re not seeing people.”

Here arethe top risk factors for back pain:

Aging. Wear and tear on the spine over theyears can produce conditions, such as disc degeneration and spinal stenosis,that produce neck and back pain. People 30 to 60 years old are more likely tohave disc-related disorders, while those over age 60 are more likely to havepain related to osteoarthritis.

Genetics. Certain types of spinal disordershave a genetic component, including degenerative disc disease.

Occupationalhazards. Any jobthat requires repetitive bending and lifting has a high incidence of backinjury, such as construction workers. Jobs that require long hours of standingwithout a break or sitting in a chair that does not support the back well alsoputs the person at greater risk.

Sedentarylifestyle. Lack ofregular exercise increases risks for occurrence of lower back pain andincreases the likely severity of the pain.

Excessweight. Beingoverweight increases stress on the lower back.

Adds Dr.Tolchin: “On World Spine Day, the message is to try to get people to bemore aware of posture and exercise and weight management, and whatever elsethey can do for improving spine health.”