Sitting in an air-conditioned office has its benefits in steamy Singapore. But long sedentary days can play havoc on our necks and cause upper and lower back pain. Orthopaedic surgeon DR YILUN HUANG talks about spinal problems faced by office workers and how to prevent them or treat them with spinal surgery.
What are the main spinal problems in office workers, and what causes them?
Neck pain and lower back pain are the two most common issues. Sitting for a prolonged duration with poor ergonomics (that is, your workstation set-up) and bad posture can cause unnecessary strain to the neck and lower back muscles, and increased pressure on the intervertebral discs. This in turn causes pain and stiffness in the neck and lower back. In severe cases, people experience nerve impingement symptoms, including tingling, numbness and weakness of the extremities.
How can prolonged sitting and poor posture contribute to spinal problems?
Firstly, they can cause muscular imbalance and poor blood flow to the muscles and surrounding tissues of the spine. Some muscles become tight and others weak due to the improper activation. Decreased blood flow impedes nutrient delivery and waste removal to and from the muscles as well as tissues around the spine causing increased risk of injury and poor recovery. Overall, there’s a negative impact on the health of the spinal structures.
Prolonged sitting can also increase pressure on the spinal discs, leading to herniated discs and degenerative disc disease over time. Herniated discs may cause nerve impingement, and cause weakness, numbness and pain of the neck, lower back and extremities. Poor posture while sitting can cause misalignment of the spine, leading to uneven distribution of load on the spinal vertebrae and surrounding structures. This can result in pain, stiffness and reduced function in the spine.
What are the warning signs to look out for?
Persistent or recurring neck or back pain, especially at rest; stiffness and a reduced range of motion of the neck or lower back; numbness or tingling in the arms, hands, legs and feet; weakness in the muscles of the back or extremities; and changes in posture or alignment of the spine.
What steps can office workers take to prevent spinal problems?
It’s important to practice good ergonomics, take regular breaks, stretch, and be aware of your posture to avoid spinal issues. The acronym to remember is SLEEP.
S: Set up, sit, stretch and sleep
Set up your work station so that the computer monitor is at eye level, your keyboard and mouse are at a suitable height so you don’t slouch, and choose a chair with good back support. It’s also worth considering a convertible standing work station. Remember to sit properly, keep your feet grounded, shoulders relaxed, and stretch regularly. Take regular breaks if you’re caught up with a work task, and keep your body moving. Getting adequate sleep allows for muscular recovery, and keeping a pillow in between your legs if you sleep on your side helps to align your spine and pelvis. Last but not least, choose a mattress that’s ideal for your body type.
L: Lifting techniques
Most injuries happen when people are lifting heavy loads – the main reason being improper carrying and lifting techniques. Always use your leg strength to offload your spine when lifting, especially from the ground up.
E: Ergonomics
Consider modifications such as a standing workstation, a lumbar cushion and wrist or elbow support to reduce strain on your spine.
E: Exercise
Regular exercise will strengthen your spinal muscles and keep your joints healthy. It also helps to keep your weight in check and reduce extra load on your spine.
P: Posture
Practicing and maintaining good posture when walking, standing and sitting will reduce the chance of you injuring your spine.
What conservative treatments relieve pain once it sets in?
Heat or cold therapy using packs from the pharmacy is something you can try yourself at home. In the initial phase of acute low back pain, when you’re having muscular spasms, cold packs may work better. After that, heat packs will be able to alleviate the pain. If over-the-counter analgesics aren’t enough, your doctor can prescribe anti-inflammatories or medication for neuropathic pain if your nerves are impinged.
Physiotherapists can provide manual therapy to ease muscular tension and knots, and reduce back pain. Dry needling in tight muscular knots works well to ease the tension in the muscle. Once the acute pain is better, your physio can also teach proper techniques of sitting, standing and lifting, and give advice on good ergonomics and posture.
Mindfulness and mind-body techniques like yoga and Pilates can help by gently stretching your muscles. And deep breathing techniques are a good way to relax your muscles and alleviate back pain.
When is spinal surgery necessary, and what are the options?
Surgical treatment is typically considered when conservative treatments haven’t resolved the issue. Also, early surgery may be advised if there is severe pain, weakness or loss of function. Some common reasons for surgical intervention include herniated discs, spinal stenosis and spinal deformities.
Minimally invasive spinal procedures have become increasingly popular as they involve smaller incisions, less tissue damage, reduced blood loss and quicker recovery times compared to traditional open surgery.
Endoscopic spinal surgery is one of the most minimally invasive techniques that we use in spine surgery. Endoscopic techniques can be used to perform a variety of procedures. Discectomy is a procedure to remove herniated disc material with an endoscope that is pressing on a nerve root and causing pain and weakness.
Another procedure is decompression laminectomy, which removes part or all of the lamina, together with thickened ligaments in the spine to achieve a decompressive effect in the spinal canal. And spinal fusion fuses two or more vertebrae together to stabilise the spine. This may involve inserting screws, rods or cages through small incisions.
Besides endoscopic surgery, there are a range of other procedures that may help. Kyphoplasty/vertebroplasty procedures are used to treat compression fractures in the spine by injecting bone cement into the fractured vertebrae to stabilise and reduce pain. Artificial disc replacement, on the other hand, is a procedure in which a damaged disc is removed and replaced with an artificial one to maintain mobility and reduce pain.
It’s important to consult with a spine specialist to determine the most appropriate treatment option based on the specific spinal condition and individual factors.
About the doctor
Dr Huang is a consultant orthopaedic surgeon with over 15 years’ experience. He specialises in spinal surgery, particularly endoscopic spinal surgeries and other minimally invasive techniques, including joint and bone preservation procedures.
Total Orthopaedic Care & Surgery
#09-24 Novena Medical Centre, Square 2, 10 Sinaran Drive
6371 0640 | enquiry@totalorthopaedic.com.sg
totalorthopaedic.com.sg
This article on posture and spinal problems first appeared in the November 2024 edition of Expat Living. You can purchase the latest issue or subscribe so you never miss a copy!
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