Nurses are the backbone of the medical system, but during a relentless 12-hour shift, it may be hard to protect their own backbone’s. Are you a nurse? Maybe this speaks to you? Do you struggle with daily stress and pain from regular work activities that affects your efficiency, or even your social life? After conversing with colleagues, you have probably realized you are not alone. There are a lot of nurses just like you suffering from the same problems. As chiropractors just a couple blocks away from DePaul hospital we see our fair share.
There are three common scenarios we see in nurses. Which category do you fit into?
-Achy Low Back Pain Across Belt Line. This feels like a dull achy pain that gradually gets worse throughout the day. This pain is usually brought on by standing. By the end of a shift, all you can do is think about sitting down. This type of pain results from one of two conditions, but in both cases have the same pain generator. In younger patients, these kinds of symptoms often have to do with the inherent curve in your low back, called your lordotic curve. For some people that curve is naturally exaggerated, termed “hyperlordosis.” This leads to increased friction and rubbing on the facet joints in your lower back. Over time this can become progressive and lead to an early onset of spinal arthritis. The second reason, which still affects the facet joints, is thinning of the intervertebral disc. With age our discs tend to dehydrate and become thin. The disc provides most of the cushion while standing. When the disc degenerates and the cushion is lost, it places a bigger load on the facet joints. An increased load over time creates inflammation, arthritis and pain coming from the facet joints in the lower back. Some of the common diagnoses used to describe this type of pain is “Facet Syndrome, Sclerotogenous Pain, Degenerative Disc Disease, or Lumbago.”
-Sharp, Shooting, Intermittent Low Back Pain. This pain can be one sided or centered directly over the spine. This pain may not be constant but can be extremely limiting with certain movements. The pain is more likely to “shoot” down the spine into the glutes and can cause a person to pause and stop what they are doing. It is often exacerbated or present while moving patients, extending over a bed or lifting. This type of pain is brought on by putting strain on one of the soft tissues in the low back. Examples of these could be muscles, ligaments or intervertebral discs. When these tissues strain or tear, it creates pain and inflammation. When you keep repeating these motions over and over again, it makes the healing process difficult, leading to conditions like disc bulges and sciatic pain down the leg. Improper management of a condition like this can turn a molehill into a mountain. Common diagnoses used to describe this type of pain are “Bulging Discs, Ligament Sprain, or Muscle Strain.”
-Neck Pain Radiating into the Upper Traps or Shoulder Blades. The everyday activities of a nurse puts a lot of strain on a person’s neck and creates imbalances in the cervical and thoracic spines. No matter how hard you try, it is hard to maintain good posture and technique during a 12-hour shift of patient management and charting. Initially, the pain may subside without too much trouble. A good night’s sleep, a massage, an adjustment, or vacation can get you feeling pretty good again. However over time, the frequency and duration of your symptoms worsen and your “sore neck” turns into a “condition.” You may start to lose the natural curve in your spine and arthritis sets in prematurely complicating the problem. This can even lead to chronic headaches. Common diagnoses for this type of pain condition are “Anterior Head Carriage, Upper Cross Syndrome, Cervicobrachial Syndrome, and Deconditioning Syndrome.”
So the question becomes, what can you do about it? The easy answer? Visit your chiropractor! Yes, having your joints adjusted improves spinal function by removing the stress and inflammation in your spine. That is only part of the equation, however. The other part is on you. A true pain management program also includes alterations in lifestyle/work habits, as well as, following specific stretches and exercises for your specific condition. Below are some tips to help you do so.
-Achy Low Back Pain Across Belt Line: This condition is caused by increased stress and friction on the facet joints creating joint inflammation. Ways to decrease facet joint friction:
– Avoid back extension exercises/ activities.
– Strengthen core to help support spinal structures (Core Activation Exercises).
– Avoid stomach sleeping.
– Avoid wearing high heels (not that you would wear them to work).
– Perform decompression stretches for the low back. (Example Video)
-Sharp, Shooting, Intermittent Low Back Pain: Most often caused by stress/strain of soft tissues (muscles, ligaments, discs). To decrease soft tissue inflammation and pain:
– Ice for 20 min, 2-3xs/day or as often as possible during flare-ups
– Strengthen core to help distribute stress and support spinal soft tissues
– If symptoms have progressed to disc involvement, ball decompression stretches may also be helpful (noted above).
-Neck Pain Radiating into Upper Traps or Shoulder Blades: Caused by repetitive poor posture, leading to a lack of normal spinal curvatures. To “undo” neck and upper back stress:
– Sleep on back w/ a cervical roll/pillow supporting neck. (Good related article)
– Perform neck range of motion exercises.
– Practice good posture when walking or sitting (sit up straight, shoulders back, ears over your shoulders).
– Keep phone and electronic use to a minimum (Text Neck Article).
The best, most conservative way to manage one of these “nurse conditions” is to try some of the tips, exercises, and lifestyle modifications we mentioned above. If you have tried these management tools without significant relief, or you get temporary relief but “it just keeps coming back,” a visit or two to your chiropractor may be necessary. Of course, there is always the possibility of a more serious underlying issue, which may need the attention of a medical doctor or specialist. In these instances, you may have tried all the “ergonomic tricks” possible, strengthened you core and been adjusted. Don’t let get worse, seek a referral from your primary doctor or your chiropractor.
Daily demands and stresses may take their toll but you don’t have to live in pain. Be proactive. Exercise, stretch, practice good posture and take care of your spine. Working those 12-hour shifts will be a lot more enjoyable when you’re not suffering from back pain.
Dr. Robert “Bo” Andel and Dr. Sarah Geringer
Chiropractic Physicians at Smart Pain Solutions