What causes shoulder and back pain?

Back pain, although not as common as neck pain and low back pain, is still a common ailment. About 30% to 40% of people suffer from back pain at some point, and 80% to 90% of people experience back pain at some point. It affects people of all genders and ages, but back pain is most common in middle-aged people. Back pain is a symptom that can occur with a variety of medical conditions. Some diseases are more serious and need to be taken seriously, such as thoracic spine trauma and fractures, tuberculosis, tumors, etc.; some back pain symptoms are mild, often caused by cold backs and poor posture, so there is no need to be too anxious. In addition to back pain caused by serious diseases, back pain generally caused by cold, fatigue, poor posture and degenerative spinal diseases, self-treatment with some simple therapies can often achieve good results. Acupuncture, massage, and cupping of traditional Chinese medicine all have very good curative effects. The latest pain self-diagnosis and self-treatment series - Back Pain is specially written for back pain patients, you might as well take a look. The book introduces the diagnosis of common back pain and the treatment methods that can be used at home. For back pain that does not require special treatment, readers can receive better results by following the treatment methods introduced in this book. Even for diseases that require treatment by professional doctors, if you can use the treatment methods introduced in this book, the curative effect will definitely be improved. Preface to the treatment of low back pain: A survey data explains: Humans stand and sit in different postures, which bring different pressures to the intervertebral discs in the human body. For example, when the pressure between the spine when standing upright is taken as a standard of 100 units, when standing When the posture is bent over to pick up something, the pressure rises to 200 units. If the posture is bent over to pick up something, the pressure is as high as 275 units! It can be seen that the posture with greater pressure should not be used for too long. Because the longer you use improper posture, the more damage your back will suffer! Moreover, the stimulation of pain is not only unbearable for the individual, but also makes the patient unable to work and live normally. It will also cause significant losses to the productivity of the family and society as a whole and the national economy! Among all chronic pain patients, patients with low back pain account for the highest proportion. In the past, Taiwan was an agricultural society. The people were hard-working and relied mostly on farming or labor to earn a living. Their daily diet was mostly light and mainly based on vegetables. There was very little big fish or meat or seafood and shark fins. Therefore, there were very few people with chronic diseases or backaches. cases. However, as we enter the 21st century, human life expectancy increases and society enters old age. People enjoy social prosperity and progress, work pressure doubles, diet becomes westernized, exercise decreases, and human physical fitness and health naturally decline! Aging, chronic diseases are increasing, and back pain has become an inescapable ailment for people from all walks of life! Who is susceptible to low back pain? Those office workers and porters who do not like to exercise and are physically weak are most likely to suffer from back pain! In fact, the range of possible ethnic groups ranges from young adults to adults to the elderly. Especially workers who stand or sit for long periods of time or who bend down to carry heavy objects for a long time, such as drivers, store clerks, porters, nursing staff, and computer users, are most likely to suffer from back pain due to fixed postures or incorrect postures; in addition, The factors may be inner anxiety, dissatisfaction with work or family disputes, or frequent insomnia. Long-term depression and depression will cause physical and mental stress. Long-term pressure on the back muscles will also cause muscle pain, and the pain will aggravate the depression and anxiety! How to treat back pain 1. Exercise therapy: Exercise can increase the softness of muscles and the flexibility of joints. It can also enhance muscle strength and endurance, thereby increasing blood circulation throughout the body and relieving physical and mental stress. Exercise can also help prevent soreness or eliminate back pain. It is the most important and effective method to treat back pain. Currently, the best light exercises are Tai Chi, Qigong and swimming. 2. Massage therapy: Massage and massage can help release or reduce physical and mental stress and relieve tense muscles. Therefore, it is also one of the important methods to eliminate back pain. 3. Traction therapy: For patients with intervertebral disc herniation and patients with lumbar foraminal stenosis, this method can help open the distance between the vertebrae, avoid bone spurs or cartilage from compressing nerves, and help relieve pain symptoms. 4. Acupuncture therapy: Acupuncture can promote the circulation of qi and blood, and has analgesic effect, and is quite effective in treating acute pain.

Recently, Mrs. Wang, who lives next door, often feels pain in her lower back. At first, she didn’t take it seriously, thinking it was a problem common to the elderly. As she gets older, she will naturally have pain on the left and right, so she always goes to the pharmacy. I bought a sore patch and applied it, and when the pain subsided, I thought it was better. I never thought of asking for help from doctors and rehabilitation staff, and I never thought that this might be a sign of cumulative damage. Until one day, Mother Wang was squatting in front of the washbasin washing clothes as usual. While chatting and laughing with Mother Liu next door, she suddenly remembered that the hot water in the kettle should be boiling. She was about to get up and turn off the gas. At this time, the muscles behind her waist A burst of intense tearing pain hit her, causing Mama Wang to burst into tears on the spot. If Mama Liu hadn't been there to help, Mama Wang wouldn't have been able to straighten her waist at all, let alone stand up. At this time, he realized that something was wrong and went to the hospital for help. The doctor said that this was a cumulative injury caused by working in incorrect postures for a long time. Fortunately, he was treated early, otherwise there would be many sequelae. In fact, there are many housewives in Taiwan who have the same problem as Mrs. Wang. Doing housework with incorrect postures for a long time can easily cause cumulative damage and then evolve into chronic symptoms. The degree of impact can be large or small. In the case of Mrs. Wang, because she washed clothes in a bent position for a long time, the back muscles were over-stretched and fatigued, so she developed back pain, which was like someone pulling the muscles. In the past, when common medical knowledge was not common, it was easy to ignore it as a "normal phenomenon", or seek help from a martial arts center, thinking that applying a medicinal patch would be fine. In fact, if you do not seek medical treatment in a timely manner, you may cause damage to your musculoskeletal and other tissues. permanent damage. When encountering this situation, you should seek help from a rehabilitation doctor as soon as possible. Medication can not only relieve pain, but also reduce excessive muscle tension and avoid permanent damage to tissues. In addition, there are physical therapists in the rehabilitation department who can provide physical therapies, such as electrotherapy, heat therapy, etc., to relieve pain symptoms and help injured tissues recover. Occupational therapists can provide auxiliary equipment or assistive devices to correct incorrect joint postures and provide suggestions for modification of the home living environment. In fact, if we can pay attention to some small details in our normal daily activities, we may be able to minimize the chance of cumulative injuries. As the saying goes: "Prevention is better than cure." Here are some suggestions for changing your living environment and working habits based on Wang's mother's example: 1. Raise the laundry platform to waist height: When using traditional laundry methods, whether sitting or sitting When sitting or standing, the laundry platform should be adjusted to a position slightly above the waist. Avoid bending over to avoid excessive and continuous stretching of the back muscles. When considering a washing machine, if the economy permits, you can choose a drum-type washing machine and raise it to about chest height to avoid bending down to get into the washing machine to pick up clothes. 2. Use a chair with a backrest or something to lean on behind your back to do things: having something to support your back can reduce the burden on your muscles. Therefore, in addition to active household chores such as sweeping and mopping the floor, as long as you need to do it for a long time For work such as cooking dinner, it is best to choose a position with back support. In addition, the back support should be at least shoulder level, so as to have a better support effect. 3. Use long-handled tools: Bending will also occur when sweeping, mopping, and lifting trash can lids. We can choose to use a longer handle or stick a long stick on the trash can, and try to use the elbow joint. The movement to compensate for the angle required for bending is around the waist. 4. Take a moderate rest: If the work takes a long time, get up and do a simple stretching exercise in about 20 minutes before continuing, so as to prevent the muscles from being tense for a long time and give them a chance to relax. 5. Maintain appropriate exercise in daily life: Moderate exercise can train muscle strength and endurance, making muscles less likely to feel sore and fatigued. It can also maintain the activity of muscle cells and accelerate the recovery of injured tissues. However, exercise prescriptions must be followed by a doctor. Or the level recommended by rehabilitation personnel (physical therapists and occupational therapists), otherwise it may become a secondary injury.

6. Intake of balanced nutrition: In addition to developing exercise habits, balanced nutritional intake can lead to the normal growth of musculoskeletal tissues. If we pay more attention to these points, I believe it can help us stay away from the ranks of people with low back pain. (The author Xu Huizhen is an occupational therapist at Bali Sanatorium of the Department of Health) How to eliminate postural low back pain? Postural low back pain is usually caused by poor posture during work, study, and daily life. Therefore, in order to eliminate postural low back pain, we must first improve our posture in sleeping, walking, etc. The second step is to correct bad posture. The following is a detailed introduction to the training methods to correct posture: 1. Sitting training: The patient sits on an ordinary wooden chair with a backrest, with both hips and knees bent at 90 degrees, and the lumbar spine and backrest are as close as possible without leaving any gaps. Reduce forward flexion of the lumbar spine. Patients who cannot achieve this posture can choose a chair with a raised front backrest to facilitate training. 2. Standing training: The patient's waist and back should stand upright against the wall, with the principle that the hand cannot reach between the lumbar spine and the wall, and then gradually bend the hips and knees to squat. This is the second step of training based on the seat. Only by maintaining an upright lumbar curvature can you maintain good functional status during walking, sports and heavy-loading activities. 3. Walking training: On the basis of sitting and standing training, carry out lumbar spine posture training when walking. The method is as follows: (1) Put a notebook or other items that are easy to slide off on your head, and move forward while keeping your lumbar spine vertical and trying not to make the items on your head fall off. (2) Lift a lighter object in each hand, keep your lumbar spine straight, and step forward at the same time. Postural training of the lumbar spine should be a regular treatment measure carried out by patients with postural low back pain and requires perseverance. In addition, this posture training can also be used for patients with lumbar disc herniation and changes in the physiological curvature of the lumbar spine. Choose the right work chair Health is a major motivation for work, so it is very important to choose a suitable work chair for yourself. A suitable work chair must meet the following conditions: ◆Chair back 1. Height: It does not have to be higher than the shoulders. For some people, a too high chair back will hinder work. 2. There must be a curvature to support the lumbar spine. Do not put a pillow behind the back to count. If the pillow is in the wrong position, it will be self-defeating and cause discomfort. ◆Chair seat and cushion 1. Width: When sitting down, leave at least one inch of space on both sides. 2. Depth: The principle is to accommodate the entire buttocks and thighs, and leave some space behind the knees to avoid local compression of the knees and thighs. 3. Chair cushion: It is best to have a curved front rather than a hard and square edge. 4. Height: It is best to adjust it. In addition to matching the height of the workbench, the user's thigh angle must be roughly parallel to the ground, the knee position can be slightly lower than the hip, and the feet can be completely attached to the ground without hanging in the air. . ◆Height of armrest: not too high, otherwise it will cause shoulders to be high. If the armrest prevents the worker from pulling the chair closer to the work surface, or affects left and right movement, it is best to look for armrests that can be adjusted in height or removed. ◆Adjustability Things that can be adjusted in chair design include: the height, depth and inclination of the seat, the height and inclination of the chair back, and the height and width of the armrests. Adjust it several times to achieve the most comfortable condition. Pneumatic adjustments are easier to use. The adjustment lever should preferably be easily accessible from a seated position. ◆Stability The base must be stable. If you need to turn often during work, you should use a chair with casters, and a five-point support is more suitable. Make sure the casters are designed to suit the type of flooring in your workplace. ◆Material: Leather is easier to clean, while cloth has good breathability. Each has its own advantages and disadvantages. Don't make the chair back and cushions too soft. ◆Special work needs If your workplace is in a production line, counter, laboratory, etc., and your work requires alternating between sitting and standing, and when you often get up to pick up things, a sit-stand chair with a higher height and designed to lean forward will be more suitable. Kneeling Chairs are designed to lean forward and have a cushion for the knees, which can better maintain a good posture of the spine; however, the load on the knees and lower limbs is too great, which often causes different pain problems; it should Consider the height of your work surface for optimal working posture.

(Dr. Liang Huiwen, Society of Rehabilitation Medicine) To prevent back pain, we should start by improving the workplace environment. Ms. Wang has been working as a computer clerk for a year. She feels back pain every day. Especially the longer she works, the more severe the pain symptoms become. After an outpatient examination, it was discovered that it was a chronic muscle and ligament strain. The cause was considered to be related to long-term sitting work and constant repetitive movements. Therefore, in addition to prescribed medication and physical therapy, we also taught her some stretching exercises to reduce muscle fatigue. It was recommended that she spend a few minutes doing exercises during her breaks from work to reduce muscle fatigue caused by maintaining the same posture for a long time. But Ms. Wang's first reaction to this suggestion was: "It's weird to do exercise in the workplace." This sentence made me think deeply... People spend a lot of time in the workplace, so promoting health promotion programs in the workplace has been increasingly valued and promoted in recent years. Major domestic companies often promote programs for their employees, including physical fitness promotion exercises, weight, hypertension, and hyperlipidemia control programs, and smoking cessation campaigns. However, as the incidence of musculoskeletal system-related diseases caused by work, such as numbness and pain in shoulders, neck, upper arms, and lower back pain, increases, attention is increasingly being paid to them. Countries in Europe, the United States and Japan have begun to enact laws on this system, instructing employers to improve working environments and processes and provide employees with solutions and prevention methods. For example, for occupational lower back pain, in addition to stipulating the maximum carrying weight limit for employees, employees are also taught hygiene knowledge about back health and promote calisthenics before work or during breaks at work. In the past, courses similar to back pain classrooms were implemented in hospitals in China for patients with low back pain. However, many patients were often unable to fully apply the knowledge they learned because the knowledge they learned was not highly relevant to their work, or the objective environment did not allow them to fully apply it. With improvement, lower back pain often reoccurs. Therefore, if back health knowledge and exercise can be promoted in the workplace and truly implemented in work life, coupled with the employer's engineering improvements, such as changing the height of the workbench to avoid long-term bending work, the work will be improved. Process, reduce unnecessary handling, or replace manual handling with machines, and adopt a rotation system to avoid doing the same repetitive work for a long time to reduce exposure risks, etc. According to foreign research results, this multi-faceted intervention and improvement can not only reduce the incidence of low back pain, reduce medical expenses and employee absenteeism, but also improve productivity and enhance employees' attachment to the company. (Dr. Hong Yixun, Association of Rehabilitation Medicine) You shouldn’t tolerate back pain! Back pain has become a common problem all over the world. Office workers who operate computers all day long, store clerks who have to stand to serve customers, and busy salespeople all face the pain of back pain. Why can't doctors treat this problem properly? The latest research report in the "Journal of the British Medical Association" shows that in the ten years from 1987 to 1997, although the number of severe back pain problems that caused difficulty in mobility decreased by 0.7 points, the proportion of back pain affecting the average person increased by 12.7 points. In order to understand the true impact of back pain on the general public, researchers from the University of Southampton conducted a survey on 2,667 people aged 20 to 59 between 1987 and 1988. The first 59 people participated in the full study; and the second The first study conducted a survey among 10,363 people aged 20 to 59 between 1997 and 1998. A total of 57 people participated in the entire study. The results showed that within a year of the survey interview, the proportion of respondents with back pain increased from 36.4 in the first study in 1988 to 49.1 in the second study in 1998. The proportion of back pain is increasing in terms of men, women, economic class, and region of residence. Researchers believe that there are two main reasons for the increase in patients with back pain. The first is that modern people pay more attention to their own health, so they treat back pain as a symptom. The second reason is that modern bosses have accepted that back pain is a disease as a reason for taking leave, so employees are more able to use the medical system to treat back pain problems.

Are you also a hard-working office worker suffering from back pain? Please go to the rehabilitation department of a large hospital for treatment as soon as possible. You will find that you can return to work comfortably. (Zheng Huiwen, Doctor of Pharmacy, University of California, USA) Backache: Five tips for preventing pain Backache is the most troublesome problem for women. Compared with men's back pain, as long as men improve their sitting posture and strengthen warm-up exercises before exercise, they can greatly improve the symptoms of back pain. However, a woman's back pain also involves maintenance during her menstrual period, shoe selection, and kitchen activity space design. When you have back pain, the smartest choice is to ask a rehabilitation physician for examination immediately; but for women who are busy with home and work, correct resting postures can provide you with appropriate relief if you do not have time to see a doctor. When you feel low back pain, it is recommended that you: 1. It is best to lie on your side, bend your body, and lie down on the mattress. When the mattress is too soft or too hard, it is best to adjust the mattress hardness. If you sleep on your back, place pillows behind your knees to raise your feet slightly. 2. Soak in warm water for no more than fifteen minutes. It is best to use hot spring powder, bath oil or essence on the market to relieve the pain of low back pain. 3. Check your shoes. Put away all shoes with pointed toes, heels higher than five centimeters, and shoes made of excellent materials. Wear flat shoes with round or square toes instead, and multifunctional sneakers are also suitable. 4. Check the height of the kitchen sink. Try to choose an appropriate sink that matches your height. You can try this part at major kitchenware display centers to understand the impact of various sink heights on your housework. 5. Increase calcium intake. Eat more soy milk, tofu, yogurt, milk and other foods. By supplementing calcium, you can slow down bone loss and avoid the occurrence of osteoporosis. Lifestyle methods to alleviate low back pain can only treat the symptoms, not the root cause. It is recommended that when you suffer from low back pain, you must see a doctor immediately so that you can truly solve the problem of low back pain! (Zheng Huiwen, Doctor of Pharmacy, University of California, USA) Have you ever experienced back pain? According to statistics, about 70 to 80 people have experienced back pain in their lives. When you have this problem, in addition to seeking medical treatment, you should also pay attention to maintenance. Here are some daily life precautions for your reference: u Correct sitting posture: 1. Keep your upper body straight and your back straight when sitting. In a straight state. 2. The ideal choice for a seat is one that is hard, has a backrest, and can support the lower back. When sitting, your knees should be slightly higher than your hips, your feet should be flat on the ground, and the chair should be wide enough to support your thighs. 3. Avoid sitting in the same position for too long. If necessary, move around every one to two hours. uStanding and walking: 1. When going from sitting to standing, you must move your hips forward first, and then stand up. Avoid bending forward too much. 2. When standing, keep your back straight, raise your head, tuck your chin, tighten your lower abdomen, tighten your buttocks and lift your chest. 3. When going up or down stairs or entering or exiting thresholds, you must first measure the height. Do not be careless to avoid tripping and injuring your waist. 4. Avoid standing for a long time. If you must stand for a long time to work, you can use a foot stool to rest one foot, which will also reduce the burden on the waist. 5. When changing from standing to walking, you should move your feet first and then your body. uRest and sleep: 1. Choose a suitable bed, ideally a flat and solid mattress, usually a quilt, blanket or cushion on a 3/4-inch thick wooden board. The bed surface should be wide enough, as it may cause discomfort if it is too narrow. 2. The best sleeping position is to sleep on your side, with your hands in front of your body, your knees and hips bent. When lying down, you must place a pillow under your knees to raise your lower limbs and keep your lower back flat. Do not raise your hands above your head. 3. Pay attention when getting in and out of bed: before getting out of bed, lie on your side on the edge of the bed, bend your knees and move your hands to the edge of the bed, move your body with your hips, and support your body weight with your hands to sit up. When getting into bed, sit on the edge of the bed first, bend your elbows and lie on your side, bend your knees and move your legs to the bed. u Moving or lifting heavy objects: 1. When moving heavy objects, use a crane or other tools as much as possible to reduce the chance of injuring your back.

2. If you must lift heavy objects, you must do so correctly. You must bend your knees and squat down, use your lower legs to push the objects as close to your body as possible, and stand up slowly; do not bend down to pick up things, and do not twist your back when lifting heavy objects. 3. When picking up an object, do not reach over other objects, and do not reach out but do so reluctantly. Don't make any movements across furniture to open or close windows. u Driving: 1. Before driving, you should prepare the driving seat so that your knees are bent higher than your hips so that your feet can operate easily when stepping on the accelerator and braking. If the seat is too soft, you can prepare a seat to support your waist and adjust the height of the headrest on the seat to make it more comfortable. 2. When driving, your waist should be close to the back of the seat, keep your upper body straight, do not lean forward, and fasten your seat belt. 3. When driving long distances, it is best to stop and walk around every hour to relax your nervousness. u Work and housework: 1. Work that involves sitting or standing for a long time requires changing postures and moving around every once in a while (one to two hours). If you work reluctantly, it will only cause excessive muscle fatigue. 2. When doing household chores, such as washing dishes, using a vacuum cleaner, etc., do not bend over excessively. Try to bend the knee joint slightly to maintain normal lumbar curvature. u Exercise: 1. Develop the habit of regular exercise, such as walking, swimming, aerobic dance, calisthenics or back exercises, etc., to maintain good health. 2. You should warm up before each exercise, and when exercising, you should start from slow to fast, and then from fast to slow down. 3. Avoid excessive stretching of the lower back during exercise, such as bending down at will, jumping up suddenly or raising the legs, etc. 4. If you have any signs of back pain during exercise, do not be careless and seek medical advice immediately to prevent it from getting worse. uOthers: 1. The use of belt support or waist support can limit spinal movement, reduce mechanical stress, correct bad posture, and also help relieve pain. 2. Avoid collisions, sudden jumps, and twisting movements, and do not climb or lift weights. 3. To prevent constipation, eat more fresh fruits and vegetables and high-fiber foods. 4. Maintain appropriate exercise. 5. Women are not allowed to wear high heels. 6. Maintain a happy and relaxed mood.