Results of research into the prevalence of lower back pain in “developing” countries may come as a surprise to those of us who live in more affluent parts of the world. Chronic back pain is a leading cause of disability, missed work days and the lowering of our quality of life in the U.S. Yet, according to some studies, “developed” countries in North America and Europe have higher lifetime incidences of back pain than less affluent nations.
A study conducted by the Liberty Mutual Research Center for Safety and Health reviewed the available literature on the lifetime prevalence of lower back pain in both high-income and low-income countries. The study found that rates were 2-4 times greater in the general populations of the affluent nations of Belgium, Germany and Sweden than they were in Nigerian, southern Chinese, Indonesian and Filipino farmers. This calls into question the idea that hard physical labor necessarily corresponds with back pain.
The study also found that, among low-income nations’ populations, incidences of back pain were higher in urban than rural populations. The highest incidence of lower back pain in these countries occurs in what the study calls “enclosed workshops.”
You can view the study at www.ncbi.nlm.nih.gov.
Why would lower back pain be less prevalent in less wealthy nations? There are a couple of possible explanations. One comes from Noelle Perez-Christiaens, a French yoga student under the tutelage B.K.S. Iyengar in 1959, who began traveling to other parts of the world to observe postural trends. She found that in India and Africa, people generally maintained proper spinal alignment and moved with greater biomechanical grace.
It is possible that the repetitive movements and unergonomic lifestyles fostered by industrialization have taken a toll on the backs of people in industrialized nations. The other component of the study involves rural and urban populations.
Canadian and German researchers performed a study to compare the brain activity of people who live in big cities, smaller cities and more rural areas while under stress. The participants were given difficult math problems to do while being criticized. Both people who currently lived in cities and those who grew up in cities showed increased activity in the areas of the brain that process fear and the drive of self-protection. More details on this study can be found at www.webmd.com.
This study indicates that living in an urban environment can cause people to have heightened reactions to stress. There are strong links between stress and back pain. One is the simple fact that mental stress can cause the body to tense up. You may notice that, when stressed, your shoulders are raised or your jaw is clenched. Constant stress can cause significant muscle pain and postural distortion via this muscle tension.
Another link occurs in the brain. The areas of the brain that process psychological and emotional stressors – namely the amygdala and anterior cingulate cortex – also process physical stressors such as pain signals. Hyperactivity of these areas caused by emotional stimuli may actually create increased sensation of physical pain.
Finally, attitude is relevant. Stress can cause a person to perceive a problem as being greater than it actually is. This is called catastrophizing. People who catastrophize feel more pain, are less proactive about treatment and tend to cease activities they enjoy because of fear of injury.
Living in the wealthiest nation won’t help prevent back pain; technology, industrialization and urbanization may put our backs at risk. People in affluent nations aren’t doomed to back pain, however; getting back to our natural alignment, creating work environments that reflect our body’s needs and taking a walk in the woods from time to time can help to significantly reduce back pain in advanced nations.