November 7, 1997

"Oh, my aching back!"

Dr. Shrawan Kumar holds up a spine that's feel- ing no pain.

Dr. Shrawan Kumar knew it was serious. Starting up his gas lawn mower one day sent him into hospital with excruciating and debilitating back pain. He was in for several days. "It was the worst back pain I ever had."

As a physical therapy professor, he knew exactly what had happened. Unfortunately, for that nagging, tense feeling people have in general, there's no definitive explanation for the causes of low back pain. "There are over 100 risk factors. You can't even isolate one factor," says Kumar.

While it seems everyone knows someone who suffers from low back pain, Kumar does not believe this affliction is becoming more prevalent. But greater social awareness, and social economic policies like no-fault insurance, which makes back pain eligible for compensation, contribute to a perception back pain is on the rise, says Kumar.

"If you increase the number of risk factors, or the severity of risk factors, then you certainly see a rise in incidences of lower back pain," explains Kumar. "But, you cannot say if one sits too long, or lifts too much, one will have 'x' amount of back pain." Doctors can only make informed guesses and suggest work or lifestyle changes but they can never entirely eliminate the risk factors, says Kumar.

Evolution contributes to the human propensity to lower back pain. Our change in posture, from quadruped to biped, has certainly had a significant impact, says the professor. "We rely on the lower extremities for support. The lower back provides the bone connection to the upper back," says Kumar.

He illustrates by pointing to the last five vertebrae on a model human spine, where all the forces are concentrated in the body. "This stress concentration is such that everything one does passes through here. It's not just bones, but soft tissues which hold everything in place," says Kumar. More important, these tissues are visco-elastic. That means they are highly sensitive to how fast one moves. A tissue that can move one millimeter but stretches to two during a quick motion can cause significant problems, says the professor.

In addition, Kumar says back pain is an affliction. "You're not always going to get better by simply resting. In fact, too much resting can increase the chances of the person's disability," he says. "Very sedentary people are second only to people with extremely heavy workloads in incidences of back pain."

What is one supposed to do, then? Well, Kumar says don't be afraid to put any stress on the lower back because that's what it was designed for. "You must use it or lose it, " he says.

His research into low back pain has led Kumar to invent two devices: a teaching aid for therapists and a spinal mobilizer therapists use to treat their clients. The physical therapy professor has been recognized internationally with two prestigious awards: the Sir Frederic Bartlett Medal, the first Canadian to receive the honor; and the Human Factors and Ergonomics Society Award. He is also a previous McCalla Research Professor.

"No one will rid the human race of lower back pain," says Kumar. That should keep the professor's classes full for a long time to come.

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