Would Santa have back pain?

Is Santa at Risk for Back Pain?

Just for fun, I started to think about whether or not Santa Clause would be at risk for back pain.  Based on my experience as a Chiropractor and Athletic Therapist, as well as my experience of treating back pain these are my thoughts.

First let’s look at Santa’s job description. Throughout the year he is responsible for the logistics and production of toys for girls and boys throughout the world. He needs to monitor kids to make sure if they are being naughty or nice and place them in the appropriate list. He needs to check all of his lists at least twice. Then on Christmas eve he is the driver of a sleigh which is pulled by 9 reindeer, including Rudolph. That’s a lot of horse … reindeer power that he has to control through the entire trip. Then he needs to lift up his heavy sac and carry it up and down a chimney.

Thankfully, Santa has his elves helping him make all the toys for the boys and girls.  It was smart of him to delegate some of the work.  If he had to do all the work himself he would likely experience repetitive strain injuries in his wrists, elbows, shoulders, neck in addition to his lower back.

Sadly though, in the case for lower back pain, the odds are against Santa. Approximately 80% of people will have suffered from back pain at least once in their life.  The occurrence rate is also high among those who have had a previous back injury.

Here are some of the risk factors for back pain that Santa possesses.

Smoking

Years ago Santa was a smoker. Smoking is a risk factor for back pain.  People who smoke tend to experience an increased occurrence of degenerative disc disease of the spine.

Smoking tends to reduced the anabolic activity of cells within the discs. This shifts the balance, between repair and break down, towards breaking down.

Santa may not be smoking (or he is hiding it because it is less socially acceptable) now but the damage to his spine has already been done. The effectiveness of quitting smoking on the regeneration of a degenerated disc has been shown to have limited benefit on the health of the disc.

On a positive note, the presence of disc degeneration does not necessarily mean that back pain is present. One study found the following

• 37% of pain-free 20-year-olds have disc degeneration
• 96% of pain-free 80-year-olds have disc degeneration

In addition, smoking is associated with chronic pain which is often experienced by those who have had a back injury. The current theory is that chronic smoke exposure may decrease pain tolerance and therefore increase pain awareness.

Overweight

It is rather evident that Santa is overweight. Every time he laughs his belly jiggles like a bowl of Jello.  The extra weight he carries places added strain onto all of his weight bearing joints, including his spine and the intervertebral discs between his vertebrae. This added strain can lead to an intervertebral disc derangement/herniation  and possibly lead to sciatica down his leg. With his extra weight in his belly his spine needs to extend backwards so he can stay upright.  This can cause abnormal compression onto the joints between the vertebra causing what is known as facet syndrome. It also means the lower back muscles are having to work.

There is a positive association between obesity and back pain especially for those who who have back pain for more than 30 days.

If Santa were to work on changing his body composition by increasing his activity levels and changing his calorie consumption there is good evidence that his lower back would improve or even disappear.

In addition, with Santa being overweight he may be suffering from Metabolic syndrome which has also been associated with lower back pain. In one study the prevalence of metabolic syndrome among chronic lower back pain patients was 36.2%.

  Metabolic syndrome is linked to Type II diabetes. Considering all of the cookies that Santa consumes on Christmas Eve he likely has Type II Diabetes (He may want to learn how exercise can help with diabetes).  Santa may also want to consider better eating habits and read this great weight loss success story by my friend Kymberley (She has now lost 80lbs!).

Age

Typically disc herniations occur around 25 and 45 years of age.  Santa has been around for a long time.  His origins begin back to the 4th Century.  That would make him very old.  One might assume that he is from a lineage of Santa Clauses and if that is the case, the white beard likely places him in his 60s or later.  At this age we are more concerned about arthritis of the joints or even stenosis of the intervertebral foreamen where the nerves exit the spine. 

Arthritis of the spine has sometimes been called “grey hair of the spine”.  It is a natural process and thus it is highly expected to be found in Santa’s X-rays . And, sometimes arthritis of the spine can cause back pain.

Inactivity

It is quite evident that for most of the year Santa is inactive.  I am going to assume he has not performed any core exercises to aid in protecting his back and he likely doesn’t have the muscular strength or endurance to perform his job. You would think that he needs considerable strength to hold the reins of his flying reindeer, carry his Santa sac and to climb up the chimney after leaving from a house.

Inadequate core endurance and fatigue results in poor technique and can increase the chance of hurting your back.  The problem with having to work only once a year is similar to the weekend warriors who only play on the weekend and do not exercise any other time of the week.  Weekend warriors are often the ones who get injured.

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