A Healthy Back: Protecting Your Back
When it comes to back pain, the culprit is usually something right under your nose. Improperly lifting a heavy suitcase or a child, strenuous workouts, sleeping on a bad mattress, even your golf swing can wreak havoc on your back.
According to the American Academy of Orthopaedic Surgeons, approximately 80% of us will experience significant back pain sometime in our lives. In fact, back pain is the second leading cause (after the common cold) of lost work days in adults under the age of 45. It's estimated that lost wages and insurance-compensated medical claims alone resulting from back pain exceed 11 billion dollars annually.
Fortunately, to a large extent, back pain is preventable. The use of proper lifting techniques, a healthful diet, and regular exercise are some of the keys to promoting good back health.
Moderation in Everything
Jerold Lancourt, MD, a fellow of the American Academy of Orthopaedic Surgeons, says that while couch potatoes are not doing their backs any favors. Neither are those whose mantra is "no pain, no gain."
Couch potatoes with stiff, weak backs, he says, are more likely to suffer back injury than those with strong, flexible backs. But he warns, don't suddenly leap off your couch and make a beeline for the nearest gym. Start slowly.
Aerobic exercise is good, as long as you are willing to stop after ten minutes or so for the first couple of weeks to give your body a chance to adapt to the new routine. Walking is also wonderful, and not just for your back.
"Walking works the muscles. It is, fundamentally, the best exercise for the whole body," Dr. Lancourt says. Incorporate stretching exercises into your routine, too, he adds, as stretching is "absolutely critical to injury prevention."
Obesity is often a contributing factor to back pain. "We've gotten too fat and it hurts," he says. "People are really hurting themselves by being overweight. Backs can't take the stress."
"Exercise is great in your 20s and 30s," says Dr. Lancourt, "but it's critical in your 40s and 50s. Take preventative measures in your middle years so you can enjoy your older years. It's never too late to start."
But, he adds, there are some caveats.
"Avoid using heavy weights when working out, and be very careful with personal trainers who may have credentials in health but no clue about disease."
Because the profession is largely unregulated, he says, it's crucial to check credentials before signing on with a trainer. Most importantly, stop what you’re doing if it doesn’t feel right. Then ask questions about proper technique before starting up again.
Be Careful With Your Spine
"The spine has been proven to be a hydraulic structure. The more you load it, the more it bursts at the seams," Dr. Lancourt explains. "When you're young and strong, you have to be careful not to overload your spine, because, with backs, we pay dearly for our mistakes."
Mom Was (Probably) Right
According to generations of mothers, good posture is essential for a strong, healthy back. However, the medical community has yet to reach consensus as to the benefits of good posture in the prevention of back pain. Dr. Lancourt believes good posture to be important, but says there are limits to what it can achieve. So, as long as the jury is out, SIT UP STRAIGHT! (And keep nagging your kids to do the same).
He notes that for women, high heels increase the curve of the lower back, which can add unnecessary stress. Wider heels provide more support than spiked heels and put less stress on backs.
Learn to Lift
Improper lifting is the cause of a great number of back injuries. Practicing good body mechanics is crucial. "You want to lift with bent knees and only a partially bent back," says Dr. Lancourt. "Get close to the item you need to lift, bend your knees not your back and keep the load close to your body." Back straps won't hurt, he says, but they've never been proven to help. "They do, however, make you more aware of your back, which can only be good."
Follow the lifting rules whether you're carting grocery bags, packing crates, laundry baskets, or young children. "Parents have to train children not to jump up on them when they want to be lifted," adds Dr. Lancourt.
If you often have a sore, tired back after being chained to your desk all day, you need to schedule time each day to work the kinks out. "Allow some time for exercise during each day, whether you get up a little early, do it when you get home, or walk for a half hour during your lunch break," Dr. Lancourt advises.
Take some advice from Goldilocks and choose a mattress that's not too hard and not too soft. Find one that's just right. While your mattress should conform to your back and be comfortable, Dr. Lancourt says, it should also provide a measure of support. "It's a very individual thing. If you wake up with back pain, change your mattress."
Other Causes of Back Pain
In women, back pain can be a symptom of other ailments including uterine or ovarian problems. If you are experiencing unusual cramping, heavy bleeding, or other symptoms along with back pain see your gynecologist or primary care practitioner.
In women who are post menopausal sudden and severe back pain may also be a sign of a fracture of the vertebrae due to osteoporosis—a disease that is characterized by bone loss and increased bone fragility.
Any back pain that is severe or does not resolve with usually measures warrants further investigation and evaluation by a physician.
We don't usually get hurt doing routine tasks. Most back injuries occur when we're doing extraordinary tasks such as planting a tree, playing in the surf, or shoveling snow.
"Be more deliberate in your actions when you're doing something out of the ordinary, when you're in a hurry, or when you're tired. That's when most of us get hurt," cautions Dr. Lancourt.
Luckily, most back pain is self-limited. It hurts for a few weeks and then goes away. But when it does act up, the Texas Back Institute recommends the following seven steps:
- Stop what you're doing. If your back starts to hurt while you're golfing the second hole, don't even think about playing the entire 18! But don't wait too long to get back to activity. Studies conclusively show that two days of bed rest are better than a week.
- Take aspirin or ibuprofen immediately. After an injury (unless medically restricted), take the smallest effective dose that will minimize side effects.
- Ice, then heat. Ice first for 48 hours, then heat. Ice will help reduce the swelling and help relieve soreness. Follow with heat to relax muscle spasms. Apply either ice or heat for only five minutes at a time to avoid skin damage. No ice pack handy? Freeze a small paper cup full of water. Peel back the top edge and voila! An ice massager that's handy to hold.
- Massage. Gentle hand massage may provide relief by stretching tight muscles and ligaments.
- Exercise. Unlike medication, which simply masks symptoms, exercise has a lasting effect, and makes the back more resistant to strain. It also improves blood supply to the back to improve healing of back injuries. It works for both treatment and prevention.
- Adjust. When you are in pain, a few adjustments in your lifestyle can provide relief. Sit as little as possible, drive as little as possible, and avoid heavy lifting or pushing.
- Relax! Try a home remedy version of biofeedback. Imagine a tranquil place and take a vacation in your mind. Listen to your favorite music or read a good book. You'll be surprised how much a few minutes of relaxation can help relieve back pain.
American Academy of Orthopaedic Surgeons
Canadian Orthopaedic Foundation
Cooper, C, Atkinson, EJ, O'Fallon, WM, Melton LJ, 3rd. Incidence of clinically diagnosed vertebral fractures: a population-based study in Rochester, Minnesota, 1985-1989. J Bone Miner Res 1992; 7:221.
How to prevent back pain. American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/fact/.
Ingram T. Winning Back Pain. John Wiley and Sons; 1996.
Low back pain. American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/brochure/.
Texas Back Institute website. Available at: http://www.texasback.com.
Last reviewed March 2008 by Marcin Chwistek, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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