The spine is composed of an articulating set of bones called vertebrae, muscles, soft tissue, tendons and intervertebral discs. They work together to provide the framework for your body that keeps you erect. The spine also protects the spinal cord and associated nerves, the messaging system that carries instructions from your brain to the body. It's unsurprising how common back pain is considering the spine's centrality to so much of our movement and activity. In fact, a 2018 CDC survey found that over 28% of the US adult population experienced low back pain within the past three months.
Back problems vary in severity from simple strains and strains caused by exercise to severe nerve impingement or vertebral displacement due to traumatic injuries. Over time, excessive use, poor body mechanics and the natural aging process compromise the spine. This causes pain and prevents them from functioning normally. Another issue is arthritis, inflammation of the joints from overuse and excessive wear-and-tear. While the incidence of spinal problems is common, preventing pain is possible by minimizing the risk of injury and taking proactive steps to reduce spinal degeneration.
Types of Back Pain
The National Institutes of Health categorizes back conditions as either acute or chronic. Most cases are acute. They typically resolve with self-care within a few weeks. Acute cases have no ongoing loss of function. This type of pain results from something like a sports injury, strain suffered during work activities or a sudden jerky movement. Chronic back pain occurs when symptoms last more than three months, even after the initial injury responsible for the pain has been treated.
Chronic pain may be managed with medication, electrotherapy, physical therapy, steroidal injections, or surgery. These treatments carry different levels of risk and effectiveness. Resolving the pain in its acute phase minimizes the risk of it becoming chronic. This is important because, although there are many treatment options, chronic pain does not always respond to interventions.
Preventing and Relieving Back Pain
The adage "use it or lose it" holds true. Movement is one of the most effective ways to prevent pain. All muscles tighten and weaken when they are not used regularly. Back muscles are one of the vital components of a properly functioning spine. Keeping the muscles loose and strong maintains spinal stability and protects against strains that cause pain. Consistent physical activity also promotes circulation and the movement of synovial fluid, which lubricates the joints. Increased blood flow also eases pain by reducing inflammation.
Eat a Healthy Diet
A balanced diet, in addition to regular exercise, is vital to maintaining a healthy weight. Keeping your weight within ten pounds of the ideal for your body size prevents back pain. Individuals that carry extra weight, especially around the trunk, shift their center of gravity. This places excessive stress on the spine because of abnormal body mechanics.
Beyond maintaining a healthy weight, getting the proper nutrients is important. One of the greatest causes of spinal pain in older individuals is osteoporosis and resulting fractures. Including foods rich in Vitamin D and Calcium in our diets nourishes bones, strengthening them throughout our lives.
Monitor Your Posture
Like any bad habit, poor posture becomes something you don't even think about. Whether you spend an entire workday hunched over a desk or continually slouch or stoop while standing, poor posture affects your back. The spine has a natural S-curve and our neck is meant to hold the head straight. Continually glancing down at a monitor or slouching at a counter misaligns the spine and alters its normal curve.
Correcting abnormal posture takes time and attention, but prevents back issues from developing. Sitting straight up with your back touching your chair, standing tall with your shoulders back, and holding your head in a neutral position by raising your computer monitor are all fixes that can improve posture. Certain exercises and stretches also retrain muscles that may have weakened due to prolonged poor posture.
Make Your Environment Comfortable
No two bodies are identical, so no environment affects them in the same way. Assessing your surroundings and modifying them to be more ergonomic can prevent spinal pain. Select chairs that are comfortable with firm-straight backs. Adjust the chair's height so your knees sit higher than your hips when your feet are flat on the ground. A standing desk or convertible workstation prevents hours of extended sitting that can stress the back. Raising your monitor so that you can view it with your neck held in a neutral position prevents strain.
Stress is an inevitability, but how we manage it has a direct impact on our physical health. Tension and anxiety are part of the flight or fight response. So, stress causes you to tense your muscles. The constant tension from unmanaged stress can cause pain on its own or make the back vulnerable to an injury that will cause pain. One of the best ways to manage stress is physical activity. Yoga, meditation, deep breathing, tai chi, and walks are great ways to reduce stress.
Practice Good Sleep Habits
Sleep is the body's opportunity to recharge, recover, and repair itself from the day. By getting the recommended eight hours of sleep, you ensure your back isn't at unnecessary higher risk of injury. While everyone is different, certain sleeping positions are generally better for the back than others. Doctors often recommend sleeping on your side with your knees pulled up slightly toward your chest for individuals with spinal pain. If you're unable to sleep on your side, sleeping on your back with a pillow under your knees and another under your lower back is recommended. Sleeping on your stomach is generally discouraged because it places stress on the spine. If you must sleep in this position, it is best to place a pillow under your hips. This places the spine in a more natural alignment.
No mattress is right for everyone. There is little consensus on whether a softer or firmer mattress is better for the back. Find what works for you. A board between a mattress and box spring can make a mattress harder while a mattress pad can soften it. Find what works for you.
The obvious reason to stop smoking is to reduce the chances of heart disease and cancer. However, there are far more negative effects of smoking. Researchers have seen a link between smoking and persistent back pain. They also believe smoking can exacerbate existing back pain. Investigators are not yet clear on the link, but they theorize that, by narrowing blood vessels, smoking deprives the soft tissue and discs in the spine of oxygen and nutrients. This weakens the back, making it more vulnerable to injury and slower to heal.
Learn and Practice Good Lifting Techniques
Whether your job requires you to load and unload heavy objects or you're rearranging furniture in your home, proper lifting techniques are essential for preventing pain. Take your time lifting heavy objects and be mindful of your body. Get as close to the object as you can. Keeping the weight close to your body places less pressure on the back. Always bend at your knees and tighten your abdominal muscles. Push up with your legs while maintaining the spine's natural curve. You should not be too loose or too rigid. Keep the object close to your body while moving your feet. Never twist because contorting your spine while it's under stress can cause an injury. Always lift with a partner when you think an object is too heavy and never lift something if you're unsure you can manage its weight.
Develop a Strong Core
Beyond the overall benefits of physical activity, targeting specific trunk and back muscles effectively prevents and treats pain. Over time, our body adapts to injuries. The back may be overworking itself to compensate for weakened abdominals or tight hamstrings for example. Retraining the muscles returns the spine to its natural state, reducing the excessive burden causing pain. The Athletic Medicine department at Princeton University has a workout of lumbar and core strength and flexibility exercises that are effective at preventing pain. Consult with a doctor before beginning a workout plan. Properly diagnosing the nature and cause of the condition is important to prevent an exacerbation of your pain.
Change Positions Frequently
Regardless of how good our posture is, prolonged sitting or standing in the same position harms the back. The pressure on your intervertebral discs is higher when sitting than standing or lying down. This can irritate nerves, leading to shooting pain like sciatica, or permanently compromise the disc, leading to irreversible deterioration. Harvard researchers recommend getting up from your chair every half hour. A walk to the water fountain at work or a trip outside at home minimizes the harmful effect of sitting.
Choose Comfortable Footwear
Shoe choices can impact the spine. High-heeled shoes and those with poor soles burden the back by altering our natural center of gravity or exacerbating the impact of steps. This can overwork the discs that cushion the individual vertebrae, leading them to flatten and lose their elasticity. Shoes with low heels and comfortable soles are the best option.
Avoid Heavy Bags
Purses, backpacks and briefcases are a necessity, but they're also a danger to your back. Bags that hang over one shoulder or are carried in one hand create an imbalance that forces the back to work harder. We're less likely to maintain good posture. Backpacks are often overloaded and rarely sit on the back properly. The weight is then improperly distributed and places stress on the spine. Better alternatives include roller bags and ergonomically designed backpacks with thick straps that evenly disperse the load.
Be Wary of Miracle Solutions
The widespread nature of back problems has made treating them a profitable business. Everything from elastic braces to metal-lined straps to specially engineered shoes is marketed as a cure for spinal pain. While there is anecdotal evidence these devices may help, there is very little research supporting their use. Considering the fact time and self-care often resolve back injuries, their role may be incidental at best. The CDC has even stated that there is no proof back belts, a common tool in preventing workplace back injuries, are effective at preventing injury.
Take Care of Your Back
Everyone is going to experience spinal pain at some point in their life. Preventing and resolving the pain in its acute stage helps get us back to normal life. It also minimizes the risk of chronic, potentially intractable, pain. The best solution is to promote a healthy spine by minimizing wear-and-tear and avoiding bad habits that can lead to spinal deterioration. Proactive steps will preserve and maintain your mobility.