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Reducing Back Pain

Back pain, while among the most common complaints of our society, and the reason for much expenditure of resources within our health-care system, remains elusive to efforts at characterization, both in terms of etiology and treatment. It is the cause for a variety of lifestyle issues ranging from reduction of daily function and/or participation in favoured recreational activities to missing work, both in the short and the long term. Prevention has demonstrated a degree of effectiveness as a strategy to counter back pain, whether it be injury prevention or vigilance to daily habits that may cause or promote musculoskeletal issues that can lead to back pain. The following article explains ways of preventing, reducing or eliminating back pain that I have found to be very useful for my patients as well as for me.

1. Perform daily back extension exercises
A lot of back pain is generated from bulging discs. Discs typically bulge posteriorly, or backwards (no pun intended). Back extension exercises help to move the bulge forward again. This reduces the pressure on the annulus (outer fibres) of the disc and allows the nucleus (inner gel-like substance) to move forward.

You can improve disc health and reduce back pain by performing 15 back extensions twice a day, every day, or after prolonged sitting at a desk or in a car.

To perform back extensions, stand up straight with your feet shoulder-width apart.

Place your hands on your low back, and then bend backwards to your point of comfort. Repeat 15 times. (Figure 1) Another way to perform a similar exercise is to do a push-up, arching your back while pushing your upper body away from the floor.

2. Lift properly
Improper lifting will increase the pressure on the disc in the lumbar spine by up to 400 per cent. In other words, lifting 50 pounds incorrectly can add 200 pounds of compression onto the discs – this may be enough to rupture the disc if the disc is already compromised. Disc ruptures and bulges are a major source of back pain and disability.

Always bend your knees and keep your back straight when attempting to lift a heavy object (Figure 2). Never attempt to lift weight beyond your ability.

3. Fight gravity – do daily posture correction exercises
Gravity tends to lead us to having poor posture over time. Poor posture includes head-forward carriage, rounding of the shoulders, forward rounding of the upper and mid back (thoracic spine) and flattening of our low back (lumbar spine). These positions put a lot of force onto the musculoskeletal systems, which eventually leads to back pain.

To perform posture correction exercises, find a wall, place your heels against the baseboard and bend your knees slightly. You should feel the base of your spine and your shoulder blades touching the wall. Think tall and straighten up. Now tuck your chin in and try to touch the wall with the back of your head without extending your neck (lifting your chin). If you can’t, put a small pillow or towel in the space between the wall and the back of your head. Most people have slight head-forward posture. Do these exercises regularly and you can remarkably reduce and prevent back pain.

4. Keep active
Your back needs oxygenated blood flowing to the muscles and surrounding tissues in order to eliminated toxins. Toxins in the tissues can cause muscles to tighten and even spasm. Tight muscles not only use up more energy because they are working too hard, they produce toxins that generate back pain.

You can eliminate excessive toxins with aerobic exercise, which in turn improves circulation. Improve muscle health and reduce pain by going for a brisk walk or swim every day.

Save your back and heart. Get moving!

5. Ensure proper biomechanics at your workstation
Poor ergonomics at your workstation can lead to repetitive strain injuries, as well as back, neck and shoulder pain.

Have your computer mouse close by so that you are not reaching, straining or rounding your shoulders. Your elbows should be close to your sides and your arms at a 90-degree angle. The computer screen should be at the same level as your eyes so that you are not extending your neck – this may generate tension headaches.

An adjustable height chair with a good lumbar support will help eliminate back pain. The chair height should be adjusted so that your hips are at the same level as your knees and your feet are firmly planted on the floor. This will prevent back and neck strain.

6. Do not sit on your wallet
When you sit on your wallet, it tilts your pelvis unequally – this not only puts stress on your joints, but causes pressure on your sciatic nerve. The sciatic nerve, when compromised, causes sharp pain that radiates into the low back and down the leg.

Stay off of your wallet, so that it does not cost you what is in your wallet!

7. Limit the wearing of high-heeled shoes
High heels force your low back into extension (backward bending) and this stresses the joints and intervertebral discs in the lumbar spine. This puts a lot of extra stress on the spine. Try limiting the use of the high heels to special occasions. If you must wear heels during your workday, consider wearing a lower heel or a platform shoe.

8. Practise correct sleeping posture
Try to position yourself in proper spinal alignment before going to sleep. If you sleep on your side, put a pillow between your knees and a comfortable supportive pillow under your neck. If you typically sleep on your back, put a large pillow under your knees, which takes the stress off of the low back. Your pillow should be the right size so that your neck is in neutral position, not flexed (chin towards chest) or extended (neck bent backwards).

Try never to sleep on your stomach, as this causes your neck to be turned to one side or the other in order to breathe. Prolonged rotation of your neck will wreak havoc on your neck and back and may cause back pain.

9. Watch your weight
Extra, unwanted weight adds to the compressive forces of the whole back, particularly the weight-bearing structures of the lumbar spine. The more weight you carry on your body, the more the lumbar spine tends to flatten out to support the added weight. This is called hypolordosis, the result of which adds compressive loads onto the intervertebral discs. The extra pressure on the discs can lead to tearing or rupturing of these discs. Reduce unwanted weight and save your discs to prevent back pain.

10. Don’t ignore back pain
Remember to treat your back better than your car – that is, don’t ignore back pain until the problem it is trying to alert you to is costly and difficult to fix.

There are many sources of back pain. It could be due to something as simple as a muscle strain or it could be the sign of a nerve compression. A professional such as a massage therapist can provide a medical opinion and set a patient on the road to recovery and a pain-free back.

Encourage your patients to give their backs regular “maintenance and tune-ups” and to be vigilant regarding prevention, and they will find that their backs treat them well!

Mike Dixon, RMT, has practised massage therapy for 25 years. He is an educator, a published author, and an international presenter in massage therapy continuing education (Arthrokinetic Therapy). Mike graduated from the West Coast College of Massage Therapy in 1986 and has been teaching at the school since 1993.