General Back Care Information

What is back pain?

As you probably already know, back pain is a very common complaint. About four in five adults will experience back pain during their lifetime—and that number may very well rise, given our aging population and recent trend of obesity.

Back pain can range from a dull, constant ache to a sudden, sharp pain that leaves you incapacitated. It can come on suddenly – from an accident, a fall, or lifting something too heavy – or it can develop slowly, perhaps as the result of age-related changes to the spine. Regardless of how back pain happens or how it feels, you know it when you have back pain. And chances are, if you don't have it now, you will eventually.

Who is most likely to develop back pain?

Up to 80 percent of adults will experience some form of back pain at one or more times in their life. Men and women are equally affected. It occurs most often between ages 30 and 50, due in part to the aging process but also as a result of sedentary life styles with too little (sometimes punctuated by too much) exercise. The risk of experiencing low back pain from disc disease or spinal degeneration increases with age.

What causes back pain?

As people age, bone strength and muscle elasticity and tone tend to decrease. The discs begin to lose fluid and flexibility, which decreases their ability to cushion the vertebrae.

Pain can occur when, for example, someone lifts something too heavy or overstretches, causing a sprain, strain, or spasm in one of the muscles or ligaments in the back. If the spine becomes overly strained or compressed, a disc may rupture or bulge outward. This rupture may put pressure on one of the more than 50 nerves rooted to the spinal cord that control body movements and transmit signals from the body to the brain. When these nerve roots become compressed or irritated, back pain results.

Low back pain may reflect nerve or muscle irritation or bone lesions. Most low back pain follows injury or trauma to the back, but pain may also be caused by degenerative conditions such as arthritis or disc disease, osteoporosis or other bone diseases, viral infections, irritation to joints and discs, or congenital abnormalities in the spine. Obesity, smoking, weight gain during pregnancy, stress, poor physical condition, posture inappropriate for the activity being performed, and poor sleeping position also may contribute to low back pain. Additionally, scar tissue created when the injured back heals itself does not have the strength or flexibility of normal tissue. Buildup of scar tissue from repeated injuries eventually weakens the back and can lead to more serious injury.

Occasionally, low back pain may indicate a more serious medical problem. Pain accompanied by fever or loss of bowel or bladder control, pain when coughing, and progressive weakness in the legs may indicate a pinched nerve or other serious condition. People with diabetes may have severe back pain or pain radiating down the leg related to neuropathy. People with these symptoms should contact a doctor immediately to help prevent permanent damage.

Sources:

http://www.ninds.nih.gov/disorders/backpain/detail_backpain.htm
NINDS - The National Institute of Neurological Disorders and Stroke, USA

Understanding Back Pain, The British Medical Association BMA, professor Malcolm I.V. Jayson; Family Doctor Publications 1997 – 2006

Back Pain – A simple guide to back pain, Bestmedicine Health Handbooks, Published by CSF Medical Communications LTD, September 2005

Back Care Tips

Quick tips to a healthier back

Following any period of prolonged inactivity, begin a program of regular low-impact exercises. Speed walking, swimming, or stationary bike riding 30 minutes a day can increase muscle strength and flexibility. Yoga can also help stretch and strengthen muscles and improve posture. Ask your physician or orthopedist for a list of low-impact exercises appropriate for your age and designed to strengthen lower back and abdominal muscles.

• Always stretch before exercise or other strenuous physical activity.
• Don’t slouch when standing or sitting. When standing, keep your weight balanced on your feet. Your back supports weight most easily when curvature is reduced.
• At home or work, make sure your work surface is at a comfortable height for you.
• Sit in a chair with good lumbar support and proper position and height for the task. Keep your shoulders back. Switch sitting positions often and periodically walk around the office or gently stretch muscles to relieve tension. A pillow or rolled-up towel placed behind the small of your back can provide some lumbar support. If you must sit for a long period of time, rest your feet on a low stool or a stack of books.
• Wear comfortable, low-heeled shoes.
• Sleep on your side to reduce any curve in your spine. Always sleep on a firm surface.
• Don’t try to lift objects too heavy for you. Lift with your knees, pull in your stomach muscles, and keep your head down and in line with your straight back. Keep the object close to your body. Do not twist when lifting.
• Maintain proper nutrition and diet to reduce and prevent excessive weight, especially weight around the waistline that taxes lower back muscles. A diet with sufficient daily intake of calcium, phosphorus, and vitamin D helps to promote new bone growth.
• If you smoke, quit. Smoking reduces blood flow to the lower spine and causes the spinal discs to degenerate.

What else can you do?

Learning relaxation techniques could also help you. It is vitally important to relax as much as you can. Learn to live with your discomfort, rather than fighting against it. Other ways of relaxing include aromatherapy and massage. A professional massage can be really helpful if you have muscle spasm, but be sure to tell your practitioner about your back pain first.

Remember: Try to keep positive. It is important not to underestimate the power of human thought. Having chronic pain does not mean the end of your life as you knew it.

Sources:
http://www.ninds.nih.gov/disorders/backpain/detail_backpain.htm#119483102
NINDS - The National Institute of Neurological Disorders and Stroke, USA

http://www.niams.nih.gov/Health_Info/Back_Pain/default.asp#5

NIAMS - The National Institute of Arthritis and Musculoskeletal and Skin Diseases, USA

Understanding Back Pain, The British Medical Association BMA, professor Malcolm I.V. Jayson; Family Doctor Publications 1997 – 2006

Back Pain – A simple guide to back pain, Bestmedicine Health Handbooks, Published by CSF Medical Communications LTD, September 2005

Back Talk, An owner’s manual for backs, Works Safe BC, worksafebc.com

Back Pain Prevention

Exercise and Your Back

One of the best things you can do to prevent back pain is to exercise regularly and keep your back muscles strong. Many people who have back pain are afraid that any exercise will cause further damage. The fact is, most backs benefit from exercise. Strong, flexible muscles are essential to a healthy back. They support the spinal column and determine posture, which is the key to a healthy back. If your muscles are weak or tight, back injuries are more likely and recovery is more difficult. Exercise is the only way to keep your muscles healthy. Exercises that increase balance and strength can decrease your risk of falling and injuring your back or breaking bones.

You may be thinking what can I actually do? – Here are few suggestions of activities that some people with back pain have enjoyed and found benefit from:

• Hydrotherapy – exercising in a warm water
• Swimming is generally excellent for people with back pain, although avoid breaststroke. Try swimming on your back, with a float held across your chest if need be. Otherwise use a simple sculling arm action and a gentle straight leg kick.
• Aquaerobics can be great fun and a good way to exercise your body with the support of the water.
• Floatation Therapy has relaxing effects and is usually comfortable.
• Walking is usually one of the best forms of exercise. Choose comfortable shoes with low heels and cushioned soles, start on flat ground as this is easier than rough or hilly areas.
• Exercise bike

Exercises such as tai chi and yoga – or any weight-bearing exercise that challenges your balance – are good ones to try as well.

Exercise to:

• Build strength and endurance for more efficient support and better posture
• Stretch shortened muscles that are causing imbalances
• Maintain mobility of joints

When exercising, follow these simple rules:

• Do each exercise slowly.
• Start with five repetitions of each exercise, and work up to 10 repetitions.
• Always remember to begin and end your exercise sessions with stretching.

Your diet and your back

Excess weight places an unnecessary strain on the spine. Good nutrition and a balanced diet are important components of overall health.

Eating a healthy diet also is important. For one thing, eating to maintain a healthy weight – or to lose weight, if you are overweight – helps you avoid putting unnecessary and injury-causing stress and strain on your back. To keep your spine strong, as with all bones, you need to get enough calcium and vitamin D every day. These nutrients help prevent osteoporosis, which is responsible for a lot of the bone fractures that lead to back pain. Calcium is found in dairy products; green, leafy vegetables; and fortified products, like orange juice. Your skin makes vitamin D when you are in the sun. If you are not outside much, you can obtain vitamin D from your diet: nearly all milk and some other foods are fortified with this nutrient. Most adults don't get enough calcium and vitamin D, so talk to your doctor about how much you need per day, and consider taking a nutritional supplement or a multivitamin.

Posture and a healthy back

Practicing good posture, supporting your back properly, and avoiding heavy lifting when you can may all help you prevent injury. If you do lift something heavy, keep your back straight. Don't bend over the item; instead, lift it by putting the stress on your legs and hips.

• Good posture – standing: The way you stand, particularly over prolonged periods, has a direct effect on your back. Good posture when you are standing is straight vertical alignment of your body from the top of your head, through your body’s centre, to the bottom of your feet. Avoid standing in one place for too long and walk around from time to time. Raise and rest one foot on a block about 15 or 20 centimetres high. Crouch periodically to relax your back.
• Good posture – sitting: Badly designed chairs or seats cause the pelvis to tilt, flattening the lower back and causing discomfort or pain. Using a proper chair or a small pillow will relieve this strain. To sit correctly, the pelvis should be in a neutral position. The spine should be supported along its natural curve, allowing the muscles to relax. The feet should be supported. The height of the seat should place the knees level with, or slightly higher than the hips. Stand up regularly – at least every 45 minutes – and walk around.

Sources:

http://www.ninds.nih.gov/disorders/backpain/detail_backpain.htm
NINDS - The National Institute of Neurological Disorders and Stroke, USA

http://www.niams.nih.gov/Health_Info/Back_Pain/default.asp#5

NIAMS - The National Institute of Arthritis and Musculoskeletal and Skin Diseases, USA

Understanding Back Pain, The British Medical Association BMA, professor Malcolm I.V. Jayson; Family Doctor Publications 1997 – 2006

Back Pain – A simple guide to back pain, Bestmedicine Health Handbooks, Published by CSF Medical Communications LTD, September 2005

Back Talk, An owner’s manual for backs, Works Safe BC, worksafebc.com