A patient complains to a doctor: “Doctor, it hurts when I do this.”
Doctor: “Then don’t do that.”
Simplistic, silly and trite as it is, the advice in this old joke is inherent to any discussion of back pain. For instance, since bending at the waist stresses the spine, it should be implicit that to avoid back pain, you should not lift this way.
This does not mean, of course, that we should never move at all. It simply means that we should move in the right way. What is the difference between the right and the wrong way? Most of the time, common sense will tell you: if it hurts, then don’t do it. On the other hand, there is no substitute for good advice because many sources of back pain are not so apparent. Talking explicitly about it helps to raise concerns that we may not have considered.
We have already seen the statistics:
- 80% of Americans suffering back pain at least once.
- $50 to $75 billion spent on back pain.
- Fifty percent of workmen’s compensation focused on the lower back, with well over one million workdays lost to back pain.
It is a perilous world. But does this mean that we simply resign ourselves to this peril? Should we push ourselves headlong through it, hoping that we can mend our ills after they have happened? Surely, it is wiser to avoid as many of them as possible.
In this vein, then, we must explore methods of steering clear of back pain pitfalls. We will present some specific tips for strengthening your back in order to help reduce the likelihood of damage. This will help underscore one of the main tenets of chiropractic: i.e., a healthy spine is less likely to suffer injury.
Good Advice
Mention the word “advice” to some, and they immediately think of unwelcome attempts to convince them of ideas that have no value to anyone but the advice giver. Those with back pain are frequently deluged with such advice, compounding their physical pain with frustration. Further, the flood of advice for treating back pain is rivaled only by advice for preventing it. Much of it is useful while much is ineffective, or even harmful.
In the end, it comes down to personal judgement. In weighing the evidence, it is important to consider the variety of opinions and adopt those that suit you. Advice givers usually mean well and intend the best. We will therefore look at advice that has produced the best results and has stood the test of time.
Posture
We begin with posture because it suffers from the mother syndrome. The admonition offered (stereotypically) by your mother to “stand up straight” is ineffective by itself. It may even aggravate matters, since it reduces the advice to nagging, which we tend to either ignore or defy. As we grow up, then, many of us make slouching a full-time habit, and rarely consider standing up straight. As adults, however, we can recognize objectively the importance of posture. The first step to correcting faulty posture is to understand how it causes damage. The second step can simply mean making an effort to stand straighter. It can also mean strengthening the back muscles to be able to maintain proper posture.
If the vertebrae were stacked perfectly straight, there would be fewer back problems. However, since the spine is designed to curve like an S, the center of gravity is delicately balanced. Any deviation from that center results in abnormal spinal curves that can damage the vertebrae, disks, or muscles. Imagine the spine as a stack of checkers. A straight column has great stability. If the column curves a little, they begin to waver a bit. If you press your thumb on the top checker, an unstable column will burst apart, sending the checkers everywhere. While your vertebrae do not typically fly across the room, they nevertheless suffer stresses that, when continued uncorrected, can inflict harm. Since the spine differs from the checker column in shape, it must maintain its center of gravity in a curved position. This makes it vulnerable.
In terms of posture, the neck vertebrae are especially vulnerable. Because the human head weighs on the average 10 pounds, the neck vertebrae in a normal posture will bear that much weight. For someone who slouches forward, however, the neck vertebrae must support up to 20 pounds. We can understand, therefore, how an extreme hyperlordosis can cause the disks to bulge backward, irritating nerve roots or facet joints. It can make disks vulnerable to rupture and loss of flexibility. Reduced flexibility means the back muscles are less able to function within normal range of motion. Muscle spasms can cause a tightening reflex, which causes more spasms, and thus more reflex. Compounding this cycle of pain is the formation of trigger points, which can transfer a localized pain to other regions.
All this is to say that poor posture can have some significant consequences. Prolonged bad posture has even greater consequences. And so, an important prerequisite for curing back pain is making sure the spine is in a position that will retain the proper curvature..
Your spine should be shaped like a lazy S. Slouching forward will stress it. Standing too erect, as in a military posture, can stress the lower curve as well. To find the correct posture, stand one foot away from a wall.. Lean against the wall, bending your knees slightly. Tighten your abdominal and buttock muscles, tilting the pelvis backward and flattening the lower spine. Holding this position, inch up the wall to standing position by straightening the legs. Now walk around the room with that posture. Place your back against the wall again to see if you have maintained it.
Good posture, no matter how you achieve it, is important in preventing back pain. There is no cure-all for bad posture habits. It lies in the realm of behavior modification. Because we form habits when we are young, it is best to encourage healthy activity for children, who imitate what they see in adults around them. For adults, since it is very difficult to change posture once the habit is formed, it takes perseverance. There are programs available for modifying posture habits. But at the very least, it takes simple awareness.
