As the days get longer and warmer you may find yourself engaging in more physical activity, whether it is through yard work or a "pick-up" game of softball.  This increase in activity creates more opportunities for stress and strain to be placed on your back, and resultant discomfort if you are not careful.  Back pain is a common ailment that sends individuals to visit their doctor or to miss work.  Knowledge of who is at risk for developing back pain, what conditions cause back discomfort, and steps that you can take to minimize your risk for developing back problems can help prevent this from happening to you.

     Your back is composed of bone (vertebrae), muscles, connective tissue (ligaments and tendons), discs (round "pads" found between the vertebrae that have a gel-like center that act as cushions/shock absorbers), and nerves (spinal cord).  Any of these structures could be involved in causing your back pain.  Back pain can be acute or chronic.  Acute back pain comes on suddenly and resolves in a few days to a few weeks.  Chronic back pain lasts longer than 2-4 weeks.  

     You are at a greater risk for developing back pain if you are overweight or obese, a smoker, are of the female gender, are older in age, or have anxiety or depression.  Job positions that are stressful, require strenuous manual labor, involve repetitive motion, or require sitting for prolonged periods of time (desk work) increase your risk as well.   Implementing proper body mechanics throughout the day can promote back health.  Often times back pain results from improper lifting mechanics.  Common mistakes made while lifting are listed below.

Lifting Mistakes:

• Lifting an item that is too heavy for one person.
• Lifting an awkward object.
• Lifting a heavy item above your shoulders (e.g. placing a heavy box on the top shelf).
• Bending at the waist while lifting an object.
• Holding/carrying an overweight item away from your body.
• Twisting your body while lifting a heavy load.

The Proper Lifting Technique Involves:

• Think before you lift.  Develop a plan.  What is the best way to approach picking-up the object?  Does it require more than one person to lift it?
• Position yourself close to the object to be lifted.
• Create a wide base of support by separating your feet shoulder-width apart.
• Squat down, bending at the knees and hips.  Do not curve your back forward.
• Tighten your stomach muscles while slowly lifting the object with your leg muscles (not your back) as you assume the standing position.  Make sure to keep your back straight and avoid twisting movements while you lift the item.  Do not "jerk" the object up toward you.
• Carry the object as close to you as possible while moving to a new location.
• To set down the object, squat down by bending at the knees and hips.  Do not curve your back forward.  Slowly lower the item to the ground.

     Improper posture can lead to back pain as well.  To maintain a healthy back while sitting, provide support at the curve of your back with a lumbar roll, small pillow, or a rolled towel.  Adjust the height of your chair so that your knees are even with or slightly higher than your hips.  You may need to use a foot rest to achieve this.  While working at a desk, your shoulders should be relaxed with your elbows resting on either the desk or the arms of the chair.  In order to avoid the habit of slouching forward, organize your work station so that your work can be tilted up toward you.

     Back pain can arise from poor sleeping habits.  Avoid sleeping on your stomach.  To support and maintain the natural curve of your back, consider using a pillow under your lower back or your knees.  When getting out of bed in the morning, roll onto your side, bend your knees and swing your legs slowly to the side of the bed as you push your torso up with your hands to the seated position.

     In addition to implementing proper body posture and body mechanics, improving your overall fitness level will promote back health.  Exercises should focus on strengthening your stomach, as well as your back, muscles to stabilize the vertebrae.  Strengthening your hip and leg muscles are essential for proper lifting mechanics.  Exercises that increase flexibility will help reduce risk of injury if sudden unexpected movements are required.  Some toning and stretching exercises to consider include the following:

Wall Squats:

• Stand with your back against the wall
• Move your feet approximately 12 inches away from wall
• Slowly bend your knees to a 45 degree angle while keeping your back straight and stomach muscles tight - hold for 5-10 seconds
• Slowly return to upright position
• Repeat 5- 10 times

Pelvic Tilt:

• Lie on your back on the floor with your knees bent
• Tighten your stomach muscles until the curve of your back lies flat against the floor - hold for 10 seconds
• Relax stomach muscles
• Repeat 5- 10 times

Knees-to-Chest:

• Lie on your back on the floor with your legs straight
• Bend one knee
• With your arms "hugging" your knee, bring it up to your chest, hold for 10 seconds
• Release your arms and straighten your knee while lowering your leg back to the floor
• Perform with your opposite leg
• Repeat 5-10 times for each leg

     Implementing the above guidelines, when performed appropriately and consistently by most apparently healthy individuals, should help to promote back health and reduce your risk for developing back problems.  However, if at anytime while attempting these tactics, you experience pain, you should discontinue the activity.  Seek medical attention if the symptoms do not subside.

Note:  A physician's approval should be obtained prior to beginning an exercise program, especially for older adults and those at risk for or who currently have chronic health conditions.

Resources:

The Cleveland Clinic website (my.clevelandclinic.org)

The Mayo Clinic website (www.mayoclinic.com)

American Academy of Orthopaedic Surgeons (www.aaos.org)

WebMD (www.webmd.com)