Take Care of Your Back

Joyce Remy

About 80% of adults seek medical care for lower back problems at some time during their lives. Back pain can result from poor posture, muscle tension, back sprains, ligament tears, joint problems, or "slipped" or ruptured discs.

The normal changes associated with aging are not helpful to the back. As we grow older and become more sedentary, back and abdominal muscles weaken and become less stretchable. As a result, more pressure is transferred to the back when lifting. Also, degenerative changes begin to take place in the structure of the discs. The discs become soft and thinner, decreasing their shock-absorbing quality.

Avoiding Low Back Pain

Prevention of back problems is an important goal. Knowing how to use the back correctly is critical in avoiding back problems. It's especially important to know how to safely stand, sit, sleep and lift:

• Standing—Don't slump. And if you must stand in one position for a long time, try putting a low stool under one foot.
  
  
• Sitting—Sit with your knees higher than your hips; use a footstool if necessary. Slide to the front of the chair when getting up, and slide back into the chair when sitting down. Avoid sitting in one position for long periods of time. Try using a small pillow behind your waist for support.
  
  
• Sleeping—Sleep on a firm mattress with a small head pillow or none at all. Try to sleep on your back with a pillow under your knees, or on your side with your knees bent. If you must sleep on your stomach, try putting a pillow under your hips.
  
  
• Lifting—Get a firm footing, bend at the knees, hold the object close to you, tighten your stomach muscles, and use your leg muscles to support the weight. Avoid twisting while lifting. Do not lift a heavy object higher than your shoulders. If possible, push instead of pull.

Dealing with Low Back Pain

Rule #1: Do not do anything that causes pain! If something causes pain, stop.

Most people with back pain are better within a few weeks, and almost all improve within one month. Here are some immediate self-care steps you can take:

• Medications that reduce both inflammation and pain, such as aspirin or ibuprofen, may be taken to relieve discomfort. For most people, these medications appear to be as effective as stronger ones and are less likely to cause side effects.
  
  
• Application of heat and cold can minimize pain and stop muscle spasms to permit stretching of the affected muscles. Since back sprains do not produce a great amount of swelling, heat is recommended more often than cold. If heating pads or hot water bottles do not work, try ice packs wrapped in towels. Some people find that alternating heat and cold provides relief.
  
  
• Excessive rest is more harmful than helpful. If recommended, a short period of bed rest may relieve symptoms, but too much rest weakens muscles and bones and does not hasten recovery. In most cases, it's best to get back to your regular activity level as soon as possible. Consult your physician for a regimen that is best for you.

Sometimes low back pain may extend into the buttocks and upper leg. Pain that extends down the leg to below the knee is called sciatica. It is caused by pressure on the nerves as they leave the spinal cord. You should consult your health care practitioner if you have symptoms of sciatica.

The Role of Exercise

Abdominal and back muscles weakened from underuse or poor posture can reduce support of the spinal column, making the lower back vulnerable to injury. Exercises such as walking and swimming are excellent for strengthening abdominal and back muscles, as well as for cardiovascular fitness. Your physician or physical therapist can advise you on an appropriate course of exercise, as well as recommending strengthening and stretching exercises for the key muscles.

A final word about avoiding low back pain: back problems frequently occur in overweight individuals. If you are overweight, try to re-establish your ideal body weight to decrease stress on your back.