Lower-Back Pain Prevention and Managment

·        Many people suffer from lower back pain every year.   Incorrect posture when standing, sitting, lying, and lifting cause many of these back issues.^[1]

·        There is no clear evidence that you can prevent low-back pain.  Nearly everyone experiences it at some time. But there are some things you can do to attempt to prevent low back pain. These things can prepare you for faster recovery if you do have low back pain. Some of them also have added health benefits.^[2]

·        Regular exercise aimed at increasing muscle endurance and strength in the back and abdomen is often recommended to prevent back pain, as is lifestyle physical activity such as walking.  Movement helps lubricate your spinal joints and increases muscle fitness in your trunk and legs.^[3]

                                   ^[1]

Suggestions to help Prevent Low-Back Pain^[2]

     1.     Lose weight, stop smoking, and reduce stress.

2.     Avoid sitting, standing, or working in the same position for too long.  Stand up every hour or half-hour and move around. 

3.     Use a supportive seat and a medium-firm mattress. 

4.     Use lumbar support when driving, particularly for long distances, to prevent muscle fatigue and pain.

5.     Warm up thoroughly before exercising.

6.     Progress gradually when attempting to improve strength or fitness. 

Specifics on Maintaining Low-Back Pain

1.Posture

The best way to sit involves:^[3]

• Sitting in chairs with straight backs or low-back support.  Keep your knees a little higher than your hips. Adjust the seat or use a low stool to prop your feet on.
• Turn by moving your whole body rather than by twisting at your waist. 
• When driving, sit straight and move the seat forward. This helps you not lean forward to reach the controls. You may want to put a small pillow or rolled towel behind your lower back if you must drive or sit for a long time.
• The best way to sleep is on your side with your knees bent. You may put a pillow under your head to support your neck. You may also put a pillow between your knees.
• If you sleep on your back, put pillows under your knees and a small pillow under your lower back. Don't sleep on your stomach unless you put a pillow under your hips.
• Use a firm mattress. If your mattress is too soft, use a board of 1/2-inch plywood under the mattress to add support.

              ^[4]

2.Quit Smoking

•      If you are a smoker, quit.  Smoking increases your risk of bone loss (osteoporosis) and increases your sensitivity to pain. Smoking also interferes with blood circulation by tightening the arteries, which makes it harder for blood to flow, and by decreasing the amount of oxygen the red blood cells can carry. 

•      Spinal discs do not have their own blood supply, but receive nutrition in part from the blood supply to the vertebral bones above and below them. Decreased circulation may increase the speed of degeneration and/or slow the healing of the discs.^[5]

3.Eat A Nutritious Diet

•  Getting plenty of calcium, phosphorus, and vitamin D may help prevent osteoporosis, which can lead to compression fractures and low back pain.^[6]

4.Exercise

Some specific exercises can help your back.

•      One is to gently stretch your back muscles. Lie on your back with your knees bent and slowly raise your left knee to your chest. Press your lower back against the floor. Hold for 5 seconds. Relax and repeat the exercise with your right knee. Do 10 of these exercises for each leg, switching legs. While some exercises are specific for your back, it's also important to stay active in general.

•      Swimming and walking are good exercises to improve your overall fitness.^[7]

 ^[8]

5.Strength Training^[9]

Improving your core body stringth can help cure and prevent lower back pain.  Here are some exercises that do not require any equipment.

• The Bridge: Strengthens several core muscle groups

Lie flat on back; bend knees at 90-degree angle, feet flat on floor. Raise buttocks off floor, keeping abs tight (You can activate these abs by coughing - concentrate on contracting these muscles) Shoulder to knees should be in straight line. Hold for a count of five. Slowly lower buttocks to floor. Repeat five times.

• The Plank: Strengthening exercise for back and abdomen (also strengthens arms and legs)

Lay on stomach, place elbows and forearms on floor. In a push-up position, balance on your toes and elbows. Keep your back straight and legs straight. (Like a plank) Hold position for 10 seconds. Relax. Repeat five to ten times. If this exercise is too difficult, use balance on your knees instead of your toes.

• Leg and arm raises: Strengthening exercise for back and hip muscles.

 Lay on stomach, arms reached out past your head with palms and forehead on floor. Lift one arm (as you raise your head and shoulders) and the opposite leg at the same time, stretching them away from each other. Hold for 10 - 30 seconds. Switch sides.  A veriation of this is called Superman.  From the same position of laying on your stomach, attempt to raise your chest and arms and at the same time raise your feet with your knees locked. Hold for 10-30 seconds.  

Strong abs are essential for supporting the spine.

• Leg lifts: Quad Strengthening Exercise 

Lie flat on back. Bend left knee at 90-degree angle, keeping foot flat on floor. Keeping the right leg straight, slowly lift it to the height of the left knee. Hold for a count of 3. Repeat 10 times. Switch sides. Work up to 10 sets of 10 over several weeks.

*Safety Tip for Leg lifts:

Lifting both legs at the same time causes excessive stress on your lower back so only lift one leg at a time; the opposite leg should be kept slightly bent with foot on floor.

•  

  Crunches: upper abdominal exercise

•  

Crunches/sit-ups can be performed in a number of ways.  I suggest that you experiment with some different styles until you find one which is comfortable and safe for you.  Keep in mind that several styles can cause stress on your neck or may be to aggressive to start out with.  I have found the Pilates methods to be vary safe and benifical.

Youtube Videos on exercises for people with low back pain^[10][11]

The following videos demonstrate some proper excercises in order to stretch out the back muscles. Try them at home.