Poor posture is exhibited by misalignment of the cervical, thoracic and/or lumbar curvatures of the spine (i.e., rounded shoulders, protruding buttocks and abdomen, excessive arch of the lower back). This imbalance of spinal alignment may cause associated ligament and muscle strain as well as compressed nerves. Poor posture over the long-term may increase wear on joint surfaces, contributing to the development of osteoarthritis. Thus, to reduce back pain it makes sense to readjust the spinal curvatures into balanced alignment so as to lessen muscular strain and nerve compression.
"I shouldn't do any physical activity if my back hurts"
The above statement is a myth because physical activity can reduce back pain by increasing muscular strength and spinal flexibility. In fact, it may be due to muscular weakness that is a root cause of back pain. If necessary, follow your doctor's recommendation to get one or two days of bed rest only if the pain is debilitating. In general, acute and chronic pain require up to 2 days and 2 weeks of rest, respectively. Be sure to get up and about soon afterward since lying in bed for an extended period of time may actually exacerbate back pain due to increased stiffness. Remember, staying in bed and relaxing is NOT the best cure or treatment for back pain--the sooner you get moving, the better.
SOME BACK PAIN PREVENTION TIPS:
- Maintain proper posture by sitting on a stability ball while at your desk (it's hard to slump while sitting on the ball)
- Perform core stability exercises daily (e.g., ball hyperextensions, glute kickbacks, supine ball hamstring curls, ball abdominal crunches)
- Take a Yoga and/or Pilates class to increase muscular flexibility, particularly at the spine and hamstrings
- Stretch your muscles daily (esp. hamstring stretch)
- Decrease your bodyweight
- Stop smoking
- Wear comfortable footwear and avoid high-heels and worn-out shoes
- Walk with your chest out, abdomen in, and buttocks tucked in
- Practice abdominal contractions throughout the day
- Shift your bodyweight periodically from one foot to the other when standing for prolonged durations or simply rest one foot on a stool
- Avoid sitting for long periods of time (this is a big one!) and when sitting, be sure to sit up without slouching!
- Put a small lumbar roll against your lower back for additional support while sitting
- Sleep with one pillow under your waist and another between your legs while on your side
- Avoid wearing a heavy backpack or shoulder bag for long periods of time
- Thermotherapy (e.g., ice pack for acute injury to lessen inflammation, heat pad or hot bath for chronic injury to relax tight muscles)
- Cryokinetics (e.g., ice pack immediately followed by knee-to-chest stretch)
- Nerve stimulation (e.g., transcutaneous electrical nerve stimulation (TENS) may block incoming pain signals)
- Chiropractor (e.g., manual manipulation, spinal realignment)
- Massage (esp. deep-tissue)
- Psychologist (cognitive behavioral therapy to target how one thinks about physical activity)
- Biofeedback (train your brain to control your response to pain)
- Spinal injection (e.g., corticosteroid helps relieve inflammation)
- Flexibility (e.g., knee-to-chest stretch, cat-dog stretch, child's pose)
- Exercise (e.g., swimming, walking, yoga)--bed rest is the worst thing you can do and may make your back pain even worse!!
- Sleep with plenty of pillows (i.e., when on your back: position pillow under your knees; when on your side: position a pillow between your knees and another one under your waist)
- Physical therapy (i.e., learn how to properly sit, stand and move without causing back strain; learn core exercises)
- Medication(s): NSAIDs, acetaminophen (e.g., Tylenol)
- Surgery: should ALWAYS be the last option (e.g., discectomy to remove disc material to lessen nerve pain caused by bulging disc; spinal fusion to help stabilize the spine)
- F: resistance training: 2 to 3 days/wk; cardio training: 3 to 5 days/wk
- I: resistance training: less than 80% 1-RM; cardio training: 40 to 65% HRR
- T: resistance training: 15 to 30 mins; cardio training: 20 to 40 mins
- T: resistance training: perform core isometric exercises (e.g., lumbar extension); cardio training: walking, swimming, cycling
- STRETCHING: perform gentle lumbar flexion stretches
Bottom line: You should make every effort to keep your spine limber and your muscles strong and flexible in order to reduce spinal curvature misalignment and the resulting back pain. Don't let back pain be a deterrent to exercise! Continue exercising but at a reduced intensity level and be sure to stretch regularly.
Brian Danley, CFT
"Motivation is what gets you started. Habit is what keeps you going."