Laura J. Martin, MD
Like the nearly 80% of Americans who will experience a back problem during their lifetime, Beverly Hayes suffers from back pain. For many, the injury is triggered by a strenuous activity, like gardening or weight lifting. Others simply bend down to pick up a pencil and their back gives out.
“It felt like a screwdriver was piercing through by bones,” the 46-year-old Chicago artist says about the pain that developed shortly after she ran a half-marathon. “It took over my life. I couldn’t bend down or sleep — I was petrified I would never feel normal again.”
Mary Ann Wilmarth PT, DPT, OCS, a spokeswoman for the American Physical Therapy Association and chief of physical therapy at Harvard University, says it is critical that people address any back pain or injury right away. “Early intervention can help prevent a chronic problem from developing and obviate the need for medication and surgery,” she says.
Thanks to a combination of activity, core strengthening exercises, and physical therapy, Hayes says her symptoms have improved dramatically over the last year. Here are 12 ways to help alleviate back pain:
It may seem counterintuitive, but studies show that people with acute low-back pain who rest have more pain and are less able to perform daily tasks than those who stay active.
“Patients should avoid more than three days of bed rest,” says Mike Flippin, MD, an orthopaedic surgeon who specializes in back and spine care at San Diego Medical Center. “I encourage my patients to get moving as quickly as possible.”
Activity is often the best medicine for back pain. “Simple exercises like walking can be very helpful,” Wilmarth says. “It gets people out of a sitting posture and puts the body in a neutral, upright position.”
But remember to move in moderation, Flippin says. “Stay away from strenuous activities like gardening and avoid whatever motion caused the pain in the first place.”
The pain may have started after a long workout at the gym, but the strain that caused it has probably been building for years. Wilmarth says most people perform their daily activities with poor posture, putting unnecessary strain on their back.
“Little things add up,” she says. “You can increase the pressure on your back by 50% simply by leaning over the sink incorrectly to brush your teeth. Keeping the right amount of curvature in the back takes pressure off the nerves and will reduce back pain.”
Developing an individualized exercise plan is essential to managing chronic back pain, says D. Scott Davis, PT, MS, EdD, OCS, an orthopaedic physical therapist and associate professor at West Virginia University.
“There is no magic aspirin that addresses lower back pain in everyone,” Davis says. “Some patients need more core strengthening while others benefit mainly from stretching and improving flexibility. Find a physical therapist, exercise physiologist, or chiropractor who specializes in back care. They will match you with the right exercise plan.”
Most people with chronic back pain would benefit from stronger abdominal muscles.
“The torso is a combination of many muscle groups working together,” Frank B. Wyatt, EdD, professor of exercise physiology at Missouri Western State University, tells WebMD in an email. “If the abdominals are weak, other areas must pick up the slack. When we strengthen the abdominals, it often reduces the strain on the lower back.”
Too much tension and tightness can cause back pain. "Our goal in increasing flexibility is to put an equal load throughout the body from the feet all the way up to the head,” Davis says. “One good exercise is to sit on the edge of the bed with one leg extended and the other one on the floor. Give your hamstrings a stretch by leaning forward while keeping your back in a neutral position.”
It’s tempting to baby your back muscles, but Davis says braces should be used sparingly. “Braces are helpful for strenuous activities, like heavy lifting, but only keep them on for 15 minutes at a time,” he says. “If you wear a brace all day, the muscles — which should be providing stability — atrophy and you will have less core strength.”
Heating pads and cold packs can comfort tender trunks. Most doctors recommend using ice for the first 48 hours after an acute injury -- particularly if there is swelling — and then switching to heat.
But "it is difficult to say if ice or heat is more beneficial,” Flippin says. “I recommend that patients use whichever they find comforting as long as their skin is protected.”
The amount of rest you get is important, and so is the position you get it in. “Sleeping in a bad position or on a mattress without support can cause back pain,” Wilmarth says.
Lighting up doesn’t just damage your lungs; it can also hurt your back.
A study recently published in the American Journal of Medicine found that current and former smokers are more likely to have back pain when compared with people who have never smoked.
“Nicotine causes the small blood vessels to constrict and decreases the delivery of blood to the soft tissue,” Flippin says. “I tell all my patients that quitting smoking could help alleviate their back pain.”
Back pain is often associated with underlying psychological issues such as depression and anxiety, says Alex Moroz, MD, associate professor of rehabilitation medicine at NYU Langone Medical Center.
“Your emotional state colors the perception of pain,” Moroz says. “Therapy can be a helpful part of rehabilitation.”
Research shows that practices such as meditation, deep breathing, tai chi, and yoga, which help put the mind at rest, can do wonders for the back.
“If you can induce a relaxation response, it will help reduce the perceived pain level," Moroz says.
SOURCES:American Chiropractic Association.Beverly Hayes, Chicago.Mary Ann Wilmarth, PT, DPT, OCS, spokeswoman for the American Physical Therapy Association; chief of physical therapy, Harvard University.Hagen, K. Cochrane Database of Systematic Reviews, (4): CD001254. Mike Flippin, MD, orthopaedic surgeon, Southern California Permanente Medical Group Kaiser Permanente, San Diego Medical Center; fellow, American Academy of Orthopaedic Surgeons.D. Scott Davis PT, MS, EdD, OCS, orthopaedic physical therapist and associate professor, West Virginia University.Email from Frank B. Wyatt, EdD, professor of exercise physiology, Missouri Western State University.Shiri, R. The American Journal of Medicine, January 2010; vol 12: pp 87.e7-87.e35.Alex Moroz, MD, associate professor of rehabilitation medicine, NYU Langone Medical Center.Morone, N. Pain, February 2008; vol 134: pp 310-319.
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