Help for your aching back

By JOAN PATTERSON

VIEW ON HEALTH

Our backs are the workhorses of the body, a complex marriage of ligaments, muscles, joints and discs that let us do everything from compete in triathlons to dance the Texas Two-Step. In fact, when they work, they work beautifully. But when they do not, simply bending over to tie a shoe can seem insurmountable.

According to national statistics, back pain is one of the most common complaints patients have when they visit their doctors and about 80 percent of us will experience lower back pain at some point in our lives. Of course, beyond all the statistics is how back pain can interfere with our quality of life.

There are, however, some very simple steps that can be taken to help prevent common back pain. We talked to three experts about the issue: Dr. Robert Kessler, a doctor of osteopathy and associate professor at Touro University Nevada in Henderson; Andrea Avruskin, a physical therapist and spokesperson for the Nevada Physical Therapy Assoc.; and Kathleen Grace Santor, director of the Stress Management Center of Nevada located in Henderson.

Together, they gave us their advice on keeping back pain at bay, everything from walking up flights of stairs to learning how to cope with the daily stressors in our lives.

AVOID SMOKING, CAFFEINE

One of the risk factors for back pain is smoking because it actually decreases the oxygen level in the body which means muscles cannot function as well, Kessler notes. Smoking also increases the load on the sympathetic nervous system which serves the body by increasing heart rate, for example, and constricting blood vessels.

Other risks factors include too much caffeine, the abuse of alcohol, lack of physical activity and obesity. According to Avruskin, every pound that a person is overweight puts 10 pounds of stress on the spine.

GET MOVING

The most common causes of back pain are stiffness in the spinal joints, weakness of the trunk muscles and overstretched ligaments, which are the fibrous bands of tissue that hold together the spine’s vertebrae and discs, Aruskin notes.

These can be the result of sitting or standing for long periods of time, particularly in a slouched position. Avruskin recommends consistently sitting and standing up straight, and getting up from a sitting position every 30 minutes to walk around. She also suggests bending the spine backward and side to side, and rotating it side to side.

When watching television use those commercial breaks to move around, and try to avoid the couch, she adds. Couches are the worst when it comes to supporting the back because their softness allows the sagging of the spine which overstretches the ligaments and can lead to bulging discs. Instead, use a supportive chair such as a dining room chair.

WORK IT OUT

To prevent back pain, doctors will usually tell their patients to exercise, no matter what age, because it strengthens the back muscles and keeps the joints moving. This does not mean running a marathon but taking steps to get the body moving in a helpful way.

Kessler recommends activities such as Tai Chi, yoga, water aerobics, swimming and walking which are all beneficial for the spine. In fact, it is a good idea to practice more than one type of exercise in order to use different muscles and, therefore, reap the most benefit. Just make sure they are activities you enjoy and will continue to do.

It is a good idea for those who are just starting an exercise regimen to begin slowly, such as going for short walks. Those with health problems should always consult a doctor to determine what exercises will be the most helpful and pose no risks, he added.

TARGETING MUSCLE GROUPS

There are exercises to target key muscles such as the postural muscles on the back side of our bodies which keep us standing and sitting straight. They can include “rows, lat pulldowns, scapular squeezes, swimming-type motions while lying on your stomach on a mat, and lifting one arm and the opposite leg while on your hands and knees,” Aruskin says.

But, again, it is important to consult a physician or physical therapist to make sure these practices are right for you, and to ensure they are being done correctly.

Aruskin points out that if you already have back pain, exercises that work the joints are the most beneficial. There is a specific technique that physical therapists use called McKenzie MDT “which focuses on finding the spinal motion that will quickly relieve your pain.” Once the right exercise is determined by a therapist, it can be taught to a patient who can then use it at home.

Those with simple back aches that came on after sitting too long, for example, or bending forward, might benefit from the book, “Treat Your Own Back,” by Robin McKenzie which shows readers how to get rid of their own pain at home.

FIND THE TIME

Sometimes it seems impossible to fit exercise into the daily routine. Among the top reasons clients at the Stress Management Center say they do not exercise is lack of time and feeling too tired at the end of the day, Santor notes.

All three experts agree, however, that it is vital to spend the time to exercise or at least get up and move around to prevent back pain, especially if you are sitting at a desk all day. It could mean walking the perimeter of a building on campus or at work, using stairs instead of elevators, even parking at the far end of a parking lot to increase the walking distance to the front door of a grocery store or restaurant, Kessler says.

MOM WAS RIGHT

Your parents may have had their own reasons for encouraging you to “sit up straight” but were actually teaching you a very important lesson about maintaining a healthy back. Good posture is key in staving off back pain and can actually allow the spine to heal faster after an injury.

“The natural arch in the small of your back should be maintained whenever you are sitting or standing. When your low back or upper back is allowed to slouch, the muscles and ligaments get slowly overstretched which can cause them to be painful,” Aruskin says.

When sitting it is important to make sure the hips are all the way back, “jammed up” against the back of a chair, Aruskin says. She also provides this tip for keeping the natural curve of the back and, therefore, preventing or reducing pain: Roll up a towel to the thickness of your forearm, and place it between the small of the back and the chair, then lean back against it.

Kessler notes that while sitting at a desk, the knees should be bent at a 90-degree angle and computer monitors should be set up so that one’s eyes are looking straight ahead “at the middle to upper three-quarters of the screen.”

MAKE JOB BACK-FRIENDLY

There are thousands of Las Vegans with jobs that require them to be on their feet for long periods of time including dealers and cocktail servers. But there are ways to make it easier on the back.

Aruskin recommends standing up as straight as possible with the chest up and shoulders back. Dealers should be standing as close to the tables as possible to limit how far they have to reach, she added, and they need to periodically shift their weight from one foot to the other.

During breaks, it is a good idea to take a brisk walk to restore circulation in the legs and back, and to stretch and twist the back.

When lifting something, including a young child, get as close to it as possible, bend your knees rather than learning forward, hold the object or child close to your stomach, then rise by straightening the knees.

ADDRESS THE STRESS

When Kessler talks to a patient about back pain it usually means looking at their lives as a whole.

“One question that is predictive (of back pain), and it’s going to surprise you, is, ‘Do you like your job?’ Being happy. Stress causes us to use our bodies differently,” Kessler notes.

Santor agrees. Stress such as that experienced on the job or at home can cause muscles to tense up and exacerbate problems in the lower back. The best way to deal with it is to regain some kind of control.

A gentle yoga class that includes breathing techniques and calming poses is one way to learn how to soothe an overtaxed nervous system. “The calming effect of a good yoga class is excellent because the parasympathetic part of your nervous system kicks in and now you get the benefit of rebuilding,” Santor says.

Relaxation tapes are also helpful and, in some cases, the advice of a counselor who can help you directly address the stressors in your life.

“It’s a good idea to approach (stress) from different directions,” Santor added.

WHEN TO GET HELP

Finally, there are certain red flags when it comes to back pain that can signify something more serious, according to Kessler. These include back pain that travels from the back to the legs; worsens while laying down at night; pulses or is accompanied by symptoms such as a cold temperature, loss of sensation, numbness or weakness; or is associated with the loss of control of the bladder or bowel, weight loss, diminishment of appetite, fever or abnormal uterine bleeding.