Back Pain – Avoiding It

Here is some of the advice that I hear myself sharing with patient’s who suffer from low back pain.

Tip 1 – Don’t perform repeated bending over or heavy lift in the morning.

Don’t get right out of bed and start bending over to lift objects at home or for work. The lumbar disc pressure is greatest in the morning due to the uptake of fluid into the disc overnight. If the disc is pre-swollen and thus already has higher intradiscal pressure, then it makes sense to avoid any flexion (bending over, rounding your back) based movements early in the morning.

I love working out first thing in the morning. So I have to be especially careful when I bend over that I bend from the hips and not the lumbar spine. I make sure that I’m warmed up properly, and I do bodyweight squats before adding any loads to my deep squats or deadlifts. If you work in a manual labour based occupation, then if possible avoid the lifting jobs until a little later in the morning.

Tip 2 – Sit at work or the car  with a lumbar support

Avoid sitting in a slumped position. Sustained sitting postures tend to be a big factor in people who suffer flexion based back pain. If you have to sit for long periods, use a lumbar roll. Buy a McKenzie roll at Relax The Back Store, Acology on Wilshire Blvd., or use a rolled up towel to put in the small of your back.

Tip 3 – Regarding chairs at work & home

The biggest factor in back pain and back muscle fatigue is sustained poor posture – again, avoid slumping. The best chair in the world is useless if you don’t frequently change position. By this I mean getting up every 20 minutes. Stand up, reach both arms up to the ceiling as if you are pushing the ceiling upwards. Hold it for 20-30 seconds. If you have an ergonomic chair, change the elements of the chair such as height, pitch of the seat and angle of the back support often. While at work or driving long periods, every 1/2 hour change 1 element of the chair to share the load and fatigue around the spine-pelvis. If you have a poor chair, get a new one!

Tip 4 – Mattresses.

We move around a lot more in our sleep than you think – about 40 times per night. It may be a slight change in arm position, or flipping from one side onto the back. I’m not big on spending a ton of  money on a mattress. If your mattress is more than 10 years, you probably need a new one. If you wake up stiff in the morning, try another bed for a couple of nights. If you wake up feeling better, it’s your bed. Get a good quality mattress, usually medium firm is the right one. 

Tip 5 – Bending over

If you have to bend over to pick something up, then bend at your hips not at your back. A Romanian deadlift is an exercise/movement that involves bending over by pivoting the hips into flexion whilst keeping the spine in a neutral position. This is far more effective for protecting the lumbar spine from high disc pressure than bending from the spine or even deep squatting. When you deep squat to lift, most of us don’t have the flexibility in the hips to maintain a neutral pelvis position. What invariably happens is the pelvis posteriorly tilts (tilts backwards) and flattens out the lumbar spine. This is akin to flexing the spine and thus leads to higher disc pressures.

If the object you need to pick up is light and small, then use a golfers lift. This is performed by bending from the hips on one leg whilst the other leg extends straight out the back. Use one hand to support the balance on a table or chair.

Tip 6 – If you have pain, the sooner we talk the faster we can try home remedies and therapy 

If you happen to suffer an acute back pain episode, call me right away. 

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