Back Pain
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Please refer to our health precautions section before proceeding.
Please refer to our health precautions section before proceeding.
BACK PAIN IS almost as common as the common cold in keeping people from work, keeping them from activities they enjoy, and keeping them generally uncomfortable and sometimes in serious pain. The tragedy of most back pain is that it's avoidable. Of course, there are different varieties of back pain. Some people suffer an occasional backache after they do too much yardwork; some women get a backache every month with their period; some people get a backache after an all-day car ride. These backaches have obvious causes. Usually a bit of rest, an aspirin or a simple pain reliever, and a heating pad solve the problem. But the people who often complain to me are those who have chronic "bad backs." That is, they feel fine most of the time, but then, seemingly out of the blue their lower back will begin to ache. They may be under particular stress, or perhaps they just moved in an odd way when they got into the car. Sometimes they can point to a particular event that participated the pain, but often they can't. Occasionally the pain is so bad that they have to go to bed. Sometimes the pain lasts for a day; sometimes for a few weeks; sometimes for a month or two.
Before I say any more about backs, I should tell you that if you have severe pain, pain that lasts for more than several days, or weakness or tingling in your legs and feet, you should consult a doctor. Back problems that are caused by congenital deformities or severe injuries will need the care of a physician. But if you have occasional or even regular general pain, you probably can rid yourself of that pain by following some basic rules and adopting a simple exercise program. I've found that one of the biggest challenges in controlling back pain is convincing the patient that simple measures, if adopted consistently, really will make a difference.
The spine is a finely tuned instrument, and its proper functioning depends on a complex system of muscles, ligaments, and bones. The spine is, in effect, a collection of more than thirty bones that are lined up like spools on a rod. The vertebrae--the "spool" bones--are separated by a spongy pad called a disk, which acts as a shock absorber. The term "slipped disk" is misleading: a disk never slips, but it sometimes bulges out and presses against a nerve in the spine, causing pain. Most pain in the lower back is caused by strained and torn muscles, ligaments, and tendons. Disk injury, which is less common, can be more serious. Sometimes the muscles that surround the injured back can go into spasms that effectively immobilize the back (nature's way of preventing further movement) but the spasms can also be severely painful. if you have pain that radiates down your leg, this is known as sciatica, caused by irritation of the sciatic nerve, usually due to pressure from a disk. If the pain is severe, see a doctor for an evaluation. Just remember that in many cases, natural remedies will work as well as medications or surgery.
What do you do when you suddenly feel that major ache in your back? If you're feeling discomfort, the best thing may be to take aspirin or a NSAID like ibuprophen to relieve pain. If you have a history of acid indigestion, heartburn, or ulcer symptoms, acetaminophen is the preferred pain reliever. (Remember that the use of pain relievers should be for the short term only. I recently had a patient who had taken so much ibuprofen to relieve his back pain that he suffered kidney damage. Fortunately, the damage was not permanent. NSAIDs can also irritate the stomach and exacerbate an ulcer.) It's also very helpful to take 1,200 mg. of calcium to help relax your back. Then you need to rest your back; this is best done in bed with your knees raised. While you are resting, you can begin simple stretching exercises: With one leg flat on the bed, pull the other bent knee to your chest. Hold it there for a few seconds and then release it and repeat with the other leg.
While you may need time to rest a back when you feel initial pain, too much bedrest is actually counterproductive; resting muscle fibers start to shorten and stiffen within days, and as little as two weeks of bed rest can cause demineralization of your bones; their return to normal can take many months. You should not spend more than a day or two immobilized. As soon as you feel able, you should start moving and begin the crucial exercises that will help you heal your back and avoid future problems. The key to a strong, healthy back is movement: Regular, correct movement will relieve pain, get you strong, and keep you healthy.
Marianne, a graphic designer, is one of my patients who has learned to conquer her back problems. Here is how she describes her backaches: "My back got really bad after my third baby. I'd always had occasional back twinges but nothing serious. Then after my daughter was born my back would go into spasms about every couple of months. I'd have to lie in bed for days until I could move again. Needless to say, with three children, this wasn't easy. Sometimes I'd feel pain for weeks at a time, and it affected every minute of my day. I'd get impatient with the kids, and I always felt tired.
"But now that I know how to treat my back, I haven't had an ache in two years. I always knew I should do exercises for my back, but I just never did. Now I do them every morning. They're simple and they take almost no time. I do back stretches, bent-knee sit-ups, and some pelvic tilts. That's it. Of course I'm careful about lifting and how I move and bend, and stretch regularly when I'm working at my desk. The relief of not having weeks of distracting pain is certainly worth a few minutes of exercises every morning."
Many people with back problems are aware that exercises might help, but they don't do them. I can't tell you how many patients have told me that they stopped back exercises because they seemed so simple they didn't believe they could really be making a difference and besides, their back was feeling okay. The truth is exercises make all the difference and they can help you banish back pain entirely. The key to avoiding back problems is developing strong limber muscles in the lower back and also in the abdomen.
In addition to the simple stretch you can do in bed, here are three exercises that you should do at least once, and probably twice a day.
- Bent-knee sit-ups: Lie on your back with your knees bent. With your arms extended toward your knees, do a sit-up. It is not necessary to actually sit up; in fact you should simply lift your head and shoulders off the floor. You'll feel the pull in your stomach. You should do twenty-five of these. When your stomach muscles are strengthened, you can cross your arms in front of your chest as you do the sit-up.
- Pelvic tilt: Lie on the floor and tilt your pelvis so that the small of your back is flattened into the floor. Press your back down while counting to ten. Repeat this exercise ten times.
- Wall press: Stand about 10 inches from a wall. Bending your knees, let your back rest against the wall (use your hands to guide you back so your back muscles won't strain). As in the pelvic tilt, press the small of your back hard into the wall, feeling the stretch in both your back and in the front of),our thighs. Hold for a count of ten. Repeat two or three times.
This last wall-press exercise is very effective in stretching your back and in relieving pain, It's particularly useful if you work at a desk or in a sitting position. Most people aren't aware that sitting is the position that's hardest on the back. Even if you sit correctly in a well-designed chair, the pressure on your disks is twice that when you stand. And when you lie down, the pressure is half what it is when you're standing. If you sit for long periods, it's essential that you take frequent breaks, l tell my patients that they should break for a back stretch every half hour. Stand up, do a wall press or two, stretch the arms and neck.
In addition to these crucial back exercises, it's important that you get regular exercise that works the whole body. The best activities for back pain include swimming, cycling (providing you cycle in an upright position), walking (probably the best overall exercise), and rowing (if you are scrupulous about maintaining a straight back). Activities that are more risky because of back twisting and jarring include jogging, golf, tennis, bowling, football, basketball, baseball, and weight lifting.
Obesity can be a major factor in back problems. It stands to reason that a back that is carrying excessive weight can readily become strained. If you are overweight, you need to reduce.
Nutrition is important in maintaining a healthy back, and certain supplements can help relieve pain and strengthen tissue. Be sure to take vitamin C; also, calcium at bedtime to relax muscles.
If you have been told that your back pain is associated with arthritis, the fish oil supplement MaxEPA can be beneficial.
There are many tips that can help you with your everyday movements for times when your back is in pain and also to help you relieve back stress.
NATURAL PRESCRIPTION FOR BACK PAIN
- If you are in severe pain, if you feet tingling in your legs or feet, if your backache is due to a congenital deformity or an injury, you should consult a doctor. You may stiff be able to heal your back yourself with the exercises below, but you should confirm that nothing serious is wrong with your back first.
- If you're feeling pain in your back, try to rest it; if necessary, rest in. bed. Do the knee-to-chest exercise described earlier, alternately lifting one knee. to your chest, keeping the other leg fiat on the bed. Do this every half hour °r so while resting in bed.
- Do the four basic exercises every morning and every evening: the knee-to-chest stretch, the bent knee sit-up, the pelvic tilt, and the wail press. You must do them religiously if you want to enjoy their benefits.
- Don't do any strenuous exercise first thing in the morning.
- When severe pain is improved, get regular aerobic exercise such as walking, cycling, and so on.
- If you sit for long periods of time, you must take regular breaks that include doing the wall press and overall stretching. Take a break every half hour. This includes stopping while on long car or plane rides to stretch.
- If you are over weight, you must lose weight to lessen the strain on your spine.
IN ADDITION TO YOUR DAILY SUPPLEMENTS, TAKE:
- Vitamin C: 500 mg. three times daily with meals.
- Calcium: 1,200 mg, at bedtime.
- Vitamin E: 400 I.U. daffy.
- MaxEPA: 1,000 mg. three times daily (if you have been told that you have arthritis that contributes to your back pain).
HERE ARE SOME TIPS ON LACK-WISE WAYS TO GET THROUGH YOUR DAY
- Pay attention to your posture: Stand with your back straight, your pelvis tucked under, and your knees relaxed. Avoid any position that puts you in a swayback position.
- Never bend with the knees straight; always lift using your leg muscles, not your back muscles.
- When you work standing up, such as at a sink, rest one of your feet a few inches from the floor, say, on the base cabinet or a low stool. This keeps your pelvis tucked in rather than swaybacked.
- When sitting, try to keep your knees higher than your hips by resting your feet on an ottoman or a pile of books. This is especially important if you spend long periods of time sitting.
- Keep your car seat dose to the steering wheel so your lower back is flattened and you're not leaning forward.
- Try not to sleep on your stomach, but if you must, try using a pillow under your hips to prevent a swayback position.
- Never bend forward without bending your knees and tucking your buttocks under.
IN ADDITION: I feel that acupuncture is the most effective treatment {'or lower back pain. This does not supplant the need for regular exercise, but it can help relieve pain and inflammation and make daily activity, including exercise, easier.
There is an anti-inflammatory drug, colchicine, that seems to be helpful in relieving back pain for some people when injected intravenously. [f natural treatments are not successful, you might discuss colchicine with your doctor.
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