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Back Pain

Updated 02 October 2018

Preventing back pain

There are many things we can do to prevent sprains, strains and even degenerative disc disease, as well as the fractures caused by osteoporosis.

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While we cannot easily prevent some of the less common causes of back pain such cancer, arthritis, sciatica, kidney infection, infection of the spine, tuberculosis of the spine (Pott’s disease), epidural abscesses and fractures caused by ankylosing spondylitis, there are many things we can do to prevent sprains, strains and even degenerative disc disease, as well as the fractures caused by osteoporosis. 

Follow these preventive steps to lower your risk for back pain:

  • Strengthen your body’s core muscles. This will reduce strain on the back and help prevent injury and pain. It’s important to keep your stomach and back muscles strong to protect you during exercise and sport, or when you’re doing gardening or moving furniture. Even if you sit at your desk working at your computer all day, strong back and stomach muscles will help you to maintain a good posture, preventing neck and lower back pain. 
  • Stretch your back muscles every day. You could also ask a physiotherapist, biokineticist or your gym instructor to show you exactly how to do appropriate stretching exercises.
  • Practise good posture in order to keep your spine strong and stable, and your vertebrae correctly aligned. When you slouch, you put strain on your muscles and ligaments as they try to keep you balanced. This continuous effort can lead to back pain. A lifetime of poor posture can even lead to anatomical changes in your spine. 
  • Stop smoking and avoid second-hand smoke. Smoking causes a restriction in blood flow to the disks that cushion your vertebrae and increases the rate of degeneration.
  • Lose weight if you need to. The burden of extra weight on your spine speeds up vertebral deterioration.
  • To build strong bones and minimise bone loss (i.e. avoiding osteoporosis), make sure you get enough calcium, especially if you’re over 50 (a time at which bone loss accelerates). Take your calcium with vitamins D and K, both of which allow the body to absorb calcium and bind it to the bones.
  • Be mindful of how you use your body when picking up objects. Never bend forwards from the waist. Keep your back straight and bend your knees to lower yourself. Keep your weight on your feet when coming upright and keep your back straight. An adult shouldn’t lift anything heavier than 10kg.
  • Always carry a heavy object against your body, between your hips and shoulders.
  • Never lift your arms above shoulder height when you’re reaching for an object. Rather stand on a stool and store things you use regularly on shelves positioned between hip and shoulder height.
  • Use your leg muscles rather than your back muscles when you push something. Don’t bend your back forwards when pushing, or backwards when pulling. Instead, stand with a straight back, knees bent and one foot in front of the other. This will give you a firm footing.
  • Sleep correctly. Don’t sleep on your stomach, as it forces the lower back into a concave position. Place a pillow under your knees when lying on your back, or between your knees when sleeping on your side. Research shows that sleeping on a medium-firm mattress compared to a firm mattress is twice as likely to improve back trouble in people who suffer from chronic lower back pain.
  • Get up correctly. First sit up when you wake; then move your body and legs to the edge of the bed as a unit. Get up from this sitting position, keeping your back straight.
  • Stand and walk correctly. Pull your shoulders back, keep your head up straight and get into the habit of pulling in your stomach when you’re standing.
  • When driving, support your lower back with a small pillow. Sit as far back as possible and make sure your rear-view mirrors are correctly adjusted. When you get into your car, sit down with your legs outside the car. Now lift your feet and swivel your whole body inside at the same time. Use the hand closest to the safety belt to pull it over you so that you don’t twist your back unnecessarily.
  • When sitting, use a seat with good lower-back support. Keep your knees and hips level and your feet on the floor. Ensure your pelvis isn’t further forward than your shoulders.
  • Bad posture when using your cell phone creates pressure on your neck, which can travel all the way down your back. Good posture means your head is upright, your ears are in line with your shoulders, and your shoulder blades are down and retracted.

The latest research

Take a look at the latest research on what causes back pain:

  • High blood cholesterol and triglyceride levels are associated with faster age-related wear and tear of the spinal discs, confirming a link between your heart health and good blood supply to your intervertebral discs.
  • Smoking has been directly linked to damage of the vascular structures of the discs and joints. The discs that separate the vertebrae of the lower back are kept healthy with blood that’s delivered from the blood vessels. When this blood flow is decreased or stopped because of atherosclerosis (the hardening of arteries that’s often a result of smoking), the discs and joints that keep the back in good working order are not able to do their job properly. Back injury may occur as a result.
  • Reversing vitamin D deficiency (hypovitaminosis D) can improve chronic musculoskeletal pain. This is a type of pain that affects the muscles, ligaments, tendons and bones. It includes chronic lower back pain.
  • Tight neckties can increase muscle tension in the back, neck and shoulders.
  • Slouching on a couch stretches and strains muscles over time, causing imbalances that can be the root cause of back and neck pain.
  • Women who are susceptible to back pain and who suffer from endometriosis may experience a spike in lower back pain during menstruation.
  • A 2014 study published in the Asian Spine Journal showed that about 31% of women and 25% of men who suffered from back pain also had gastrointestinal complaints such as abdominal pain and food intolerance. The link between nutrition and back pain is inflammation: foods high in fat and sugar trigger inflammation throughout the body, including the lower back. 

Reviewed by general practitioners Dr Lienka Botha and Dr Suzette Oelofse, FX Health. April 2018

References:
- Umile Giuseppe Longo et al. Symptomatic disc herniation and serum lipid levels, Eur Spine J. 2011 Oct; 20(10): 1658–1662.
- Dr. Nicholas U. Ahn of Johns Hopkins University, presented his findings at a 2001 meeting of the American Academy of Orthopaedic Surgeons
- Vitamin D Supplementation in Patients with Chronic Low Back Pain: An Open Label, Single Arm Clinical Trial.
- Abdulbari Bener et al. Prevalence and Correlates of Low Back Pain in Primary Care: What Are the Contributing Factors in a Rapidly Developing Country. Asian Spine J. 2014 Jun;8(3):227-236. 

Image credit: iStock

 

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Susan qualified as a Physiotherapist in 1990, and completed her master’s degree in Physiotherapy in 2013 at the University of Pretoria. She has a special interest in human biomechanics, as well as the interaction between domestic and work-related ergonomics.

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