Back Pain ­­ The Low Tech Treatment Approach

part one

Statistics show the 85 percent of all Americans at some time in their lives will experience some form of back pain, especially lower back pain. And back pain costs the average American, the medical system and corporate American more money than any other disease except heart disease. Is there an answer to all this back pain, or should we all run out and buy stock in drug companies?

We buy back braces, weight belts, drugs; we have our backs injected, rubbed; we do chiropractic, hot packs, ice and surgery. Yet many continue to suffer unrelenting pain. Why the back and not the shoulder, hip or knee? These joints are exposed to tremendous amounts of use as well, yet they do not cause nearly the problems as does the low back. Why?

The problem begins with the fact that most treatments fail to address the underlying problem and treat only the pain. Pain is simply a message sent by the brain that something is wrong ­­ to take action, change, move or avoid. We use crutches, such as drugs and palliative treatments, that are only covering up the real issue.

The evolution of our species fell short when we went from using four extremities to two for weight bearing, therefore leaving the lower back a weak point in our body. And because the lower back is at the bottom of the spine and the top of the legs, it is exposed to forces from above as well as below. When someone complains of low back pain, they may be referring to one or more of the 18 joints that comprise the lower back. As complex as the "machinery" is, fine tuning it is not as difficult as it may seem.

First things first. If we understand the workings of our bodies­­ and in this case our backs and how to protect them­­ we're way ahead of the game. The lumbar spine is an anchor point to, and under direct influence from, the largest muscles in the body. When abdominal and back musculature are well coordinated, toned and strong, we will not be as likely to suffer with back pain. And the rate at which the spinal structures, namely the discs, wear is slower.

Even more importantly is how we use our backs. On the top of that list is lifting technique. The lumbar spine and musculature are commonly overused and abused by poor lifting ­­ lifting with straight legs, bending at the waist rather than keeping the back straight and bending at the knees. Straight­leg lifting minimizes the contribution from the strong muscles surrounding the knees and hips.

Keeping the weight off is also a must. Obesity places a great deal of added strain on the back. Because the majority of the added weight is in the abdomen, the spine is pulled forward and curves the lower spine abnormally, causing pain. The added pounds cause further compression of the discs of the lumbar spine.

Poor posture is second only to incorrect exercise in the cause of back pain and injury. We tend to stand with our knees locked which throws the entire torso forward causing more curvature of the lower spine. Slumping, slouching in chairs, leaning ­­ all interfere with our bodies' ability to resist gravity efficiently, adding extra strain on the back.

This may come as a surprise but the lumbar spine is not designed for sitting. Another cruel trick of evolution. When you sit in a chair, the compressive loads on the lumbar discs are up to 40% greater than when standing. Therefore, those who have sedentary jobs sitting can be more prone to low back pain.

And, lastly we are poorly educated about how to exercise. Attempts at exercise are often disappointing for patients working on their own without proper instruction. In fact, many individuals further injure their backs with inappropriate exercise.

What can we do? Return to the basics with focus on the above problems ­­ a low tech, no bells, gadgets and whistles approach to good, healthy back care.

Happy Holidays! Rebecca.

part two

Let's look at low-tech maintenance for the back.

Number one ­­ know your strengths and weaknesses. Were you blessed with a strong back? If you were, that's good, but you still need to know how to take care not to injure your back. If your back is not as straight or as strong as you would like, strengthening exercises can improve the situation.

Flexibility, good posture, strength and correct lifting will prevent injury and keep your back healthy. Flexibility is something we were born with, although it can be improved upon ­­ or lost if not utilized. How flexible is your back? If you can place your hands flat on the floor with legs straight, you have good flexibility. Basic stretching will be all you need to do. If you cannot place your hands flat on the floor, you will need to do more stretching and pay closer attention to lifting posture and strength.

Good posture means standing with knees relaxed, arms at your side, shoulders back, but not a stiff military posture. This allows the head to "float" atop the spine at angles that help our bodies resist gravity efficiently. If you stand for long periods of time, rest the low back by placing one foot up on a foot stool, as if you were just about to climb a set of steps.

As I mentioned last week, sitting is not good for the low back. When you are sitting, sit in a straight chair with support to the back, feet flat on the floor and no arm rests! Take frequent breaks from sitting to stretch and bend the low back. Be sure work height is appropriate. Your arms should rest comfortably at your side when working with a computer ­­ a desk top is too high.

Strengthen the back by doing exercises that strengthen the abdomen. Leg lifts, singularly or together, sit ups and crunches and bicycling are good exercises for the abdomen. If you are out of shape, be sure to warm up with stretching exercises and don't over do it! In an attempt to improve their low back pain, over zealous exercisers often end up further injuring their back. If you have recently injured your back, work with a physical therapist that can determine your strengths and weaknesses and design a program just for you.

When lifting, always squat rather than bending from the waist. This allows you to use the powerful leg and hip muscles, and protects the low back.

Obesity and low back pain is a viscous cycle. The inability to exercise due to pain further weakens the back and keeps the weight from coming off. If this has happened to you, seek professional help.

If you have injured your back, and a day or two of rest combined with heat has not improved the situation, seek professional help. Rest and sleep are vital to the restoration and repair process, so you may need medication, if simple measures are not working.

Here are some "best" home remedies I have found that can help.

Add a magnesium supplement to your diet. Most Americans have enough calcium in their diets, but without magnesium, calcium is not utilized in the body. Magnesium has the ability to "pull" calcium back into the blood stream making this much needed mineral available for healing.

Try a digestive enzyme or fresh pineapple juice high in the enzyme bromelian. Enzymes work as natural anti-inflammatories easing the discomfort of swelling and pain. Vitamin C also works like a natural antiinflammatory. Take at least 2,000mg daily, preferably Ester C which is not as acid and stays in the system longer.

Try a massage. A professional body massage has been shown to be the single best muscle relaxant over and above medication. Your professional massage therapist can also help you determine if further medical help is needed.

Medical magnets placed over the trigger points of pain have also been proven to help relieve pain and discomfort. Medical magnets can be expensive, but they don't have to be. An ordinary magnet used on the frig will not be strong enough to be beneficial.

Remember that rehabilitation through exercise, and weight loss if necessary is the answer to recovery from chronic back pain, not drugs and braces.

Till next time, Rebecca.

Posted to Zephyr Online December 24, 1998
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