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Thursday, August 12, 2010

How to Wreck Your Back

For many people, back pain seems like an unavoidable discomfort. But you may have more control than you think.

You can wreck your back in any number of ways, but a few major offenders stand out: Not stretching, not paying attention to your movements, and years of wear and tear, says Nick Shamie, MD, associate professor of orthopedic neurosurgery at UCLA and a spokesman for the American Academy of Orthopaedic Surgeons.

Here are five habits that put your spine at risk and simple strategies to stop them before the damage is done.

Back Wrecker #1: Weekend Warfare
"Most often, I see people who injured themselves during a weekend basketball game or a round of golf," Shamie says. "These people think they're athletes, but don't train like the pros, and as a result, their backs suffer."

Tackling those "Honey Do" lists at home can also set you up for injury, especially if you were idle for most of the week. Cleaning out the garage, bending over a workbench, or spending hours in the yard or garden can be just as hard on your back as anything you do on a playing field.

"Like any other part of the body, the back is likely to be injured if you haven't warmed up or stretched," Shamie says.

Prevent it: "The only preventive solution I've found for back pain is exercise," says Michael Hisey, MD, orthopedic surgeon and president of the Texas Back Institute in Denton, Texas. "The fix is to stretch and strengthen your core muscles."

The obliques -- the abdominal muscles on your sides -- are especially important for back stability, Hisey tells WebMD.

Hisey's tip: Get an inflatable exercise ball. Use it in your workouts and sit on it, instead of a chair, to engage your abs.

Back Wrecker #2: Poor Lifting Technique
"Improper bending and lifting causes back injury; that's all there is to it," says Dan McMackin, a spokesman for UPS.

Prevent it: Engage your abs to help support your back. Here are the basic principles that UPS uses for safe lifting, according to McMackin:
Bend your knees and keep your back straight. Don't bend at your waist. 
Keep the object close to you. The farther away you hold it from your body, the more it stresses your back. 
Never hold an item higher than your armpit or lower than your knees. 
Don't move something that weighs more than 20% of your body weight. 
Don't pivot, twist, or turn while lifting. Point your feet at the item you're lifting and face it as you pick it up. Change direction with your feet, not your waist. 
Back Wrecker #3: Absentmindedness During Daily Activity

Simple tasks like taking out the trash or washing the dishes can get your spine bent out of shape if your body isn't ready.

And if your mind is running on auto-pilot instead of focusing on what you're doing, you could be in trouble.

Prevent it: Train yourself to keep your core muscles engaged.
A simple way to do that is to pull your navel toward your spine and imagine you're wearing a corset that pulls the sides of your abs inward. Doing that throughout the day -- and especially when lifting or bending -- strengthens and supports your back, says Esther Gokhale, author of 8 Steps to a Pain-Free Back and owner of Ester Gokhale Wellness Center in Palo Alto, Calif.

Back Wreckers #4 and #5: Commuting and Computing
You sit, and you sit, and you sit some more -- at work, while driving, and in front of the TV. And your back doesn't like it. Here's why.

Your discs are spongy and cushion the vertebrae in your spine, but discs have poor blood supply, Hisey says. When you move, fluid circulates through the discs. When you sit still, the fluid is wrung out, so you're depriving discs of nutrition, he says. Spending so much time behind the wheel of a car or sitting in front of a computer adds mileage to our discs, which leads to stress in your back. Studies have also shown that sitting puts more pressure on your spine than lying down or standing up.

"The worst posture is sitting and leaning forward," Shamie says. This makes you lock your pelvis and flex your spine, putting pressure on the front of the vertebrae, where your discs are. The more you arch forward and exaggerate the curve of the spine, the more pressure you're putting on your discs. "This uneven pressure on a disc puts it at high risk of rupture," Shamie explains.

Prevent it: You're going to sit. So try these tactics to lessen its impact on your back:
Get up and move at least once every 20 minutes, unless you're driving. Set your screen saver to remind you; make a habit of going for a drink of water; when you answer the phone, stand up to stretch and change positions. 
Keep your spine properly aligned by holding reading material at eye level (when sitting or standing) rather than bending over. Don't lean over a desk or table to work. Whenever possible, your spine should be straight. 
Choose a chair that supports your back. Adjust the chair so that your feet stay flat on the floor. If the chair doesn't support your lower back's curve, place a rolled towel or small pillow behind your lower back. Remove anything from your back pockets, especially a wallet, if you'll be seated for long periods of time because this puts your spine out of alignment. 

Gokhale suggests doing the following exercises to help lengthen your spine:
Get on your hands and knees. Reach your left arm straight ahead and straighten your right leg behind you. Use your stomach muscles to stabilize. Hold for 5-10 seconds and slowly return to starting position. Switch arm and leg. Repeat 3-5 times on each side. 
Sit tall, lengthen your spine, and let your shoulders relax. Concentrate on squeezing your shoulder blades together, keeping your arms hanging at your sides. Hold for 3-5 seconds, then release. Repeat 10-20 times. 

If All Else Fails
The experts interviewed for this story all told WebMD that most back pain should abate with in 48 hours with a nonprescription pain reliever. But in some cases, your pain could require urgent care.

You need immediate attention if you suffer any loss of bladder or bowel control with your back pain, Hisey says. This is associated with a disc that's pressing on nerves and the faster you relieve the pressure, the faster the function returns.

"Most back pain won't radiate below the waist," Shamie says. "If you feel pain in the thighs or knees, you likely have a disc herniation causing nerve compression." Seek medical attention to ensure there isn't more serious damage.

If your back pain keeps coming back, see a medical professional. You may have begun to rupture a disc or have another injury that could require treatment. "The older you are, the quicker you should get to a specialist," Shamie says.

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