Lose weight. Keep your back straight when lifting. Take an over-the-counter pain reliever, such as acetaminophen or ibuprofen, when pain strikes. Most of us are well-acquainted with these back-care basics.
But what if your back still hurts? If you haven't gotten relief from basic treatments and preventive approaches, don't give up. There are many myths that prevent people from getting effective care.
MYTH #1: Lifting light objects won't damage your back.
Twisting or rotating your spine while lifting even a light load can easily trigger acute back pain. When you twist, you compress the spinal joints on one side of the spine and stretch the ligaments and muscles on the opposite side. This can cause pain.
Self-defense: When lifting an object, point your feet and torso in the same direction. This keeps the spine properly aligned, allowing the ligaments and muscles to function properly. Face the object, and bend your hips and knees. Lift with your legs, and keep the object close to your body.
MYTH #3: Abdominal crunches are the only way to protect the back.
These exercises can be helpful, but most people with back problems also need to strengthen and increase the flexibility of their back muscles. Flexion and extension exercises are the best way to do this.
Performing the wrong type of exercise can exacerbate back pain. Follow these guidelines carefully. If you're still uncertain about proper movements, consult a physical therapist. Ask your doctor for a referral.
Flexion exercises.
Perform these exercises at least once daily if you have pain in the lower back after prolonged standing or when you bend backward...or leg pain when walking.
For 15 minutes, lie on your back with several stacked under your knees.
Lie flat, and pull your right knee up to your chest while raising your pelvis off the floor. Hold for a count of three. Relax for a count of six. Perform 10 times with each leg. Progress to both legs at once.
Pull your right knee across your body toward your left shoulder. Hold for a count of three, then relax for a count of six. Repeat 10 times on each side.
Bend your knees, and fold your arms across your chest. Lift your head off the mat, and hold for a count of three. Repeat 10 times.
Extension exercises.
Perform these if you have lower-back pain after prolonged sitting, when bending forward or rising from a chair...pain in the leg that increases with sitting...or back pain that eases when you're walking or lying flat.
For 15 minutes, lie facedown with two pillows under your abdomen and your arms crossed under your forehead.
Lie on your stomach, and prop yourself up on bent elbows. Hold for a count of three, then relax for a count of six. Repeat 10 times.
Stand and place your palms on your lower back, then bend backward. Hold for a count of three, then relax for a count of six. Repeat once an hour.
Lie on your stomach with your arms at your sides. Raise your head and legs off the floor, lifting them as high as you can. Hold for a count of three, then relax for a count of six.
MYTH #4: Back pain is caused by repressed anger or anxiety.
One school of thought, popularized by John E. Sarno, MD, a New York University School of Medicine professor, claims that most back pain stems from repressed anger or fear. This supposedly causes people to clench their back muscles, depriving these muscles of oxygen.
For some people, eliminating emotional problems does help restore muscle function and relieve back pain. However, this approach does not work for everyone.
While anyone can benefit from stress-reduction therapy, most back pain is caused by problems in the ligaments, joints and tendons, which are largely unaffected by oxygen flow.
I've seen many patients who failed with the "psychological" approach to back pain but ultimately got relief from flexion or extension exercises.
MYTH #6: Surgery is the most effective treatment for back ailments.
Only 2% of back problems require surgery. Almost all back pain can be successfully treated with proper posture and a program of gentle corrective exercises. The cases that require back surgery usually involve spinal stenosis (narrowing of the spinal column) or a herniated disc.
If either of these ailments progresses to the point that it causes leg weakness or loss of bladder control, surgery is often the only option. To diagnose the problem, a doctor should perform a physical exam and a magnetic resonance imaging (MRI) or computed tomography (CT) scan.
BottomLine Health, July 2002, David Borenstein, MD
