Don’t Be Spineless

"In health there is freedom. Health is the first of all liberties."
Henry F. Amiel 1850

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Our spines are the backbone and foundation of our bodies.
Because of poor maintenance, millions of people suffer from chronic back and neck pain.

All nerve impulses originate in the brain and flow down the spinal cord, which is housed within the spine. There are 24 vertebrae, plus the sacrum and coccyx that make up the spine. Nerves from the spinal cord pass between the vertebrae, and these, in turn, send thousands of smaller nerve branches to every part of our body. In learning how to take care of this complex system, we need to become aware of the way we sit, stand, walk, sleep, and how we perform our daily activities, both work and play.

Posture and sleep
Only 25% of chronic low back pain is due to lifting heavy objects. 75% of chronic pain stems from bad posture, prolonged sitting, obesity and lack of exercise.

Maintaining a correct posture while sitting, standing or sleeping is an important part of keeping your back and neck free of pain. Slouching is a bad habit of mine that makes me look older and shorter. I am still working on this problem. Slouching bends your neck and accelerates aging of the skin around it and the “eventual need for neck lifts”.

Many people spend their entire work day sitting or standing, and too much of either can lead to back pain. However, there are several ways you can guard against this. While sitting, make sure your lower back is getting enough support. If possible, you should have an ergonomically designed chair for your office. Otherwise, try placing a pillow or rolled up towel behind your lower back to keep you upright and prevent slouching.

If you sit for long periods of time, get up to walk around, preferably every hour, arching your back gently and performing a few simple stretches. Even if you're driving, stop as often as possible to stretch. Do not carry bulky items, such as wallets, in your back pockets while you're sitting as this can place extra stress on the back. If your job involves twisting to the side in order to use a typewriter or computer, try positioning your chair so that you will be directly in front of the typewriter or computer. If you have to sit for long periods at the computer, make sure the screen is on a level with your eyes so that you will not have to tilt your head back adversely impacting cervical disks. If you can, tilt the computer screen so that it is comfortable for your viewing. If your job is repetitive, such as using one arm on an assembly line, try using the other arm when possible for the same length of time. If you can, switch jobs from time to time with someone who has a different repetitive job.

The proper driving position will help prevent backache and fatigue. Sitting at the wheel, your seat should give you the proper support for your back. Get in the habit of keeping your hands at the 4 and 8 o'clock position on your wheel. That will not only prevent undue strain on your back and shoulders, but it can help prevent serious injuries should your air bag inflate for any reason.

If you stand all day, have a small stool handy to prop up one foot at a time. If possible, lean against a wall or counter.

Do not wash your hair at the sink; instead use the shower so as to maintain an upright spine. When brushing your teeth, do not stay bent over the sink; brush standing up straight until you are ready to rinse.

Getting a good night's sleep will set you up for a pleasant day. Use a good quality firm mattress but not one that is hard enough to prevent proper contouring to your body’s form. Your mattress should maintain your spine in a straight line. If you sleep on your back, place a pillow under your head and neck, but be sure it is not so high as to keep your neck bent. Another pillow placed under your knees is advisable but I personally find it impractical. When turning on your side, make sure the pillow for your head and neck is thick enough (bunch up your pillow if necessary) to support your head in a straight line, so as not to let your head sink lower than the rest of your spine. Do not sleep on your stomach. Sleeping on your stomach will place too much stress on your neck. People who sleep on their stomach also have a tendency to keep one arm above their head, which in all probability is apt to cause future shoulder problems.

Lifting Techniques
Improper lifting of heavy objects causes many back injuries. If you must lift a heavy object, take some time to prepare. First, make sure that you can carry the load by lifting up a corner to test it. Next, determine where you are going to move the object and choose the shortest route possible.

A few important tips when lifting or moving a load:
• When bending down, always bend at the knees-never at the waist.
• Keep the object close to your body.
• Don't twist your body while carrying an object.
• Avoid lifting anything over your head
• When moving a heavy object, push it instead of pulling it.
• Most importantly, if the load is too heavy, ask for help.

Exercise
Exercising your back muscles can strengthen and protect the muscles, helping to prevent injuries. Abdominal muscle exercises such as sit ups and crunches are not just for teenagers who dream of having well-defined “six pack abs”. These are essential to keep your back strong and to stabilize your spine, where nerves are vulnerable to compression as they exit the spinal holes. You can ask your doctor or physical therapist to show you some special back strengthening exercises. Some sports--such as golf, tennis, racquetball and football--can be harmful if not played properly. These sports place pressure on the spine because they involve frequent twisting, bending or impact. When playing these sports, be sure to warm up beforehand to get your muscles ready.

Lifestyle Changes
There are several other changes you can make to decrease your risk for back pain: lose weight, decrease your stress level and exercise.

Finally, if you suffer from chronic back or neck pain, do not rush for surgery. With few exceptions, such as when back pain is accompanied by leg or arm pain, or when your bladder function is impaired, spinal surgery can more often make you worse. Luckily, 95% of lower back pain can be treated without surgery. I have seen hundreds of patients crippled with "failed back surgeries." At least get a second or even a third medical opinion. One of the problems with multiple opinions is that the recommendation is heavily colored by the specialist’s glasses. Acupuncturists and chiropractors rarely encourage surgery, whereas, orthopedists and neurosurgeons are much more likely to do so.

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