Originally published in The Ottawa Citizen October 2 , 2003
Original Title: Bending over backwards to save your back

About 90 per cent of adults will experience acute back strain and pain in their lifetime. It is a leading cause of work absenteeism and reduced productivity in Canada and the United States. Interestingly, most back pain resolves regardless of the type of therapy used. Indeed, most will return to work within three months of the injury. The problem is some will continue to experience recurrent back strain and movement limitations.

Back strain does not necessarily come from excessive weight bearing, carrying heavy loads, falls or trauma. Many times it is the accumulation of physical stress and strain and improper back support over time.

Factors that contribute to back strain include the ergonomics of a workstation, the type of shoes one wears, the type of chair, foot rests, car and truck back supports and medical illness among others.

Most often back strain is due to small tears in the lower back muscles responsible for maintaining posture. Some other causes include herniated or ruptured vertebral discs and arthritis.

Without proper back support, the back muscles can stiffen and become susceptible to strain. Sitting or standing for long periods can also lead to low back strain. Add in lifting and moving of heavy objects or physical labour and the risk of back trauma increases.

There are some common principles to prevent back injury. Even for those with a healthy back these principles will prevent potential back strain over the long-term.

Physical exercise, walking, cycling, swimming and other activities, will help maintain muscle tone and strength. Losing weight will reduce the strain on the lower back as it tries to maintain your body’s upright posture. Modified sit-ups (crunches) will reduce the curve in your lower back, strengthening the abdominal muscles that support it and reducing the chance of injury.

People who have physically demanding jobs are “industrial athletes.” Many succumb to injury because they do not warm-up before work by stretching and participating in conditioning exercises.

Choosing the proper back support techniques depends upon the type of physical activity and the work environment.

Many people remain seated at their desk for hours. The weight of the legs pulls the hips forward and increases the curvature (lordosis) of the lower back. You can feel the strain and tenseness in these muscles.

Shifting or rocking your hips side to side while seated can relax the pelvic muscles. Placing both feet on a footstool pushes and supports the lower back against the lumbar support of the chair. Standing up to move about every 30 to 60 minutes will loosen-up the back and legs.

Footstools can also make a difference when standing in one spot for prolonged periods. Placing one foot on a footstool or a phonebook reduces the curvature of the lower back alleviating muscle and spinal tension.

Feet can take a pounding over the course of a work day in the concrete-floored big box stores contributing to achy joints and back. Orthotics or cushion shoe inserts can act as a barrier to the unforgiving nature of concrete.

Sleep position plays a pivotal role in prevention. Placing one to two pillows under your knees while sleeping on your back will flatten your lower back against the mattress for better support. Similarly, when lying on your side, place a thick pillow between your upper thighs to prevent tilting of the pelvis. Lying on the stomach will increase the curvature of the lower spine and thus strain.

There are several common work-related injuries. Many people injure themselves by using one hand to quickly grab or lift an object. This sudden strain or stretch is akin to rapidly pulling on an elastic band. This rapid change exceeds the elastic’s ability to stretch and it snaps. Muscles respond in a similar vein. Slow deliberate movements instead of sudden jerky ones will prevent small tears within the muscle.

Lifting heavy objects from ground level requires a methodical and slow approach. Bend the knees and keep the back straight when lifting an object. Hold heavy objects close to the chest and slowly lift yourself up using your legs. Your lower back should not be bent at the waist in an attempt to pick up the object. Similarly avoid overstretching or straining to reach objects high up on a shelf.

Carrying infants and young children against the side of the hip can cause back injury should the child suddenly move. Back or front child carriers provide greater stability.

The cardinal rule for back care is to respect pain. If the back hurts, it is best to curtail the activity. For more information on back care: http://www.spine-health.com/, ,

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© Dr. Barry Dworkin 2003