Features October 2006 Issue

4 Moves That Can Save Your Back

Back pain, as you age, is common -- but not inevitable. Proper exercise and a few lifestyle changes can help you beat the odds.

Your spine is a mechanical wonder, providing the stability and strength needed to support your shoulders, rib cage, and pelvis. You depend on your spine for flexibility, which allows you to twist and bend your body. But when the structures that comprise or surround your spine deteriorate, or are unduly stressed, backache can result.


   The most common site of back pain is the lumbar region, or lower back, which bears the most weight and stress.


   “Several factors play into the increasing incidence of back pain that limits us in some way as we age,” says A. J. Cianflocco, M.D., a physician in the Cleveland Clinic's department of orthopaedic surgery. “Staying in shape, and focusing on posture, body mechanics, and back exercises, can help prevent or manage most back problems.”


Why does it hurt?

“The most common cause of back pain is loss of muscle strength,” notes Dr. Cianflocco. “After age 40, we lose muscle mass at the rate of one percent a year. Loss of strength in the back, hamstring, gluteal, and abdominal muscles puts more stress on the back.”


   Other common causes of back pain in aging adults are arthritis in the facet joints--the small synovial joints that link your vertebrae together--and degenerative disc disease, in which the spongy material between the spine’s vertebrae collapses. When this occurs, the discs no longer act as shock absorbers, and the vertebrae rub against each other or press on spinal nerves, causing pain.


An underlying cause of back pain is poor posture, which can distort the normal curvature of the spine and put stress on your back. The spine has three curves: at the neck, middle back, and lower back. When these curves are properly aligned, your weight is evenly distributed among your vertebrae, there’s less pressure on your discs, and your spine is stronger.


   A corollary to posture is body mechanics, which refers to your posture as you engage in activities. Sitting slouched or slumped, without preserving your spine’s curves, is one example of poor body mechanics. If you habitually put stress on your spine with poor body mechanics, you’ll ventually pay with a backache.


Correct alignment is key

Good posture is the basis for good spine health. Stand tall with your head straight, shoulders back, chest lifted, and abdomen in. To support the urvature of your lower back when sitting, make sure your chair has good lumbar support, or place a pillow or rolled towel between the chair and the small of your back. Don’t sit for long periods of time; prolonged sitting causes muscles to shorten and reduces circulation to spinal discs, causing more rapid disc degeneration.


   Observing some guidelines will help you develop good body mechanics as well as good posture. “When picking up an object, avoid bending from the waist. Instead, bend your knees, keeping your back straight,” advises Dr. Cianflocco. “The spine doesn't rotate well, so avoid lifting and twisting simultaneously. Certain sports that involve repetitive twisting motions, such as golf and tennis, an be particularly stressful on the back.”


Back strengtheners

To strengthen your back without straining it, engage in regular aerobic activities--such as walking, swimming, or biking--at least every other day. Warm up first by doing a slow version of whatever activity you’ve planned for10 minutes. “A sedentary lifestyle leads to loss of flexibility and strength,” says Dr. Cianflocco. “Any form of aerobic exercise will strengthen your back and abdominal muscles and lower your risk of back pain.” 


   By strengthening your muscles, you make them less susceptible to injury that can cause back pain. Do strengthening exercises for your back muscles and for the abdominal muscles that support the back. Do flexibility exercises for your hips and upper legs to help maintain alignment of your pelvis and prevent back pain. Include back-bending exercises to preserve the normal curvature of your spine, relieve pressure on discs of the lower back, and counteract poor posture.

Healthy body, healthy back Maintaining a healthy lifestyle will help you maintain a healthy back. If you smoke, stop. Smoking decreases blood flow to the discs. Lose weight if necessary; obesity increases stress on discs, joints, and muscles.


    You may be more prone to back problems if you’re stressed; stress

produces muscle tension and can interrupt your normal routine, so that you may decide not to exercise as much. Get enough sleep; discs compress when you’re standing and absorb more nutrients when you’re lying down.


Self treatment

If you have an episode of back pain, you may be able to treat it yourself. “As long as the pain doesn’t wake you at night and you don’t have sciatica,” says Dr. Cianflocco, “you can treat a backache by avoiding activities that aggravate the pain and taking over-the-counter pain relievers. Apply ice, but avoid heat. Heat can increase inflammation and aggravate symptoms.”


   Continue your normal activities. Light activity speeds healing while prolonged bed rest can delay it. Avoid heavy lifting, prolonged sitting, and repetitive bending.


   If symptoms don’t subside in several days, or if you have constant pain, numbness or weakness in the legs, fever, or unexplained weight loss, contact your doctor. Diagnosis is based on your medical history and a physical exam, during which your doctor will assess your posture, body mechanics, and flexibility. Treatment will depend on the diagnosis, but most patients recover with conservative measures. In some cases, injections of steroid medication are effective for lower back pain.


Staying pain-free

Back pain is not a normal part of aging, even though the risk for it

increases with age. By making a few lifestyle changes, you can increase your chance of being pain-free.  


“The best way to prevent back pain,” says Dr. Cianflocco, “is by staying in shape, keeping up with back exercises, and concentrating on posture and body mechanics.”