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Prevention of low back pain

Get up and walk

Karen Miller
Prevention of low back pain
Master Heg Robinson teaches tai chi out of his Roxbury studio (Photo: Ernesto Arroyo)

It’s bad enough that you will probably get low back pain at some point in your life. But to make matters worse, up to 50 percent of those afflicted will suffer a recurrence within a year. The odds are against you, but all is not lost. It may be possible to reduce the risk of recurrence or even that first bout of low back pain.

It’s impossible to turn back the clock. Age is indeed a significant risk factor for LBP. The bones, joints and discs of the spine begin to wear. Regardless, the same oft repeated mantra to reduce the risk of cancer, diabetes and heart disease applies to low back pain as well: exercise, maintain a healthy weight, follow a healthy eating plan and do not smoke.

Exercise

Exercise is essential to preventing low back pain. A recent study published in JAMA Internal Medicine analyzed the results of clinical trials including almost 31,000 participants. The findings suggest that exercise alone or in combination with education on the benefit of exercise is effective in preventing LBP.

Most people automatically think of the abdominal muscles, or “abs” to strengthen the torso, more familiarly called the core. Indeed the abs are important. They help pull you out of bed each morning, but they’re a part of a group of muscles — many of them hidden — that work together for core strength.

Actually, aerobic exercises, like walking and swimming are great core exercises that provide a high benefit but low risk. At first glance it may seem that the legs are doing all the work, but in fact the core is doing its job. The core muscles are stabilizers and work in unison to keep you erect. If the muscles are not working, you wouldn’t even be standing, let alone walking.

Exercises like planks that stabilize the torso, are recommended to increase core strength. Yoga and tai chi improve posture, balance and body alignment as well as strength.

Keep a healthy weight

Too much weight can do its share of damage to the spine. It stresses not only the back muscles but also the bones and joints. Distribution of the weight is a factor as well. Beer bellies put an unusually high stress on the back, which can result in an increased lower back curvature. According to the American Obesity Association, women who are obese or who have a large waist size are particularly at risk for low back pain.

Normal waist size for women is 35 inches or less, 40 inches or less for men. A normal body mass index, or BMI, ranges from 18.5 to 24.9. The BMI is not perfect. It cannot distinguish between muscle and fat and can push a muscular person into the “overweight” category. Calculate your BMI online or using the following formula:

BMI = Weight in pounds / (Height in inches x Height in inches) x 703

Healthy eating — a diet rich in whole foods, such as veggies, fruits and whole grains — goes hand-in-hand with a healthy weight.

Don’t smoke

Here’s another good reason not to smoke. Roughly 90 percent of all cases of lung cancer are linked to smoking or second-hand smoke. But cigarettes do a lot more damage. Smoking harms nearly every organ in the body, according to the American Cancer Society.

It also increases the risk of LBP. A study published in the Annals of Rheumatic Diseases found that smoking, regardless of lifestyle, jobs and activity levels, increased the risk of back pain by roughly 30 percent. It is unclear how smoke affects the spine. Some researchers suggest that nicotine from tobacco might influence how the brain processes awareness of pain. Another theory is that smoking reduces the flow of nutrients to the joints and muscles of the back.

Use proper body mechanics

The spine is very strong but works more efficiently when the parts are in alignment. That’s why slouching and other forms of poor posture place undue stress on the spine. For instance, a study by Dr. Kenneth Hansraj, a New York back surgeon, found that looking down at a cell phone is the equivalent of placing a 60-pound weight on one’s neck.

Improper lifting causes even more dramatic changes in the lower spine. It’s all about physics. When you lift an object the lower spine must bear the weight of the upper body as well as the weight of the object. If you lean forward when lifting you are not only changing the back’s alignment, you are moving the center of balance of the body forward. This action can exert tremendous force on the back, particularly if the object is heavy.

If you have good general health and follow these suggestions to take care of your back, you may be one of the 20 percent that manages to go through life without a painful low back.

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