There's an old joke that goes: "You know
you've reached middle-age when your back goes out more than you do." In
actuality, lower back pain is a common problem that afflicts people of all
ages and from all walks of life. The most recent statistics show that
lower back pain disables as many as 1 million persons in the United States
Lower back pain will cause about 50 percent
of ill Americans to miss at least one week of work during their lifetimes.
"Next to the common cold, back injuries are the leading cause of worker
absenteeism," notes Dr Scott Van Oosten, D.C., of the Lakewood
Chiropractic Clinic. "Back pain is a huge industrial cost in this
Last year, more than $80 billion was spent
on the treatment of lower back problems, making it the most expensive
healthcare cost in America.
While Dr. Van Oosten says that the majority
of his patients are in their early 30s to their 50s, their occupations
range from factory laborers to corporate executives. ''Many of our
patients are laborers who have experienced lifting or carrying injuries"
he says. "But we're seeing a growing number of people who have desk
jobs. Many sedentary office workers are experiencing problems in their
lower backs and cervical areas due to sitting in front of a computer all
Add to that the typical rash of "weekend
warrior" back injuries caused by excessive sports activity or even
gardening, and practitioners such as Dr. Van Oosten are assured of full
waiting rooms for years to come.
So what causes lower back pain?
Barring a serious condition such as a
ruptured disk, scoliosis or a traumatic injury, Dr. Van Oosten explains
that the main causes of lower back pain are stress, poor posture, and lack
of exercise. All of these factors can have a detrimental effect on
the curvature of the spine. Without proper curvature, the risk of lower
back injury increases.
The spine is an intricate structure: It's
sturdy enough to house and protect the spinal cord, yet it's flexible
enough to permit movement in all directions. The elastic intervertebral
discs, which serve as shock absorbers between the vertebrae, allow spinal
mobility while maintaining a high degree of stability. These discs are
susceptible to injury when they're subjected high compressive forces or
put into compromising position.
When in a "neutral" position, your spine has
a natural S-shaped curve, and the discs can withstand tremendous amounts
of force. Any deviation from neutral alignment can cause disc compression,
which may lead to excessive compression on side of the disc and/or extreme
bulging on the opposite side.
"In many cases, being sedentary can lead to
poor postural weakness," Dr. Van Oosten says. "Muscles should support the
spine, but most people don't exercise and they become deconditioned.
Along with lack of exercise, poor diet and excess weight can exacerbate
the postural problems."
If you have a slouching posture, says Dr.
Van Oosten , you put pressure on areas that are not designed for the
weight. Muscles tighten in trying to compensate for poor posture. Over a
period of time, this can produce uneven wear and tear on the joint."
Reduce the risk
Lower back pain is subject to a wide range of
treatment. Therapies include heat packs, massage, chiropractic
manipulation, steroidal injections, and orthopedic surgery. While the
American medical community has a definite prevailing stance about
treatment of lower back injuries, Dr. Van Oosten says we need a greater
focus on prevention.
Explaining that the key to prevention is
spinal fitness, he says, "To reduce your risk of back injury, it's
important to keep your spine in neutral alignment, especially when
exercising. It's essential to keep your abdominal muscles and lower back
in good condition. By maintaining torso fitness, it will be easier to
support your spine and keep it aligned."
Always strive for neutral alignment, whether
sitting or standing. In general, standing neutral alignment is achieved
when the head, neck, shoulder joint, hip joint, knee joint and ankle joint
form a straight, vertical line when viewed from the side. The key to
neutral alignment starts with the head: If your head drops, your neck
bends, often followed by rounding of the shoulders, ultimately leading to
rounding of the back and slouching.
Specific muscle exercises can help
strengthen the back and prevent the injuries suffered by millions of
Americans. To shore up deconditioned backs, focus on the lumbar extensors
and the abdominal muscles. Weak abs allows the belly to sag, creating a
greater load on the lower back, forcing it to hold up the mass in front of
it. Strengthening the abs promotes a more upright positioning of the
Exercising to increase the strength of the
lumbar extensors will help improve posture and significantly decrease the
incidence of back pain. Strong lower back muscles and strong abdominals
work together in maintaining a pain-free healthy back.
Dr. Van Oosten advises these two basic back
Opposite arm and leg raises: Start on all
fours, resting on hands and knees. You should look straight down, neither
tucked nor looking up. From this position, simultaneously raise and
straighten your right arm and left leg until they are parallel to the
ground (or as close to parallel us you can) without going past the
parallel position. Hold for two seconds and come back slowly to the
starting position. Repeal with left arm and right leg. Start with 10
repetitions on each side and build up to repetitions.
Basic Trunk Extension: Lie facedown flat on
the floor leaving your arms at your side. Slowly raise your chest off the
floor as high as you comfortably can. Hold for two seconds and come back
to the floor slowly. Gradually increase until you can do 20 repetitions
easily. Try to keep your feet on the ground - either by placing them under
a couch or by having a partner hold them down.
Stretches for golfers
Because of the vigorous rotation and
side-to-side bending involved in the golf swing, the lower back is a prime
area of injury for golfers. To help prevent injuries, it's important to
maintain a good range of motion and build flexibility. Here are a few
stretches to promote greater mobility in joints and in muscles. Before
you do these stretches, spend a few moments walking to raise your body
temperature - cold muscles aren't as receptive to stretching as warm
Forward bend: Gently bend forward at the
waist until you're able to grasp your ankles, bending your knees as
necessary. Let your neck and arms relax as you bend forward slowly from
the hips. Holding your ankles, straighten your knees until you feel
a comfortable stretch in the backs of your legs. Hold 10 to 15 seconds,
then slowly stand, bending your knees as you straighten your trunk.
("Gently" and "slowly" are the key words for this stretch.)
Trunk rotation: Standing with your back to a
tree or golf cart rotate your upper body to the right so you can grab hold
with both hands without moving your feet. Look over your left shoulder as
you stretch. Increase the tension by pulling yourself around a little
farther with your hands. Hold for 10 to 15 seconds, then repeat to the
Side bend: Stand with your feet
shoulder-width apart and raise your right arm above your head. While
keeping your slightly flexed, lean to your left and move your left hand
down the outside of your thigh to just above your knee. You should feel a
comfortable stretch along the right side of your trunk. Hold for 10 to 15
seconds, then repeat on the other side.
Neck rotation: Turn your head to the right,
looking as far over your shoulder as possible. Take your left hand and
gently push against the left side of your face. Hold for 10 to 15
seconds, then switch sides.
Shoulder stretch: Reach across your body and
grasp the back of your right elbow with your left hand. Pull that arm
across your body and under your chin as far as you can and hold. Repeat
with the other arm.
For those of us who spend our workday at a
desk, posture problems can be an occupational hazard. Slouching and
Ieaning can place unbalanced stress on the entire spine. Dr. Van 0osten
has this advice for desk jockeys: "A chair should assist you in
maintaining good posture and supporting your spine.