The Ultimate Guide to Back Pain Prevention

December 20, 2018

back pain prevention
back pain prevention

A woman doing yoga to prevent back pain

JayDee Vykoukal, DPT

Back pain is a very common problem. It has been well established that it's a leading cause of job related disability in the U.S. This ambiguous topic involves many theories surrounding the best treatment. Quite frankly, it can leave your head spinning! Whether you have experienced back pain before and want to prevent it from happening ever again, or just want to avoid it all together, here is a full comprehensive list of what you can start doing now to prevent back pain while also improving your overall quality of life (bonus!). Don't feel overwhelmed by this guide, you will notice a theme throughout as you read it so skim at first if you need to and start with what feels right. The most important part is that you start immediately (not later or tomorrow, now). Plus, if you're reading this article chances are you've probably already been doing a lot of these and just need some good reminders.

1. Make your back pain prevention routine a habit.

Prevention practices of any kind can be hard to master, especially since it might not feel like a pressing matter if you don't have back pain right now. Other priorities in your life will easily take front and center if they give a sense of urgency. This makes it crucial to turn your back pain prevention routine into a habit so that it is automatic and easy to follow. Forbes has a great article behind the science of habits and how you can use them to promote good lifestyle choices and get rid of bad ones that may be affecting your ability to live without back pain. To know which choices you should be making, keep reading!

2. Weight management.

After setting yourself up for success with good habits, weight management becomes the key to back pain prevention. If you are overweight, every posture and activity you participate in on a daily basis is constantly putting extra stress on your joints. The joints in the spine are intricately designed to withstand our daily activities when your weight is well managed. When overweight, the cartilage and discs that help cushion your back bones and spinal cord become easily overwhelmed and will eventually hit a breaking point (i.e. injury). Back pain caused by obesity is unfortunately on the rise due to poor lifestyles choices and habits. You can self assess your body mass index (BMI) to give yourself an idea of where your weight should be here. If you know you are overweight, starting to lose weight now doesn't have to be complicated. Start with these simple tips that involve making small changes in your day with things like walking during your lunch break, parking at the back of the lot or taking the stairs.

3. Daily exercise

There are so many benefits to regular daily exercise. Specifically for the back, it can help with weight management, promote adequate circulation (to muscle, joints, etc), encourage good muscle balance, flexibility and maintain optimal bone density. Finding a balance between all these factors is so important to minimizing risk of injury, especially to the back. The back is such an intricate part of all human activity that preventing pain through correct movement should make sense! The Mayo Clinic recommends 150 minutes of moderate or 75 minutes of vigorous aerobic activity spread over the week. In addition, they recommend lifting for all major muscles groups in the body at least two times per week. Considering there are 168 hours in a week, spending a minimum of 3 hours per week on exercise isn't asking much!

a. Okay so what should I do?

Variety can keep your muscles balanced and your mind engaged and motivated. Try to shoot for some kind of routine two to three times per week.

  • Weight lifting. Weight lifting has so many benefits including weight management and healthy bone density(both of which play a role in preventing back pain). If you are lifting the minimum recommendation of two times per week, try to incorporate movements that target a lot of muscles groups at once for efficiency (here are some examples). Otherwise, you may find it easier to alternate between arm and leg strengthening throughout the week (two times per week for each). Not familiar with lifting or what muscles groups to target? Gyms usually have easy to follow circuits with their machines and usually someone will gladly give you a quick run through of them if you ask. If you're exercising at home simply Google "arm workout" or "leg workout" and you'll have plenty to try!
  • Fast walking, dynamic yoga, kickboxing, plyometrics, running, dancing: The sky is the limit here as long as your heart rate is up! If you want to keep track of how hard you're working, check out this article from Mayo Clinic about how to calculate exercise intensity based on heart rate.
  • Corestrengthening. Your core includes all the muscles in your trunk (between the shoulders and hips). You can specifically target these muscles during your weight lifting routine. Otherwise, the good news is that pretty much any exercise you do should incorporate your core, just make sure you are using your muscles correctly! Not sure? Assess your core strength and how to use it here. Then try these seven simple exercises for a focus on core strength and posture as well.
  • Stretching. If your muscles feel chronically sore or tight (they might with a good exercise routine), having a good stretching routine is a no-brainer. You can try these basic stretches while at work or yoga poses, especially when your back is feeling sore.
  • Work exercise options.There is no excuse not to start exercising today. It doesn't have to be complicated! You can do exercises sitting at your desk (try these) or a desk bike. If you know you can't dedicate a bigger chunk of time on certain days, you can bike to work or simply try to keep moving throughout your day (check out these suggestions if you need ideas while at work).
  • Home exercise options. The options are also limitless (and cheap) at home (try these). You can even exercise while watching TV. You may decide to buy home equipment or simply move your body. There's no right answer, the important thing it to choose what will keep you motivated.

b. How do I keep motivated?

  • Find an exercise partner to maximize focus and benefits (see some of the benefits here).
  • Set goals to try to keep yourself accountable (try writing them down to maximize the benefit).
  • If you are struggling due to joint discomfort or general poor exercise tolerance, try lower impact exercise such as taichi or swimming
  • Re-read all the benefits above!

4. Postural habits.

Posture plays a large role in keeping proper alignment of your spine to prevent back pain. Knowing this, when you want to focus on improving posture do you usually focus on one or two parts of your daily life? Probably. For example, you might focus on posture while at work and your home desk but neglect how you're sitting when binge watching TV at the end of the day. However, it should be a focus with all your daily activities if you want to prevent back pain. This includes sitting, driving, sleeping, standing and while moving or exercising.

a. Where to start?

First, learn what good posture is and then practice it (try checking out general posture tips or be more specific with ideas for driving and sleeping). The more you practice the more likely it will become a habit, making it easier to maintain.

b. How to set yourself up for success.

Use a mirror to visually assess your posture. Get an extra set of eyes (a friend, colleague or medical professional) to analyze your posture for you. The more feedback you get the more likely you are to be successful in finding and maintaining good posture. If you're struggling with your posture there are lots of options out there including posture apps, posture shirts, posture exercise equipment (just search online). There is no shortage of ways to help yourself be successful.

c. The little things.

There may be times during the day when you're not thinking about posture and then don't make the connection that it may be causing long term harm. Things as simple as not leaning to one side on your couch or keeping your keys out of your back pocket when sitting can make a world of difference for preventing back pain by promoting balance. Try to be aware of these!

d. The key is a variety of postures throughout the day.

Learning good posture is important, however you may notice holding any single position gets tiring after a while. This is because our bodies are made to move. So try to mix it up during the day, especially at work. All that sitting puts major pressure on your spine discs and can lead to unnecessary back pain issues. Periodically switch between standing, walking and sitting if possible. Your back will thank you!

5. Work Ergonomics

Since you probably spend a lot of time at a desk at work, optimizing your work ergonomics is important to overall health and preventing back pain. Here are the basics for an optimal set up:

a. Sitting.

See this visual from Mayo Clinic for optimal desk set up. Also, think about investing in a foam seat cushion (see the benefits here).

b. Standing.

Consider getting a standing desk and standing desk mat (see why here) so that you can reap the benefits that come with getting out of a static sitting posture throughout your work day. You can also think about choosing good shoes for optimizing your comfort while standing at work. Having the option to change positions throughout the day can promote back health and keep you feeling motivated to work.

c. Lifting.

Proper lifting at work can prevent back pain. This ultimately means no movement that combines bending (at the back), lifting, and twisting all at once. This is a recipe for pain and disaster to your spine discs. For more tips look here.

6. Lifestyle choices.

Whether you make healthy or unhealthy choices throughout your days, they all affect your quality of life and ability for the body to cope with any issues it may encounter related to the back and pain.

a. Nutrition and hydration.

If you filled your car with poor quality gas and then expected it to continue performing well, this would be a ridiculous expectation. The same goes for what you put in your body, filling it with high quality nutrients and minerals while staying hydrated will keep your body running optimally. This means you will be less prone to injury and be able to recovery more quickly if anything does happen. A general rule of thumb is to minimize processed food and try to intake a balance of fruits, vegetables, protein, and whole grains. A famous simple dieting quote by author Michael Pollan is "Eat food, not too much, mostly plants."

b. Sleep.

Sleep is a time for our bodies to regenerate and is crucial for staying healthy and preventing back pain. Quality sleep is so important for quality of life. This means having a comfortable mattress, setting up a good nighttime routine, and avoiding sleep deprivation (see more ideas here). All of these affect your body's ability to heal and be in optimal balance.

c. Smoking.

According to research, the chance of experiencing back pain when smoking is significantly higher. Smoking affects the body's hormone balance, circulation and ability to heal. In case you needed another reason to quit smoking, preventing back pain is a pretty good one!

7. Stress management.

Stress plays a large role in the body's ability to cope with injury. It is a commonly overlooked issue related to health and can cause a whole gambit of issues. Stress releases hormones, such as cortisol, that can cause long term damage to body tissue and be a cause of back pain. Here are some tips for managing stress:

  • Minimize stress at work (try these tips). Set manageable life and work goals to keep you from feeling overwhelmed. Make your office set up as enjoyable as possible and try to stay organized.
  • Make healthy life choices (as listed in the entire article above) to optimize your mood and ability to cope. Exercise has been found to be more effective than anti-depressants as a mood booster and managing stress!
  • Stay social. Social isolation can lead to stress, anxiety and depression. Stay in touch with friends and family or find a support group if needed.
  • Try the power of deep breathing to calm your nervous system (start here). You can do this anywhere and anytime on your own. Otherwise, you can try something more guided with yoga or meditation with a teacher or online video.
  • Keep a positive outlook. Stress and negative pain belief scan lead to the worst kind of pain: chronic pain!
  • Educate yourself. The unknown can also make us anxious so try to read up in any particular field (like spine anatomy when your back is sore) to help you understand and alleviate fears. Get in touch with your body and know when any pain or discomfort is expected and when you should be worried.
  • Be mindful. Being aware of your stress triggers in life can help you manage them more effectively.

8. Look for patterns.

If you have experienced back pain before, paying attention to patterns can help immensely so that you can adequately treat, recover and prevent future problems. Take note of any patterns and try to make changes where you can. It can be helpful to keep a journal related to daily activities and when you have back pain throughout your day. This can help identify triggers that you can learn to avoid or manage better. Here are some examples to be aware of:

  • Muscle strain. Are you chronically moving in ways that strain certain muscle groups? What muscles groups seem to be sore when you injure yourself? Is it always the same ones?
  • Poor flexibility. Do you feel tightness in certain muscle groups that make it hard to move comfortably?
  • Flexion biased pain. Does your back pain tend to be worse with activities when the spine is bent (such as sitting, bending, driving, and sleeping on your side)?
  • Extension biased pain.Does your back pain tend to be worse with activities when it is extended (such as lying on the stomach and standing)?

***Note what causes pain and what makes it feel better and use this as starting for what movements to avoid and do when it comes to preventing back pain. This doesn't mean you should feel afraid to move but it can help you take control of your back pain!

9. Talk to a medical professional.

Getting help from someone trained in treating back pain can help you identify any of the above mentioned patterns. They can give you prevention and treatment recommendations. What professional is best for you depends on your personality, values and beliefs. Here are some of your options:

  • Physical Therapists. They are extensively trained in anatomy and movement patterns and can help in identifying anything out of balance and help you fix it. The end goal is usually being able to treat yourself independently.
  • Chiropractors. They are trained in assessing spine alignment and how it affects movement. This typically requires continued follow-ups due to the nature of the treatment approach but can be very effective.
  • Massage Therapy and Acupuncture.They promote relaxation and body healing. They can help point out trouble areas for you to focus on in the future with or without assistance.
  • Medical Doctor.They can prescribe medications, order imaging or give advice on what other treatment options (or other professionals) can help. However, with drug abuse being a huge problem today, try making lifestyle changes first. It has also been found that getting an MRI can be more detrimental than helpful with a history of back pain, so be wary!
  • Psychologist. If you're struggling with stress, anxiety and/or depression they can have a large effect on your ability to cope with pain. Being able to talk it through may help.
  • Personal trainer.Exercise is one of the best medicines out there. If you need someone to help push you consider getting a trainer, coach, yoga instructor or whatever motivator will help!

The conclusion.

With all these options for addressing back pain prevention right now, you should feel confident in your ability to decrease your chances of ever having to deal with it. Prevention is always the best (and cheapest) way to treat back pain. The bottom line is to create a healthy productive lifestyle for you; and who doesn't want that anyways? Even if preventing back pain isn't a top priority, being in control of your life from a health perspective will feel great and have so many benefits!

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