Back Basics – Zion Pain Management Back Pain

Motion Keeps Your Back Alive

To stay alive and healthy, your back needs to move every day. The right kinds of motion nourish your back and help keep it flexible and free of pain. Moving improperly or moving too little, however, can lead to back problems, problems that often begin in your discs, the “shock absorbers” for your spine. Fortunately, almost everyone who has a back problem can benefit from self-care—even those who need surgery.

When Back Pain Strikes

Whether it comes as sharp pain from sudden injury, an occasional twinge, or a constant daily ache, back pain can interfere seriously with the quality of life. You are not alone; four out of five people experience significant back pain at sometime in their lives. Back pain may develop, because you move incorrectly or have a sedentary lifestyle and move too little. Or you may have fallen into the “weekend athlete” trap, where you exercise vigorously, but only now and again. Whatever the cause, you can help reduce and prevent back pain with self-care.

Self-Care Can Help

Once you’ve had a medical evaluation to diagnose your spine or disc problem, you can learn how to use daily self-care. It may be all that’s needed to treat your back and keep it healthy. Understanding anatomy may help you see how the way you move can help or hurt your back. Learning good body mechanics helps you do simple everyday movements safely and efficiently. And with daily back exercises, you can strengthen your back and improve your flexibility for easier movement.

Your Medical Evaluation

A medical evaluation is necessary, so that the physician can diagnose your spine. This evaluation may include a medical history, physical exam, and diagnostic tests. After diagnosis, a team approach to treatment often works best. Each member of your team-your doctor, physical therapist, and you will play a role in improving your spine condition.

Medical History

A medical history helps your doctor understand what you’ve been experiencing and make some judgments about where to go from there. He will ask a variety of questions, such as what are your symptoms? Did your pain begin gradually or with an injury? What makes it better or worse? and the like.


Physical Exam

By observing your spine and posture in different positions, your doctor will be able to move closer to identifying the source of your back pain.  He or she may also check to see how flexible or strong your muscles are, and whether you have weak reflexes or painful or numb areas in your legs.

Diagnostic Tests

You may have one or more tests to confirm the doctor’s diagnosis.  These tests may also help your doctor determine the best approach to treatment.

A Team Approach to Treatment

Once your doctor has diagnosed your spine or disc problem and prescribed the best treatment plan for you, a physical therapist may join your health care team. An expert in body mechanics, spine care, and back exercises, your physical therapist can teach you specific self-care techniques. By regularly using them, you can improve your spine and reduce your pain. Even in rare cases where surgery is needed, self-care is a crucial part of recovery.

Understanding Anatomy

A Healthy Spine

Knowing how a healthy spine works may help you understand how moving wisely can protect your back and keep It free of pain. A healthy spine supports your body, while allowing it to move freely. It does this with the help of three natural curves, which keep your body balanced. Strong, flexible muscles support your spine and keep your curves in normal alignment. Keeping your lower back (lumbar curve) aligned is most important because it bears the brunt of your weight-and it moves the most. Soft, cushioning discs separate the hard bones of your spine, allowing it to bend and move.

Three Natural Curves

A healthy spine is made of vertebrae and cushioning pads of cartilage (discs) arranged in three natural curves that form an S-shape. When properly aligned, these natural curves keep your body balanced and support you when you move. They also distribute your weight evenly throughout your spine, making back injuries less likely.

Strong, Flexible Muscles

Strong, flexible muscles help maintain your three natural curves by holding your vertebrae and discs in proper alignment. This helps support your upper body. And if your abdominal, hip, thigh, and other muscles are strong and flexible, they can do the work of moving, taking strain off your back.

Lumbar Curve

The workhorse of your spine

Your lumbar curve is the hardest-working part of your spine. It carries more weight and moves the most. Aligning your lumbar curve helps prevent injury to your vertebrae, discs, and other parts of your spine.


The Cushions in Your Spine

Discs are soft cushions that separate vertebrae and absorb shock as you move. Each has a spongy center (nucleus) and a tougher outer ring (annulus), which contains pain fibers. The movement of fluid within the nucleus allows your vertebrae to rock back and forth on your discs, gibing you the flexibility to bend and move. Depending on how much you move, the size, shape, and flexibility of your discs change throughout the day.

An unhealthy spine often starts with an unhealthy habit like poor posture. Standing, sitting, or moving incorrectly puts extra stress on your spine and discs, causing pain. Over time, poor posture can even cause your discs to wear out early. Like wrung-out, brittle sponges, your discs lose their ability to cushion your spine, allowing a wide variety of painful spine and disc problems to develop. Unless corrected, they make your spine more vulnerable problems by changing unhealthy habits with self-care.

Poor Posture Backfires

Sooner or later, poor posture causes pain by putting your three natural curves out of alignment. Too much slouching (flexion) puts pressure on your annulus. A swayback posture (extension) can overload and inflame your facet joints. Your muscles tighten and may go into spasm to “splint” your spine, adding to the pain you feel. Worn-out or injured discs can lead to a variety of other spine and disc problems. The most common happen when your discs tear, bulge, or rupture, losing their ability to cushion and absorb shock. The rest of your spine may weaken, as well, leading to pain, stiffness, and other symptoms.

How Discs Wear Out

Over time, your discs may wear out (degenerate) from natural aging. But poor posture can make them wear and dry out, your vertebrae come closer together and become irritated. Bony outgrowths (bone spurs) may form, narrowing your foramen (a process called stenosis) and irritating nearby nerves.

Good Body Mechanics

Good body mechanics keep your spine well aligned and moving smoothly just like a well-tuned machine. By keeping your three curves in alignment throughout the day, you minimize the stress on your spine and help prevent back pain and injury. Using poor body mechanics and moving the wrong way add stress to your spine and make injury more likely. If, on the other hand, you sleep, sit and lift the right way, your weight is evenly balanced along your spine and the risk of injury greatly reduced. You can also give your back a “break” by decreasing the amount of time you sit–a stressful position for your lower back.

Bad Habits–what not to do

Sleeping on a soft bed or couch takes your three natural curves out of alignment, which puts extra pressure on your back. Try not to sleep on your stomach, because that places strain on your neck and back, especially if you use a pillow.  Standing bent over for long periods of time increases the pressure on your spine, and if you bend over with straight legs, you lose the three natural spinal curves. Wearing high-heeled shoes can give you swayback, throwing your curves out of alignment when you’re walking.  Slouching puts your spine out of alignment and adds extra stress to your lumbar curve. It’s even more difficult to maintain your curves when sitting in chairs that don’t support your back. The same is true if you sit far away from the steering wheel when driving.  Lifting without bending at the knees makes your back bear the brunt of the work. Also, if you lift an object far away from your body, you increase the pressure in your discs even more.  If you keep your feet and hips fixed in one position while turning, you are much more likely to twist your back. The joints in your back aren’t designed well for twisting, so that kind of motion increases your risk of disc injury.  When something is out of your reach, never stretch your arms and back to reach it. As you reach away from your body, you eliminate your three natural curves and your back must work harder than it should.

Good Habits–what to do

Sleep on your back or side on a fairly firm mattress. If you sleep on your back, put a pillow under your knees to keep your curves aligned. When you sleep on your side, bend your knees to take some pressure off your back.  If you must stand for long periods, put one foot on a stool to take pressure off your spine and help keep your three natural curves aligned. If necessary, bend your knees slightly. Wear supportive, lowheeled shoes, whenever possible, to cushion your weight and keep your spine aligned.  Keep your three natural curves aligned by using chairs that support your back. A rolled-up towel or lumbar roll in the small of your back can also support your lumbar curve. To aid proper alignment when driving, position your seat so your knees are level with your hips.
Bending with your knees and hips helps you maintain your three natural curves. Let your legs do most of the lifting and hold objects close to minimize their weight. Imagine your torso as one straight unit from your shoulders to your buttocks. Turn with your feet, not your back. Point your feet in the direction you’re turning and step around the turn. As you do, maintain your three natural curves.
Again, hold what you lift close to your body. Use a stool, if necessary. Tighten your stomach muscles to support your back and let your arms and legs do the work. Use a reacher for hard to reach items, or ask someone for help.

Back Exercises

Treatment for your spine or disc problem may include back exercises. They help you move wisely and well by building strong, flexible muscles to support your three natural curves. Regular back exercises help keep your spine and discs nourished and healthy, easing pain and helping to prevent injury. Not only do they make your back feel better, but your whole body benefits too. Your doctor or physical therapist may design a basic program for your specific needs.

The Zion Pain Management Center is staffed by qualified personnel specially trained in the field of pain management. Our goal is to relieve or help you manage the pain you have been experiencing so that you can enjoy a better life.