What are the high-risk times and events for your lower back? Why can you get into more trouble doing something as simple as picking up a loaf of bread from the trunk of the car, rather than doing something more challenging? What simple steps can you take to avoid injury and pain? Let's get the answers to these questions and more.
Two Critical Moments
When it comes to your lower back and injury risk, there are two critical times when you need to be especially careful. One is first thing in the morning. Your back is actually swollen at that time. You are substantially taller, and the discs have extra fluid in them. A careless forward bend or twist first thing in the morning can do substantial damage to your discs or other back structures. It doesn't seem fair that such a simple thing, bending and twisting, something you have done thousands of times before, can suddenly cause big problems.
The other critical time is after you have been sitting. Long car drives or airplane trips are especially challenging. In this case, the culprit is something called "creep." This means that your ligaments and tendons lengthen into the position that you have been in. Think of sitting as a bent-forward position, as your legs are forward. The ligaments and tendons do not provide protection properly when they have been lengthened by creep. When you first get up from sitting, you are at risk. The longer you have been sitting, the higher the risk. If you sit more upright, with good lumbar support, you will have somewhat less risk.
Here are some common events that can contribute to lower back pain. Keep in mind that in all of these scenarios, your back was already vulnerable.
Scenario #1: You didn't sleep well last night, perhaps from sleeping in an unfamiliar bed after travel, after sitting too long. You get up, feel stiff, but ignore it. You sit down in a soft chair to enjoy your morning hot drink. You get up and get a sudden sharp stab in the back.
Scenario #2: You get up from sleeping, and sit at your laptop, and get entranced by a video or article. You end up sitting far longer than you planned. You get up, and can't completely straighten up.
Scenario #3: You get up from sleeping, drink your morning coffee, which wakes up your gut, and you go to bathroom to empty your bowel. You are a bit constipated, and have to strain. When you get up from the toilet, your back spasms.
Overnight sleeping, even a good sleep on your favorite bed, leaves your back somewhat swollen. Swollen may be an exaggeration, but the reality is that there is extra fluid in all of your joints.
If you have a good back, none of this matters. If you have a vulnerable back, it all matters. Ideally, when you get up, you should do some kind of activity that warms up and "wrings out" the excessive fluids. A short walk, some simple movements, can make a real difference. Sitting down at the computer, sitting on the toilet, etc., can get you in trouble.
So, who has a good back versus a bad back? Unfortunately, most of us have bad backs, at least in the sense that they can be subject to injury and pain at any time. In fact, studies suggest that as many as eight in 10 people experience low back pain during their lifetime. That's a lot of back pain already happening or waiting to happen. And as you can tell from the above discussion, some of the scenarios whereby people experience back pain are all too common.
How to Avoid Injury and Pain
Don't bend over immediately after sitting. Sitting, even in good posture, puts you at risk. The longer you sit and the worse the seat, the more at risk you are. Airlines are very risky; it's hard to get up and move around because of the tight quarters, and the minute the plane stops, you bend over and get stuff from under the seat, or reach up, and twist and lift to get your bag from the overhead compartment. After a long sit, give yourself at least a few seconds of backward bending and/or moving around to reset your spine. Then you can carefully, using your hips rather than your back, bend over to pick up something.
When you sit, don't slump. Slumping reinforces the risks, makes it more likely for something bad to happen to your discs or joints or muscles. So, sit up straight, and keep your back in neutral. Neutral means that you keep a bit of a lordosis in your lower back, keep the lumbar spine from slumping forward, stay more upright. This simple action can make a huge difference. Like any habit, this will require you to "Just Do It" for a few weeks.
Talk to your doctor about these and other high-risk moments for your lower back and what you can do to relieve low back pain or avoid the pain altogether. And make sure to review "Self-Care for Back Pain" in the May 2010 issue, which provides information on exercises your doctor may prescribe if you are experiencing back pain.
Marc Heller, DC, maintains a chiropractic practice in Ashland, Ore. He is a nationally recognized expert in treating tailbone, sacroiliac and lower back pain.