Low back pain is the 2nd most common reason for visits to primary care physicians and the most common reason for visits to orthopedic surgeons and neurosurgeons.  It is estimated that 80% of the population will suffer from an episode of disabling acute low back pain at some point during their lifetime.  Although there are many different treatment options for those who suffer from low back pain, self care is the most important action that a person can take to maintain a healthy back, to prevent low back pain and to facilitate the healing process if low back pain occurs.

Bad habits such as the way you stand (posture) or the way you position yourself (body mechanics) can contribute to the onset of low back pain.  Poor posture and body mechanics change the optimal alignment of the spine over time leading to a process of degeneration.  Often, the process can and will result in weakened discs, inflamed joints, irritated nerves, and painfully tight overworked muscles.  Maintaining proper posture during lying, sitting and standing positions has a significant affect on reducing the stress and strain on the spine which are associated with pain and injury.  Learning how to move properly during common daily activities such as bending, lifting, turning, and reaching is also critical in preventing low back pain.  Many of you may have experienced the ill effects of poor body mechanics during activities such as moving furniture, lifting children, or snow shoveling.

A healthy back needs to be strong and flexible.  Daily exercises aimed at stretching and strengthening muscles and maintaining the flexibility of your spine will help to accomplish this.  One highly recommended exercise for your back is regular walking.

There are many other useful self care tips and techniques that can be learned to keep your back healthy.  Here are a few: maintain an optimal body weight, wear the right shoes, shift positions often at home and work, choose the right bed, use lumbar support for sitting, self-massage, or better yet get someone else to give you a massage.

A physical therapist can help develop an exercise program that is right for you while teaching you the skills you need to move safely and keep your back healthy.  If you are interested in taking care of your back to prevent the onset of low back pain or to address a current back pain problem you should consider seeing a trained physical therapist.

At some point throughout our childhood we have heard the phrases “sit up straight” and “don’t slouch.” During adulthood the idea of good posture is of increasingly great importance in maintaining well-being and optimal health. Especially during a time when our society has shown trends of increased time spent watching television, sitting in front of computers, working sedentary desk jobs and commuting long hours.

The long term effects of poor sitting posture have been associated with numerous painful conditions relating to the function of muscles, joints, ligaments, nerves, connective tissue, circulation, respiration, and digestion. Common associated diagnosed conditions include temporomandibular joint dysfunction, headaches, neck pain, shoulder pain, repetitive strain injuries, mid and low back pain, thoracic outlet syndrome, and myofascial pain syndrome. More importantly, poor sitting posture may adversely affect activities of daily living and overall energy level at work and home.

The concept that there is a single ideal posture is misleading. This idea does not take into account that people are proportioned differently or for example the multiple positions a worker needs to sustain to accomplish a task in varying situations. Factors that influence our postures include the environment surrounding us, our personal habits and attitudes at a certain point in time. There is no “perfect posture.” Posture is dynamic. Functionally, our bodies are reacting to and working against gravity and other stresses to maintain balance. Good sitting posture maintains the three normal curvatures of the spine. The lumbar (lower back), thoracic (mid-back), and cervical (neck) transform the spine into a flexible unit allowing the body and head to be erect with minimal muscular effort.

Prolonged static sitting position will eventually lead to feelings of stiffness, soreness, achiness and pain as body tissues become overloaded. The most commonly seen improper sitting posture is “slouching”; characterized by a rounded lower back, humped upper back, rounded shoulders, and a forward head position. The resultant alignment leads to biomechanical dysfunctions of the spine and the extremities, which include muscle imbalances, connective tissue restrictions, altered mechanics of the shoulder and spinal joints, increased vertebral disc compression and narrowing of the space in which arteries and nerves pass. In essence, poor posture allows one to become vulnerable to injury and is one of the factors which hinders healing and adequate resolution of associated painful conditions.

In most cases, it is not too late to experience the positive outcomes of improving one’s posture.  Physical therapy evaluations incorporate a postural assessment to define the severity of the postural problem, to identify contributing factors, and to recognize the possible relationship to someone’s given pain and dysfunction. Treatment of postural dysfunctions may involve regaining the normal length of shortened muscles, mobilizing stiff extremity and spinal joints, strength and endurance training of postural muscles, addressing environmental/ergonomic factors, and education of postural awareness and correction. Awareness is the key to the success of postural reeducation. Just like your body has adapted to poor posture over a number of years, you can allow your body to adapt once again to its natural structural state.

Well much of the country has experienced record snowfall this season and of course with that comes digging out of the snow.  Snow shoveling can contribute to a host of injuries to the spine, shoulders and muscles of the body.  Most of the problems are as a result of excessive bending and twisting while carrying a heavy load.  Here are some tips to avoid pain and injury from shoveling snow.

The Basics:

Think of snow shoveling as a form of exercise, so as with any exercise prepare your body for what you are about to do.

• Don’t begin shoveling snow after eating, smoking or consuming caffeinated beverages.
• Warm-up your body with some gentle movements and stretches as you would before any exercise.
• Dress appropriately.  Ensure that you have good footwear to avoid unnecessary slips and falls, dress in layers, wear gloves that will keep the hands warm and dry, and wear a hat the will keep your head dry.
• Stay hydrated.  Drink plenty of water before, during and after.
• Stop if you are hurting or you feel pain of any kind.  Don’t make a problem worse by trying to work through the pain.  The exception is the feeling of muscle fatigue, which is to be expected.
• Take plenty of breaks.  Don’t try to finish the job all at once.  It’s better to divide the work in several segments, especially if you are dealing with large amounts of snow.
• Know Heart Attack Warning Signs: chest discomfort, discomfort in other areas of the upper body, shortness of breath with or without chest discomfort, breaking out in a cold sweat, nausea or lightheadedness.  Please call for help immediately if you are experiencing these symptoms.

The Form:

Proper body mechanics is critical to avoiding pain and injury from snow shoveling.

• Use the right shovel.  Ergonomic shovels that have a curved shaft allow for better leverage and are easier on the body.  Plastic shovels are typically lighter than metal ones.
• Proper grip is important.  Don’t keep your hands too close together.  Placing your hands further apart improves the leverage, which will allow you to work more efficiently.
• Maintain proper spine alignment.  It is critical that you keep your back straight and head in line with your spine.  Your ear, shoulder and hip should always stay in line.  To attain proper spinal alignment while bending, you should bend your knees, stick your hips back, keep your back straight and tuck your chin slightly in.
• To shovel snow: keep feet apart, bend the knees, lift the shovel by straightening your knees and not by straightening your back.  If you need to move the snow, walk your feet to where you would like to dump the snow.  Never bend at the waist and twist to move the snow to the side.  Never thrown snow over your shoulder.
• Push whenever you can.  Pushing the shovel with one leg in front of the other, knees slightly bent and back straight is always better than lifting the snow.
• Lighten the load.  Don’t try to move heavy amounts of snow.  It’s better to minimize the load.

Remember to take frequent breaks and stop if you feel pain.

If by chance you do end up injuring yourself, consult a physical therapist for a consultation so that your pain and functional limitations are kept to a minimum.