It**‘**s Common
Back pain is widespread. Eventually, almost everyone gets back pain. Back pain comes in many forms. Low back pain is the most common. It can be difficult to relieve because the root causes are complicated to pinpoint.
Age
As we age, our bodies wear out. But our backs can stay healthy late in life. Disc-related back pain is common for people in their 30s to 50s. In older age, back pain is more often due to muscle issues, arthritis, or pinched nerves.
Muscles
On its own, the spine is as stable as a stack of blocks---not very. It is the back muscles that keep the spine in place. The back has 3 layers of muscles to keep it moving and upright. Keeping these muscles long and strong is one of the keys to dodging back pain.
Muscle Wrap
Every one of the 40 muscles in the back, like all muscles, is wrapped in sheets called fascia. These sheets are like a thick, strong Saran Wrap. When it is healthy, it is relaxed and loose. Sometimes, the fascia from different muscles begins to stick, restricting muscle freedom. Damage or restriction in these muscle wraps can cause muscle tightness and create tender ‘trigger points.‘
Connections
The back also has other connective tissues, like ligaments and tendons. These can get tiny tears when strained. When they do, the pain is often a slow ache that takes a while to go away, which is much different than the stabbing pain of a disc bulge. Rest usually heals back strains. Proper posture can prevent strains, especially when lifting, twisting, and bending.
Discs and Nerves
The spine is a stack of bones called vertebrae. Between each vertebra is a donut-shaped rubbery pad. The discs are as tough as hard rubber, especially in older adults. Excess wear and tear or an overload can cause a bulge, resulting in a herniated disc. As we age, the discs lose their inner fluid and become tougher. Most disc injuries occur in the lower back, where the loads are highest. When a disc swells and presses on a nearby nerve, the pain can be sudden and intense.
Back Regions
The lower back is the central joint in the body---every other joint stems from it. When the mid-back gets tight or if mid-back mobility becomes restricted, the lower back takes additional strain. The lower back is made for stability, while the mid-back is made for mobility. The mid-spine---the spine at the level of your ribs---is the most flexible part of the back. When the mid-back loses its mobility and flexibility, the lower back is forced to move in ways it is not designed to, overstressing it.
Back Spasm
The lower back muscles can lock themselves up. This can occur with a movement that doesn’t seem to overstress the back. Tight, tired muscles and overactive nerves can trigger a spasm. A spasm is a guarding response to keep you from doing damage. But the guarding system can get messed up. Sometimes the nerve signals get confused and spasm without a clear cause. That often signals muscle imbalance, either front to back or side to side. Tight muscles can also trigger a spasm. The muscle tightness that triggers such a spasm can be in the legs or the neck. Focus on a relaxed back posture and the full range of motion flexibility.
Sciatica
Pinched Penny
Sciatica pain is a pinched nerve form of back pain. The sciatic nerve is the largest and longest nerve in your body. At its thickest, it is as fat around as a penny. Because it is so large, it is easily compressed or pinched. Many people will get some sciatica-related pain in their lifetime. Typically, it resolves itself, but sometimes it stays. Sciatica in older people is often due to a bone spur pressing on the nerve.
Sciatica Risks
As with many health conditions, our risk of sciatica increases as we age. A job that requires lifting and twisting can increase the chance of developing sciatica. Diabetes also increases the risk of sciatica pain, especially since diabetes can damage nerves. Sitting for long periods over many years increases the risk of sciatica.
Sciatica Effects
Long-term sciatica pain can cause numbness, tingling, or a burning sensation. It can also cause sharp, shooting pain. And because the sciatic nerve also controls muscle movements, it can cause muscle weakness in the legs.
Prevent Sciatica
Once you have sciatica, it can be hard to deal with. The best option is prevention. Try not to sit too long at one time without standing up and walking around. Also, try regular stretching to maintain range of motion and muscle flexibility. The flexibility of your legs, especially the back of your legs and the hamstrings, can impact lower back pain.
Sciatica Relief
Sciatica has no easy treatments. Alternating hot and cold packs on the lower back can help. Try a topical or roll-on pain reliever to relieve the pain. Capsaicin, a natural pepper extract, is one of the best pain relievers for sciatica pain.
Sciatica Treatments
It is essential to stay as active as possible, even with sciatica. Too much sitting or lying down worsens it. Good posture in both sitting and standing can ease the pinch. You may need another person to help show you good posture. Stretches and exercise can help loosen the tight muscle tissues causing sciatica---if it is muscle related. Regular walking with good posture is also recommended.
Sciatica Brace
A brace to stabilize the lower back may help in the short term. A lumbar belt is usually made of strong fabric. It has a few wide Velcro connections to hold the lower back in a stable position. Lumbar belts often have some rigid ribs built in to offer additional support.
Degenerating Discs
Often, when we have back pain in our older years, the doctor will take a scan and say, ‘You have “degenerative disc disease.”’ Discs compress as we age, but they also get more stable. A research study of healthy people of the same age with and without back pain found that the people without back pain had the same ‘degenerative disc disease.’ It is a fancy way of saying you’re not 22 anymore. Don’t let a label keep you from activity.
Back Complications
There are also some infections and other diseases of the back that can be serious. If you have recurring or severe back pain, check with your health care provider to rule out other conditions.
Prevention and Treatment
Awareness
If your back feels tight and tired, be careful. When your back is in this state, it can cause spasms or injury. Learn to listen to your back. A tight back is more easily injured. Muscles keep your spine in place---when they are tired, your back needs a rest. If a movement is causing pain, back off a bit and rest. But don’t stop moving.
Avoid Bad Sitting
Sitting can be bad for the back. Often, when we sit, we round our back into a C shape instead of the slight S shape our back should be in. When you sit, don’t slouch. Try to maintain an upright posture. Don’t sit for more than an hour without getting up to walk around and stretching your back.
Neutral Sitting
When you sit, don’t over-curve your back into an S. Try to keep your heels planted on the floor. That will help your tailbone curve under your butt and your back to rest upright. Keep your shoulders down away from your ears and relaxed. Your rib cage should be upright. Keep your head balanced over your back to prevent your neck muscles from overstretching. Neck muscles run from your head to your hips, so your neck posture influences back pain. Also, be sure to keep your back pockets empty.
Correcting Sitting
If we sit for an hour, we should move and flex our backs. Roll up a towel and place it right behind where your ribs meet in the front. With the roll behind your back as you’re seated, lift your hands above your head and pull your elbows back. Do this a few times. This moves the back opposite of your hunched sitting position. Also, stand up, rest your hands on your lower back and lean back. Do this a few times.
Exercises
Trunk Strength
The first step to a healthy back is exercise. The back depends on strong muscles—in the back, around the side, and in front of the trunk. A few simple exercises can help relieve back pain.
Yoga
A lot of research supports yoga to prevent and treat back pain. Many yoga moves both strengthen and make the back more flexible.
Moves to Avoid
As we age and develop back problems, we should avoid some moves. Avoid the forward fold—basically touching your toes. This can be dangerous, especially if the back of your legs is tight. If your legs are tight, this move strains the ligaments of your lower back.
Sit-ups Banned
There are other exercises to avoid if you have back problems. Old-fashioned sit-ups that involved rolling up each segment of the back, one after the other, are not recommended for anyone at any time.
Best Moves for Back
If you have specific back problems, get tailored exercises from a movement specialist. Here are some general exercises that will build and healthy back and help relieve back pain. If the exercise causes pain, back off to where there is no pain. Don’t give up, do only one rep, then try another later in the day. Slowly you will do more before you have pain. Also, try a heating pad on your back for 10 minutes before exercising.
Cat-Cow
The Cat-Cow move is super for maintaining back flexibility, and it is easy on your back. In this move, kneel on all fours and arch your back up and down. Always do back exercises slowly.
Bird Dog
Get on all fours on the floor like a dog with your face facing the floor. Wiggle your back into a neutral, resting place. From all fours, reach your right arm straight forward, keeping your head still. At the same time, straighten your left leg by pushing your heel away straight back from your trunk. Keep your back, neck, and head still. Then swap sides.
Downward Dog
The downward dog can also help keep the back flexible and strong. To do this, assume a push-up position and then raise your butt as high as you can, hold it, and then move back to the push-up position.
Be A Sphinx
Another good pose for back pain is to be a Sphinx. Lay on a mat flat on your stomach. Put your arms out front and raise your head like the great Sphinx statue in Egypt. Raise and lower your head and shoulders, but keep your hips on the ground.
Curl up
Lie flat on the floor with your hands flat behind your lower back to keep it off the floor. Slide one knee up so that one foot is flat on the floor. The other leg is straight out. Raise your head just an inch off the ground. Hold for 10 seconds. Repeat 5 times. Switch legs. There is almost no movement in this exercise.
Butt Curl and Lift
Lie on the floor on your back. Pull your feet towards your butt to raise your knees so that your knees form a right angle. Roll your hips so the curve of your lower spine is flattened to the floor. Use your abs, not your feet or your butt, to rotate your hips. Hold for 10 seconds and repeat a few times. Transition slowly to the second exercise. Lift your butt off the ground as high as you can, hold for a second, and squeeze your butt.
Hip Lunge
Kneel with one knee right under your hip and one straight out front, with your foot flat on the ground and your knee at a right angle. From this position, pull your butt in and lean forward.
Elbow Plank
Assume the push-up position, but lower yourself onto your elbows. Keep your elbows directly under your shoulder. Hold for 20 seconds. Repeat 5 times.
Side Plank
Assume the elbow plank position and rotate your body 90 degrees while keeping it straight so you are now up on your side. Rest all your weight on one elbow and one knee. As you get stronger, you can keep your body straight from your shoulder to your feet. Keep your body straight as a board. Hold for 10 seconds. Repeat.
Lopsided Carry
Find a weight with a handle. Carry this weight in one hand and walk about 25 feet. Do this 10 times, then switch sides. This strengthens your deep back muscles that keep you upright. Be careful not to overdo it.
Lacrosse Ball
Use a lacrosse ball to massage your back against a wall or the floor. Find sore points in your back when you roll the lacrosse ball around your back against the wall. These painful points, called trigger points, often make pain appear in another part of the body when pressed by the ball. To work these out, find the point and slowly roll the ball around that spot while applying the ball’s pressure against the wall or the floor.
Neutral Posture
Posture
How we hold our body is important for a healthy back. Bad posture is sure to cause back pain. With smartphones, bad posture is rampant. Hunching over a phone is bad for your back. It pulls the whole spine out of alignment. Our head is not designed to look down for long periods. It’s made to look forward to the horizon. For good posture, imagine a thread tied to the crown of your head and pull that thread to raise the back of your head as high as possible. This aligns the spine into a slight S and pulls our head back into place. After years of bad posture, our body can get fooled into thinking it is standing correctly. It is helpful to have someone videotape you with a phone while you are standing and walking, so you can see your posture.
Stay in Neutral
The neutral position starts with the hips directly over the ankle point---hips level. Most people tip their hips forward, and often, our ribcage is tipped back to compensate. We’ve been trained to push our shoulders back, which tilts our ribs. This over curves the lower back. If the bottom of your ribs is tipped forward, try to straighten your ribcage vertically. Initially, you might need to tilt your head forward to get your ribcage in place. Then, hold the bottom of your ribs and pull the back of your head to the ceiling.
Walking
Any movement that keeps your back in a neutral position is excellent for your back. One of the best ways to get better posture is to walk. When we walk, our posture is often better than at any other time. But don’t stroll---slow walking puts a greater load on the spine than normal walking. If you get pain after a few steps, take a break. Walk a few more steps next time. To start, march a few steps in place---with high knees, but keep your hips still. Then, launch out into your walk with your arms swinging. Lead with your torso, not your head---head up and back! Work yourself up from a few steps to an hour-long walk.
Attitude
One of the often-overlooked aspects of pain is the social-emotional-mental component. We are healthier and have less pain when we have people with us. Why is a mystery, but the difference is real. Mental, social, and emotional stress makes pain worse. Connect with uplifting family and friends.
Surgery
Back surgery only works for a few limited cases. Of the back problems that are candidates for surgery, only about half are successful, and 1 in 10 have complications. Even for those few cases, surgery is never the first option. Outside badly pinched nerves, there is little research to support surgery to relieve back pain.
Long-Term Care
Most back pain gets better in 3 months or less, but consider a permanent improvement in your back care. If you’ve had back pain once, getting sloppy with your back may result in the pain returning. Proper care can make your back feel better at 70 than it did at 40. The discs between the spinal bones get tougher and are less likely to be injured.
Face It
Don’t get discouraged if you have back pain. It can get better regardless of your diagnosis---plan to tackle your back pain. First, think about good posture in all cases. Study and learn it. Second, sit properly and walk long and often. Thirdly, do exercises and stretches to keep your back in shape. These three steps will improve your back pain.
