Neck and Back

Preventing Back Pain

Anatomy

The spinal column is made up of small bones (vertebrae) stacked on top of one another, creating the natural curves of the back. Between the vertebrae are flat, round, rubbery pads (intervertebral disks) that act as shock absorbers and allow the back to flex or bend. Muscles and ligaments connecting the vertebrae allow motion while providing support and stability for the spine and upper body. Each vertebra has an opening (foramen) in the center and these line up to form the spinal canal. Protected by the vertebrae, the spinal cord and other nerve roots travel through the spinal canal. Nerves branch out from the spinal column through vertebral openings, carrying messages between the brain and muscles. Facet joints align at the back of the spinal column, linking the vertebrae together and allowing for rotation and movement. Like all joints, cartilage covers the surface where facet joints meet.

The spine contains three segments: cervical, thoracic and lumbar. The cervical spine includes the neck and consists of seven small vertebrae, beginning at the base of the skull and ending at the upper chest. The thoracic spine consists of 12 vertebrae and begins at the upper chest, extending to the middle back and connecting to the rib cage. The lumbar spine consists of five vertebrae located in the lower back; lumbar vertebrae are larger because they carry more of the body's weight. Disks in the lumbar spine are composed of a thick outer ring of cartilage (annulus) and an inner gel-like substance (nucleus). In the cervical spine, disks are similar but smaller in size. The pars interarticularis is a part of the lumbar spine that joins the upper and lower joints; it is found in the posterior portion of the vertebra.

Description

Nearly everyone experiences some type of back pain at one time or another. ThIs pain can make daily activities uncomfortable or difficult to perform. Back pain varies from person to person—it can be intermittent or constant, duration can be brief or long-lasting, onset can be slow or sudden, and the intensity can range from mild to severe. In many instances, back pain may resolve without treatment within a few weeks. However, in some cases, treatment is required.

Causes

Low back pain has many causes and contributing factors, including: athletic or other overactivity, poor posture, carrying heavy bookbags or backpacks, disk tear or other injury, herniated disk, age-related disk degeneration or arthritis, lumbar spinal stenosis, spondylolisthesis, scoliosis, fracture of the thoracic and lumbar spine, spinal fracture due to osteoporosis, as well as many other injuries and medical conditions. Some causes of back pain can be serious. If you have vascular or arterial disease, a history of cancer, or pain that is constantly present regardless of your activity level or position, be sure to consult with your primary care physician.

Symptoms

Back pain can vary according to the individual and underlying cause. The pain may dull, achy, sharp, stabbing, or it may feel like a cramp, or "charley horse." The intensity of pain may worsen with certain activities, such as bending, lifting, standing, walking or sitting. Symptoms may come and go, causing patients to experience "good days" and "bad days." Pain may extend from the back into the buttock or outer hip area, however, pain that extends down the leg, or includes numbness, tingling or weakness that goes down to the foot may be sciatica, which is common with a herniated disk. Whatever your symptoms or age, if your back pain does not improve within a few weeks, or if it is associated with fever, chills or unexpected weight loss, you should contact your physician.

Prevention

Although we cannot prevent all back pain, there are many things we can do to protect our spine and lessen the impact of any problems, which includes living a healthy lifestyle.

• Exercise and physical activity—Exercise regularly and combine walking, swimming or other activities with a spine conditioning program, low back exercises, or specific exercises to stretch and strengthen back and abdominal muscles.
• Maintain a healthy weight—Being overweight puts added pressure on your spine and lower back.
• Avoid smoking—Nicotine and other ingredients in smoke have been shown to cause the spine to age faster than normal.
• Proper posture—Be conscious of maintaining good posture as you stand, sit and lift things; this is important to the health of your spine and helps you to avoid low back problems.

Lifting a Heavy Object

Before you lift, consider the object. If you think it could be too heavy or the shape is awkward, do not try to lift it by yourself. Get help.

• Think before you lift—Consider what you want to do and how you need to do it; plan for a proper lift and don't be in a hurry.
• Position yourself—Stand close to the object you want to lift.
• Position your feet wide apart—Separate your feet, moving them to shoulder-width apart to give yourself a balance and a solid base of support.
• Bend at the knees—Do not bend at the waist.
• Tighten your stomach muscles
• Lift with your legs—Use your leg muscles as you stand up, not your back.
• Lifting luggage—Stand alongside of the luggage, bend at your knees then grasp the handle and straighten up, using your leg muscles to do so.

Picking Up a Light Object

To retrieve a piece of paper or other, lightweight object from the floor, lean over the object and bend one knee, slightly, extending your other leg behind you. Grab hold of a nearby chair or object for support as you reach down to pick up the object.

Holding a Heavy Object

While holding the object, keep your knees slightly bent to maintain your balance. If you have to move the object to one side, point your toes in the direction you want to move, hold the object close to your body, then pivot in that direction—avoid twisting your body.

Placing an Object on a Shelf

Move as close to the shelf as possible. Spread your feet in a wide stance and position one foot in front of the other to give yourself balance and a solid base of support. Do not lean forward, and do not fully extend your arms while holding the object in your hands. Keep your elbows at your side, tighten your stomach muscles before lifting, and position your hands so you can push the object up and onto the shelf.

Supporting Your Back While Sitting

When you are sitting, your back should be in a normal, slightly arched position and your head and shoulders should be kept erect. Make sure your chair supports your lower back and position your working surface at the proper height so you don't have to lean forward to work. If possible, stand up and stretch at least once every hour, placing your hands on your lower back and arching gently backward.