We Have Your Back

While many women will be promising to uphold New Year’s resolutions about reaching a certain weight, daily exercise, or miles run per week, they may not consider a crucial component to physical health – that of keeping a healthy, pain-free back.  About 25% of Americans report having low back pain at any given time within the last 3 months, and as many as 75% of Americans will have some complaints of back or neck pain during their lifetime.  While most cases of low back pain resolve without any intervention, some cases will linger and nag, nag, nag.  Back pain can result from something as innocent as lifting too much weight at the gym to health conditions such as degenerative disk disease, spinal stenosis, or herniated disk.  Less common contributors to back pain include fractures, osteoarthritis, osteoporosis, and spinal tumors.  Most acute pain lasts less than 3 months or may be recurrent, but pain lasting more than 3 months is considered chronic and should be treated as an emergency if symptoms include loss of bowel or bladder control or numbness in the groin or inner thigh, which may indicate compression of nerves at the end of the spinal cord. 

Degenerative disk disease (DDD) is a common cause of back pain that typically results from natural aging. One disk or several intervertebral disks may be involved with DDD. Intervertebral disks are rubbery, gelatinous pieces of cartilage between each of 33 vertebrae in the spine.  Age, wear and tear, and injury can flatten these disks, potentially causing pain, inflammation, or nerve compression, which can be accelerated by smoking, obesity, heavy physical work, and lack of exercise.  Gelatin pushing through a crack in the exterior of a disk can lead to a herniation (bulge) or rupture (tear) in the disk and the resulting pressure on spinal nerves or the spinal cord.  A herniated disk is likely to cause intense pain, tingling, numbness, or weakness that gets worse with sitting, bending, or reaching (depending on which disk is involved), and that is worse in the morning or after staying in one position for a long time.  Spinal stenosis usually results from aging and is a narrowing within the vertebrae that can compress nerves or the spinal cord, causing symptoms similar to disk herniation.  Physicians and/or physical therapists should be consulted if any of these conditions interfere with normal function, regular physical activity, sleep, or bowel and bladder control.  A typical approach to these conditions might include special diagnostic tests such as x-rays, education on stretching, strengthening, posture, pain control, manual therapy, and aerobic exercise.  

For the majority of adults experiencing back pain, a dose of education can go a long way in helping to alleviate their symptoms.  Starting a regular exercise program is crucial to good back health, but it is important to avoid the common exercise hazards that can bring on back pain.  A helpful hint for women who exercise regularly is to adjust their exercise routine during periods of hormonal fluctuations, notably paying attention to activities that increase or decrease back discomfort during exercise, maintaining an activated trunk (or core musculature) when lifting weights or other heavy loads, and maintaining good posture in prolonged sitting or standing.  An example of a common pain producer in women (and men) while exercising is trying to lift a heavy kettlebell overhead while squatting by using momentum versus muscle strength to swing the bell overhead, resulting in an arched back.  The lower back should be maintained in a slight curve, not a severe arch, during this activity.  Either the kettlebell is too heavy, or it is being raised too far overhead if the back has to arch severely.  Other common pain producers in the gym involve pulling the “lat bar” down behind the head while arching the back in a sitting or standing posture, or bench presses that cause the back to severely arch in order to move the weight.  The load should be adjusted to allow only a slight curve during these exercises.  Another interesting potential pain producer occurs on the stair climber.  The stair climber is a challenging piece of equipment, but good posture should be maintained despite the effort required to keep up with the moving stairs.  Frequently, adults on stair climbers will lean forward at the waist, placing a large amount of body weight through excessively flexed wrists, and placing the back in a strained position that requires the trunk extensor muscles to work much harder against gravity than they should.  This is easily remedied by adjusting the machine speed to allow more upright posture or, at a minimum, by alternating upright posture with very short periods of the flexed position. 

Add a resolution to your 2012 list that protects your back, either through starting exercise, smarter exercise, or just standing and sitting straighter.  Your back will thank you for it later.                              

References:  www.moveforwardpt.com