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FAQs: Daily Activity Causing Back and Neck Pain

 

What can I do to protect my back when I lift heavy objects? What is proper lifting technique?

The best way to protect your back when lifting is to learn how to lift properly through proper squatting and lunging techniques.  Most people typically bend at their waist and buckle their spines.  It is very important to learn how to squat and lunge through the hips.  This is often referred to as a “hip hinge.”  The hips specifically the glute muscles are the largest and probably the most important muscles when lifting heavy or light objects.

The glute fascia-connective tissues in our body is responsible for maintaining our pelvic stability that supports are spine and propels us forward.  Society has become increasingly sedentary with increased reliance on sitting which causes our glutes to become inhibited and weak.  Thus, various forms of exercises such as lateral band walks, band duck walks, and/or clam shell exercises which are designed to help strengthen our glutes and teach people how to engage these muscles is very important in lifting techniques.

We should always “hip hinge” engaging our glutes when lifting as this has been shown to decrease the forces and load transmitted to our spine.  Along with using the “hip hinge” when lifting it is crucial to keep the object that you are lifting close to your body to decrease the load on the spine.  This can be explained by simple physics as the further the object is carried away from your body the longer the moment arm which puts increased pressure on the spine.  When lifting, avoid flexion and rotation which also increases disc injuries to the spine.

What kind of shoes should I wear to protect my back? What can I do when walking or standing to ease my pain?

In my opinion the best shoes are flat shoes that help to keep your body in proper natural alignment.  I strongly support the minimalist theory with respect to shoes such as the Nike Frees.  However, this is not for everyone and their personal comfort level.  The most important factors when standing or walking for long periods of time is to have fairly flat shoe (no heel or elevation), ample room for your forefoot/toes to move freely (avoiding that cramped feeling) and ample support that you prefer.  The more natural people can be the better.  If people are standing for long periods of time than a cushioning insert can be used within the shoe to provide a little more feedback and comfort.  Too many people often purchase shoes that are “prescribed” to them based on their foot type.  Research that was actually conducted on the army showed that that those soldiers that were prescribed the wrong shoe based on their foot type actually had fewer injuries.  Individuals standing for long periods of time are best to constantly change positions, always wear rubber soled shoes, and stand on a rubber mat for extra cushioning to prevent increased load and ground reaction forces from being transmitted up to the body.

What is considered good posture? Can poor posture cause or worsen back pain?

Good posture is always remembering that our spine should be in a neutral position maintaining the natural curves.  This can be achieved by always remembering chin up, chest out, core tight and shoulders down and back.  Another good analogy is to pretend that your head is a golf ball sitting on a tee.  We must keep that ball well balanced so that it doesn’t fall off the tee. The head should be centred and not too far forward.  Forward head posture is prevalent in today’s society with the over use of technology causing our head and necks to protrude forward often termed anterior head carriage.  If you want to assess your posture, have a friend take digital photograph of you standing in your normal posture from a lateral/side view.  You should be able to draw a straight plumb line from your head to your toes that bisects through your ear, shoulder, hip and knee joint and base of your fifth toe.  If any part of your body is forward or in back of this line than your posture is off.

Poor posture has definitely been associated with back pain as it causes increased stress on your spinal joints and extremities as your weight is not evenly distributed.  Furthermore, when you do activities of daily living such as standing, lifting, squatting, sitting poor posture will result in increased load to your spinal discs resulting in inflammation and pain.

What can I do to prevent back problems while I’m sitting for long periods at a computer, at a desk, in a car, or in a plane?

The best prevention strategy is to get up approximately every 30 minutes and take what is called a micro-break.  This includes standing up out of your chair, reaching up for the ceiling with your hands as high as possible with your hands and taking a big deep breath in.  Hold this breath for a couple of seconds as you focus on retracting and depressing your shoulder blades.  Exhale as you relax back down into a neutral position.  As you stand up in this position a mild extension moment of the lumbar spine is achieved decreasing the stress and strain to your lower back.

Should I lock my feet when doing a sit up?

Never do traditional sit-ups with both knees bent either locked or unlocked.  This exercise will cause low back pain and put enormous amount of pressure to your low back.  The safest way to do a sit-up is what is called a neutral spine curl-up where one leg is straight and one knee is bent maintaining the natural curve of your low back.  You will only crunch up for a ¼ motion lifting your chest slightly off the ground while bracing the abdomen.

I have recently started to have a nagging backache that never seems to completely go away. My husband says it is because I sleep on my stomach. Could this be the cause of my backache?

Unfortunately, sleeping on your stomach can be causing your back pain as it causes hyperextension of your cervical and lumbar spine. This may cause irritation to your spinal facet joints causing them to become inflamed and irritated which may be the source of your pain.

What position do you recommend for sleeping?

The best position for sleeping is lying flat on your back with an ObusForme cervical pillow to maintain proper alignment of your neck and back while sleeping. As well, a small pillow such as the ObusForme Knee buddy can also be placed under your knees to help alleviate any low back strain. Many people find it hard to maintain this posture throughout the night. However, I often recommend practicing meditating in this position to assist with raising your comfort levels. Another excellent position is the “fetal position” or side sleeping position. When utilizing this sleeping position it is absolutely critical to use a cervical pillow to prevent your neck from becoming irritated by the extended and rotated position that will occur if the neck is not kept neutral. The ObusForme Knee Buddy pillow should also be utilized to help maintain neutral spinal alignment.

What kind of mattress is best for someone who experiences back pain? Which sleep position is best?

The best mattress is one that provides you with excellent support and comfort.  It is important to test and try various mattresses to select the one that best suits your individual needs.  If the mattress provides excellent stability but is not comfortable and allow you to sleep than it is of no use.  This is where balance comes into play.  If you find that you are waking up with pain and have not changed your mattress in the past five to ten years than it would be prudent to consider looking into purchasing a new one.  Like all products mattresses are exposed to wear and tear and should be replaced within this time frame to ensure it is providing adequate support for your body type and weight.  A mattress that has firm support may produce the best stability to the spine.  Using a top cover to a softer mattress can also be used to increase firmness.

The best sleep position is lying flat on your back with the use of an Obusforme cervical pillow which will allow you to maintain a neutral spinal alignment.  Many people find sleeping on their back difficult and uncomfortable; therefore side-sleeping in the fetal position can be used again with an Obusforme cervical pillow and knee buddy pillow to prevent the top leg from falling over and creating rotational stress to your spine.

What can I do to protect my back when I lift heavy objects? What is proper lifting technique?

Always lift by bending at the hips. It is extremely important that people learn to “hip-hinge” engaging their glutes-butt muscles to stabilize the spine. Many people lift by flexing/bending at the spine which creates increased pressure and load on the spinal discs and is often the precursor to disc bulges as a result of the increased spinal pressure. This is easily prevented by learning to squat properly by engaging the hips and lifting the object/weight close to the body. The closer the object is to the body the less strain on the low back. Even with light objects like a pencil, many patients often forget to squat properly to pick up the pencil from the floor and thus “throw out their backs.” Engaging the core muscles that stabilize the spine is also extremely important in preventing low back pain when lifting.