Ng Min Li Physiotherapist Managing Back Pain Most cases of back pain respond well to conservative treatment, such as medications and physiotherapy, and resolve in four to six weeks. While the relief of pain may be your immediate concern, reducing the risk of re-injury should not be neglected. Many studies have shown that exercise plays an important role in achieving these two goals (AHCPR Publication 95-0642, 1994; Maher et al, 1999; Saal, 1990). Exercise stimulates the production of the body's natural pain controlling hormones (endorphin) and reduces the perception of pain. Specific muscles that stabilise and support the spine needs to be retrained as studies have shown that these muscles may not necessarily restore their original function after an episode of back pain, leaving the spine susceptible to re-injury (Hides et al, 1996). By performing physiotherapy exercises designed specifically for these muscles, a full recovery is possible. You should continue to exercise even after your problem with back pain has been resolved. There are many exercises that can be performed to condition your back and body muscles. You should consult your doctor or physiotherapist about the exercise that would be best for you. Treat Your Back Well To avoid excessive strain on muscles, joints, bones and ligaments, you should develop good habits and adopt a correct posture at all times. Back pain may be related to natural aging (normal wear and tear of joints and discs), but if you follow necessary precautions, your back will serve you better.
Posture Maintain a stable, balanced and relaxed posture when you are sitting, walking and standing. Keep your head level with your chin tucked in. Shoulders should be relaxed, not hunched up or rolled forwards, and keep your back straight. THINK TALL!
Work Avoid prolonged standing, sitting or working in the same position by changing positions frequently. If you need to stand for long periods, support one foot with a stool or step.
While working at your desk, it helps to sit with your back supported by the back of the chair. Use a lumbar support or rolled-up towel for additional support if necessary. Rest your feet comfortably on the floor or on a footrest. Don't stay seated for long - stand up, stretch and walk around.
Lifting - Always practise correct lifting techniques. - Stand close to the object. - Tighten your tummy muscles. - Squat down with your back straight. - Grasp object firmly and hold it close to your body. - Lift by straightening hips and knees. - Keep your back as straight as possible. - Avoid twisting; instead, turn by using your feet.
Your mattress should be firm enough to support the natural shape of your spine. Never sleep on a sagging mattress.
Stay in shape. A healthy body weight is less strenuous on your spine. Watch your diet and exercise regularly. Walking, cycling and swimming are recommended.
AHCPR Publication 95-0642 (1994) Acute Low Back Problems in Adults: Assessment and Treatment. Clinical Practice Guideline Number 14. Agency for Health Care Policy and Research, Public Health Service, US Department of Health and Human Services.
Hides JA, Richardson CA and Jull GA (1996) Multifidus muscle recovery is not automatic after resolution of acute first-episode low back pain. Spine 21: 2763-2769.
Maher C, Latimer J and Refshauge K (1999) Prescription of activity for low back pain: What works? Australian Journal of Physiotherapy 45: 121-132.
Saal JA (1990) Dynamic muscular stabilisation in the nonoperative treatment of lumbar pain syndromes. Orthopaedic Review 19: 691-700.
Date reviewed: 11 April 2000
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