Tips for a Healthy Back

Use proper posture when standing:
• Keep your shoulders back and relaxed.
• Pull in your abdomen and engage your abdominal muscles.
• Keep your feet about hip distance apart.
• Balance your weight evenly on both feet.
• Let your hands hang naturally at your sides.
• Try not to tilt your head forward, backward or sideways, and make sure your knees are relaxed — not locked.
• Wear comfortable shoes. And avoid high heels which cause you to over compensate for your altered balance by flexing or forward bending the hips and spine.

Use proper posture when sitting:
• Choose a chair that allows you to rest both feet flat on the floor while keeping your knees level with your hips. If necessary, prop up your feet with a footstool or other support.
• Sit back in your chair. If the chair doesn't support your lower back's curve, place a rolled towel or small pillow behind your lower back.
• Stretch the top of your head toward the ceiling, and tuck your chin in slightly.
• Keep your upper back and neck comfortably straight.
• Keep your shoulders relaxed — not elevated, rounded or pulled backward.

Safely Reaching:
• Use care when reaching above your head, either to retrieve something or place an item on a high shelf. Get as close to the item as possible and use one hand for support.
• When reaching down, keep your back in a balanced position. Bend at the hips while raising one leg behind you. Hold onto a solid object for support.
•Avoid constant reaching motions which use large shoulder, chest and arm muscles that when over-used and under-stretched can begin to pull your shoulders and head forward.
Lifting Safely:
• Keep the weight close to your body. The power zone for lifting is close to the body, between mid-thigh and mid-chest height. Comparable to the strike zone in baseball, this zone is where arms and back can lift the most with the least amount of effort. Keep the load close to the waist for as long as possible while lifting. The distance of the load from the spine at waist height is an important factor in the overall stress on the spine and back muscles. Keep the heaviest side of the load next to the body. If closely approaching the load isn't possible, try to slide it towards the body before trying to lift it.
• Your feet should be apart with one leg slightly forward to maintain balance (alongside the load if it's on the ground). Be prepared to move your feet during the lift in order to maintain a stable posture. Wearing over-tight clothing or unsuitable footwear, such as heels or flip flops, may make this difficult.
• Proper handholds make lifting easier and reduce the risk of injury. Handholds should be made large enough to accommodate larger hands and should not dig into fingers and palms. Where possible, hug the load close to the body. This may be a better option than gripping it tightly with the hands only.
• A slight bending of the back, hips and knees at the start of the lift is preferable to either fully flexing the back (stooping) or fully flexing the hips and knees – in other words, fully squatting.

• Avoid twisting the back or leaning sideways especially while the back is bent. Keep your shoulders level and facing the same direction as the hips. Turning by moving your feet is better than twisting and lifting at the same time.
• Don't jerk or snatch the load as this can make it harder to keep control and can increase the risk of injury.
• Keep your head up when handling the load. Look ahead, not down at the load once it has been held securely.
• Pushing vs. pulling. Pushing is generally preferable to pulling. Pushing allows you to use large muscle groups and apply more force to the load. Pulling carries a greater risk of strain and injury.
• Don't lift or handle more than you can easily manage. There's a difference between what people can lift and what they can safely lift. If you're in doubt, seek advice or get help.

Carrying Objects:
• Try to carry similar loads on both sides of your body to balance the added weight. Make a number of trips, rather than trying to carry too much at one time. This includes shopping bags, purses and briefcases.
• When using a backpack, the shoulder straps should be adjustable, wide as well as padded. A backpack with a waist/hip strap is preferable. Pack your backpack with the heavier items close to your back and make sure the contents of the backpack does not exceed 15% of your body weight.

Sleeping:
By making simple changes in your sleeping position, you can take strain off your back. Placing a pillow under your knees while lying on your back cuts the pressure on your spine roughly in half. If you sleep on your back, you might also try a small, rolled towel under the small of your back for additional support. Lying on your side, drawing your legs up slightly toward your chest and putting a pillow between your knees may also reduce the pressure on your back. Sleep on a firm mattress and make sure to support your neck with a pillow. Never sleep in a position that causes a portion of your spine to hurt. Most often, your body will tell you what position is best.

Weight Control:
Extra weight puts undue strain on your spine. Extra weight around the midsection is likely the worst culprit, as it puts unwanted pressure on the muscles, ligaments and tendons in your low back. Try to keep within 10 lbs. of your ideal weight for a healthier back. The most efficient and effective way to reduce weight is by eating a sensible diet and exercising regularly. A healthy diet consisting mostly of lean proteins, healthy fats and lots of fresh fruits and vegetables is ideal for building a lean body and muscles that support the spine. Consult with your doctor before beginning any exercise program, particularly if you have a health condition.

Not Smoking:

  • Smoking reduces bone density, which puts the vertebrae at greater risk for developing osteoporosis, facet disease, spinal arthritis and other degenerative spine conditions
  • Nicotine causes a reduction in collagen levels, which makes soft tissues and cartilage less elastic and resilient. Tendons and ligaments in your back become vulnerable to injury.
  • Tobacco smoke also harms your lungs, making physical activity difficult. The result can be lowered muscle mass due to inactivity.
  • The discs that separate adjacent vertebrae have a very low blood supply. Smoking inhibits circulation even further, making it impossible for these discs to absorb the nutrients they need to stay healthy.
  • When cartilage, vertebrae and intervertebral discs weaken, the chances of a herniated disc or bulging disc increases. These conditions can cause disc material to impinge spinal nerves.
  • Smoking also slows the healing of injuries when they occur and leads to a higher risk for surgical complications.

When to See a Doctor:
Most back pain gets better within a few weeks without treatment. If you're very uncomfortable, you can rest in bed for a day or two, but longer than that does more harm than good. Over-the-counter pain medications often help reduce back pain, as does the application of cold or heat to the painful area.

Call your doctor if your back pain hasn't improved at all after three days of home treatment or if your back pain:
• Is constant or intense, especially at night or when you lie down
• Spreads down one or both legs, especially if the pain extends below your knee
• Causes weakness, numbness or tingling in one or both legs
• Occurs with unintended weight loss
• Occurs with swelling or redness on your back

Call 911 if your back pain:
• Occurs after a high-impact car crash, bad fall or sports injury
• Causes new bowel or bladder control problems
• Occurs with a fever

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