Oh, My Aching Back!

Oh, My Aching Back!

From Chicken Soup for the Soul: Say Goodbye to Back Pain!

Oh, My Aching Back!

You Don’t Have to Go to War to Have Back Pain

Sergeant Geist’s story is reminiscent of many stories I’ve heard from soldiers who I’ve treated for back pain. It’s physically arduous, sometimes disabling and yes, even potentially deadly, to be a soldier who is stationed far from home. But, you don’t have to go to war to have back pain. Many people who have sedentary jobs and have never carried a rifle, never even seen “body armor” much less worn it, and never run from an enemy carrying 60 to 100 pounds of gear, will nevertheless develop severe, perhaps “crippling,” back pain.

In fact, the vast majority of us will suffer from back pain at some point in our lives. People are the most likely to suffer between the ages of 20 and 40. However, even though you may be at the greatest risk when you are young and active, getting older doesn’t protect you. Aging disks (the “cushions” between the bony vertebrae), arthritis and other problems in the spine may remind you of the passing years. Perhaps not surprisingly, the older you are the more severe and longer lasting the pain may be.

What Does Sex Have to Do With It?

Studies show that back pain doesn’t seem to discriminate between the sexes and affects men and women fairly equally. But there do seem to be some sex-related differences. An example where women may be at higher risk for back problems is osteoporosis. While it’s true that men get osteoporosis, too, women are particularly susceptible to loss of bone density and strength that can lead to vertebral compression fractures. This may cause them to become shorter and appear somewhat stooped over (commonly known as a dowager’s hump).

Men in Western industrialized societies are more apt to have disk problems and this is often treated surgically. Both the problem with their disks and the surgical “solution” may be influenced by the work that they do — with men more likely to be in jobs that require heavy, physical labor and perhaps more interested in pursuing a surgical remedy to get them back to work as quickly as possible.

My Job Is Hurting My Back!

Speaking of jobs and other activities that might predispose someone to back problems, it’s probably obvious that jobs that involve lifting, bending, stooping, and so on can take a toll on your back. It’s also true that riding in motor vehicles, especially big trucks, construction equipment and even planes that include prolonged sitting combined with vibration, can cause back problems. Lest you think that you are safe in a nice, cushy office, beware — sedentary jobs at the computer are also stressful for backs. Which is why I often counsel young adults who are planning their careers to consider not only their intellectual interests but also how they will physically feel doing their chosen profession year after year. The best kind of a job for your back is one where you don’t have to lift too much or sit too much. Backs like to move around but not be too stressed out.

Your neck is the upper part of your back, and it can get stiff simply from daily activities such as sitting at a computer or talking on the phone. Sometimes the stiffness is associated with pain. Your neck is the most flexible portion of your spine. If you have full range of motion, you should be able to:

 

Forward Flexion: Touch your chin to your chest (or nearly touch it to your chest)

 

Lateral Flexion: Tilt your head to the side so that it’s about halfway to your shoulder

 

Extension: Look up at the sky

 

Rotation: Move your head so that you can clearly see oncoming cars when you are driving

 

When Pain Strikes: An Exercise to Relieve Neck Pain

Here is a simple, gentle exercise to do when moderate neck pain first strikes. For severe pain, contact your health care provider immediately.

1. Sit in a neutral position, holding your head in a normal resting position.

2. Next, slowly glide your head backward, tucking your chin in until you have pulled your head and chin as far back as they will go. Keep your head level and do not tilt or nod your head. Pull in gently for three to five seconds, then release. Repeat 10 times.

3. For a stronger stretch, gently apply pressure to your chin with your fingers and release. Repeat every two hours as needed.

If this exercise increases your pain, try it lying down on your back. Tuck your chin in and make a double chin. Hold for a second or two and release (your head never leaves the pillow). If pain increases or you develop numbness or tingling, stop and contact your doctor.

Where It Hurts: Muscles of the Neck

The posterior (rear) neck muscles do the lion’s share of work in supporting the weight of your head while tilting and turning. Pain can result when an injury strains or tears your neck muscles, but more often, aches and pains result when muscles tense and strain to protect neck joints and nerves that have deteriorated. The brawny trapezius muscle is one of the most common sites of neck pain and strain.

Neck Stretching

Perform these exercises gently to the point where you feel a slight stretch but no pain.

Rotation range-of-motion

Start by facing forward. Turn your head slowly to one side. Hold three seconds and return to the original position. Turn your head slowly to the other side. Hold three seconds and return to the original position. Repeat 10 times.

 

Side bending range-of-motion

Face forward and let your head bend slowly to the side. Hold three seconds and repeat to the other side. Repeat 10 times. Do this exercise slowly and gently.

Neck Strengthening

Front neck muscles:

This exercise can be done in a sitting position — at the office, for example — or lying down with your knees bent and feet flat on the floor. Place your palm on your forehead and press gently as you try to bring your chin to your chest; your neck muscles will tighten without your head moving. Hold for a count of three to five seconds. Repeat 10 times.

 

Rear neck muscles:

Place one or both hands behind your head and use them to resist as you press your head backward. Hold for a count of three to five. Repeat 10 times.

Neck Strengthening

Side neck muscles:

Place your right palm on the right side of your head, using it to resist as you try to bend your right ear toward your shoulder. Hold for a count of 10. Repeat on the left.

 

Rotation muscles (not shown): Place your right hand on the right side of your head. Try to rotate your head to the right, resisting with your hand. Hold for a count of three to five. Repeat on the left. Repeat 10 times.

Shoulder Strengthening

Shoulder blade retractions

Stand up straight with your arms at your sides. Squeeze your shoulder blades together for a count of four and release. Repeat 10 times.

Shoulder strengthener

Secure an elastic exercise band (available at sports and fitness stores) to a sturdy post or railing at waist level. With arms extended, hold the ends of the elastic taut. Pull back slowly, bending your elbows at waist level and squeezing your shoulder blades together. Return slowly to the starting position. Perform three sets of 10 repetitions. Rest one minute between sets.

 

All figures in Chapter 1 are reprinted with permission from the Harvard Health Publications Special Health Report: Neck and Shoulder Pain (2009)

 

As people age, they often lose some range of motion. Losing a little is okay, but significant restrictions in neck range of motion can be problematic for daily activities such as driving. On the other hand, sometimes the neck is stretched too far, and this can injure various spinal structures. For example, in a whiplash injury the head is forcibly pushed to the extremes of forward flexion and extension. This causes injury. Too much motion can be harmful, even when it’s not associated with trauma. Your neck is only designed to move so far. Pushing it beyond its limits may cause problems.

So, when it comes to neck pain and most other types of pain that involve motion of your body, it’s important to stay active and keep things moving well but not overly stretch beyond a normal range of motion. Certainly trauma is one reason why people have neck and back injuries, but sitting for hours on the computer is the cause of many visits to doctors’ offices.

Maybe I Can Blame My Parents for My Pain

Some of my patients tell me that they knew they were going to have back problems, because it “runs in my family.” Just how much does heredity play a role in back pain? Well, that’s a good question and one that is not always simple to answer. Some people may have a genetic susceptibility or “weakness” in certain spinal structures that may predispose them to having back problems. There also is a hereditary link in some back conditions such as ankylosing spondylitis (an inflammatory arthritis that affects men more than women and tends to run in families).

Your family and the environment that you grew up in may also influence your back. For instance, if you grew up in a family that had big meals and relaxed by watching TV after dinner versus a family that ate light meals and went for a hike before dark, these habits — either good or not so good — may influence you now and therefore affect your back.

While there are some genetic and environmental factors that may play a role in back pain, I think it’s good to remember that just because someone in your family has back problems doesn’t mean that you have the same (or even a very similar) back. This means that there may be treatments that work for you that someone in your family may have unsuccessfully tried. Your back is your own. And this book is both an inspirational guide as well as a back owner’s manual!

The Myth of Perfect Posture

Having perfect posture won’t keep you from experiencing stiffness and even pain, because your body wants to move. However, many people spend time on the computer, phone and reading at home and work. While improving your posture won’t take the place of moving around, it does help when you need to use your arms for a period of time to type or hold a phone or book. Here are some things you can try to better support your upper body. (Hint: even if you don’t have neck pain, these are great tips to put your body in a better position and avoid future injury):

1. Support your arms. This is especially important if you use the computer. It’s very stressful on your body to have your arms held out in front of you for any period of time. The muscles in your upper and mid back have to contract for long periods of time to hold that position.

Try this: hold your arms in front of you as if you were typing on the computer. Feel how the muscles in your back are working when you hold your arms in the typing position. Now put your arms in your lap and relax those muscles. Try this a few times until you can really feel the muscles working. Spending 20 minutes at the computer means that those muscles must contract for that period of time. If you are at the computer longer, your muscles work harder. Many people don’t have the upper body strength to tolerate this kind of stress on their muscles, so they develop neck and mid back pain.

There are really two solutions to the problem of too much stress on your muscles. The first is to increase strength by doing specific exercises. The second is to decrease the stress on your muscles. When it comes to decreasing stress, there are two options — do less or support more. You can decide whether doing less is an option. Either way, consider offering your upper body more support. One way to do this on the computer is to place a pillow on your lap so that your forearms are supported. Avoid direct pressure over your elbow (where the ulnar nerve is most superficial — you have probably felt the ulnar nerve tingle when you hit your “funny bone” in the past). More sophisticated solutions include ergonomically designed forearm rests (also sometimes called data arms).

2. Use a speakerphone or telephone earset. Even if you don’t hold the phone between your neck and shoulder so that your hands are free, it’s stressful on your neck to hold the phone up to your ear. Try it without your phone. Pretend you are holding your phone and bring your hand up to your ear. Now, hold that position for the length of a short phone call (say 5-10 minutes). How comfortable does that really feel when you have to hold your arm in that position (and also engage many of the muscles that support your arm, shoulder and neck/back)? Most people don’t realize how sustained muscle contractions promote neck pain when they are talking on the phone, but they do. So, go hands-free by using a speakerphone or an earset.

3. Avoid bifocals. You don’t really have to throw away your prescription glasses, but if you do wear bifocals think about how you are positioning your neck in order to see. Are you moving your neck into awkward positions so that you are able to see things better? If so, that’s probably not helping a sore neck.

4. Use a bookstand. If you love to read, you probably never noticed that it puts stress on your neck muscles to hold a book or an e-reader. This is another thing to try without the actual object. Hold our arms in front of you as if you were reading. Now, keep your arm(s) there for 5-10 minutes. Is that comfortable? Probably not. If you like to read, then it’s likely you are holding this position for a lot longer than 5-10 minutes — the whole time engaging your arm, shoulder and neck/back muscles. Instead, try using a bookstand or a pillow on the tabletop or your lap to let your muscles relax.

 

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