Brush and Floss Your Back

Taking care of your back is a lot like caring for your teeth. Daily habits, like brushing and flossing, make all the difference. While brushing and flossing won’t guarantee that you’ll never get a cavity, there’s no doubt that these habits help prevent problems. My patients often tell me that they want me to fix their backs so that they never hurt again. I say, “That’s a lot like going to the dentist and saying that you never want to have another cavity. It’s just not possible.”

However, what is possible is to “brush and floss” your back, so that you have fewer future problems and when they do occur, they aren’t as severe. Backs are a lot like teeth — taking care of them pays off but doesn’t prevent every problem.

So, here are some “brushing and flossing” tips for your back:

1. Strengthen your core. Try this simple test that I ask patients to do in my office. I have patients lie on their backs, fold their arms across their chests and then sit up without using their arms at all. When you do this, be careful not to straighten your arms or use them in any way to help you sit up. This is a simple test for “core strength.” Many people have strong arms and legs but weak abdominal muscles (these help support the back). If you can’t easily do this, chances are you have a weak core, and need to do some strengthening exercises (to start you can try pelvic tilts and curl-ups — for further advice about how to do these, ask your doctor, physical therapist or a “trainer”).

If your core is already strong, keep it strong by exercising it — for the rest of your life. Focus on your posture. Slouching is hard on your back, but we all tend to do it during the day. I always ask my patients if they are sitting in supportive chairs with good lumbar supports. Positioning your low back and neck to improve posture and support can relieve a lot of pain.

2. Stand up. Sitting for too long is hard on your back, so spend a good part of your day standing. Better yet, move around. Walk and stretch. Get your muscles contracting and your blood pumping.

3. Sit down. Are you confused? Well, here’s the thing — our bodies are not made to stay in one position — either sitting or standing. So moving around and alternating between sitting and standing is the best thing for your back. The more you move, the better your back feels (and the rest of your body). Of course, some positions or activities will bother sensitive backs, so always do what feels good for your body.

4. Invest in good shoes. By “good shoes,” I mean ones that are supportive and cushion your steps as you walk. The best ones are usually excellent running sneakers. The worst ones — high heels. Keep in mind that healthy, active people should be taking 10,000 steps a day. This means that every year your feet are taking close to 4 million steps. Every step counts and translates forces up your leg to your hip and back. Millions of forces that are just a tad more than they need to be add up to “back pain.” So, invest in good shoes.

5. Throw your “good shoes” out. I know this is counterintuitive, but even when your investment still looks nice on the top, it’s probably not working that well on the bottom (where you need it). The heels and soles of shoes often wear out long before the rest of the shoe does. Which means that your shoes may look good, but don’t feel good to your back. I tell my patients to consider getting a new pair of shoes every six months or so — after 1-2 million steps. Of course this depends on how active you are, how heavy you are, how often you wear a particular pair of shoes, etc. The point here is — don’t judge your shoes by how they look but by how they are cushioning every single step.

6. Relax! Relaxation techniques can help lessen pain by decreasing muscle spasm and focusing on pleasant or peaceful thoughts.

These are all fairly simple strategies which can become regular habits. Once they become part of your regular routine, like brushing and flossing your teeth, you won’t even have to think much about them. Developing routines to care for your back usually leads to less pain and better function. So, brush and floss your back regularly!

Curl-up*

Exercises the central abdominal muscles

Lie on your back on a mat. Put your hands beneath the small of your back and bend both knees to help stabilize your spine. Slowly raise your head and shoulders just a few inches off the floor. Pause. Slowly lower your head and shoulders. Aim for eight to 12 repetitions. Rest and repeat the set.

*If you have osteoporosis, talk to your doctor before trying this exercise. He or she may recommend that you avoid it.

Reprinted with permission from the Harvard Health Publications Special Health Report: Strength and Power Training (2010)

Back strengthening exercises

1. Lie on the floor on your back. Bend your knees and keep your feet flat on the floor. Squeeze your buttocks and pull your abdomen in toward your back. Your lower back should be pressed flat on the floor. Now raise your buttocks about an inch off the floor. Your lower back will lift slightly off the floor while your upper back remains flat. Hold for a few seconds before relaxing. Repeat 10 times.

2. While lying on the floor on your back, with your head and neck supported, grasp your leg just below your knee. Pull your leg gently toward your chest. Hold for 20 seconds. Repeat on other side. Repeat 10 times.

3. Stand with your feet slightly apart and your hands on the top of your buttocks. While looking up, push your hips forward slightly and gently bend backwards. Keep your knees straight. Hold for 10 seconds. Relax. Repeat 10 times.

Reprinted with permission from the Harvard Health Publications Special Health Report: Low Back Pain (2010)

If you brush and floss your teeth and back — every single day — there is no doubt that they’ll be healthier!

Which technique is right for you?

By regularly practicing techniques that elicit the relaxation response, you create a well of calm to dip into as the need arises. As this chart details, these techniques can be especially beneficial under certain circumstances, but may not be suitable under others.

Method

What is it?

Especially beneficial

May not be suitable

Breath focus

Focusing on slow, deep breathing and gently disengaging the mind from distracting thoughts and sensations

If you have an eating disorder or tend to hold in your stomach; may help you focus on your body in healthier ways

If you have health problems that make breathing difficult, such as respiratory ailments, heart failure, or panic attacks

Body scan

Focusing on one part of the body or group of muscles at a time and mentally releasing any physical tension you feel there

For increasing your awareness of the mind-body connection

If you have had a recent surgery that affects body image or other difficulties with body image

Guided imagery

Using pleasing mental images to help you relax and focus

When you want to reinforce a positive vision of yourself or a goal you wish to reach

If you have intrusive thoughts that make imagery difficult; if you have difficulty with visualizations

Mindfulness meditation

Breathing deeply while staying in the moment by deliberately focusing on thoughts and sensations that arise during the meditation session

If racing thoughts make other forms of meditation difficult

If you find it too hard to commit the needed time

Yoga, tai chi, and qi gong

Three ancient arts that combine rhythmic breathing with a series of postures or flowing movements

At times when your mind is racing; whenever you find it especially hard to settle down and focus; if you wish to enhance flexibility and balance

If you are not normally active or have health problems or a painful or disabling condition; if so, speak with your doctor before starting any program of exercise

Repetitive prayer

Using a short prayer or phrase from a prayer to help enhance breath focus

If religion or spirituality is meaningful to you

If you are not religious