Archives for posts with tag: low back pain

Daily activities can sometimes, literally, be a pain in the back or neck. According to the NIH, Americans spend at least $50 billion each year on low back pain. And while overloading the back can certainly cause pain, how the spine is used is more often the culprit.

We’ve listed a few common activities below and some tips to help you avoid hurting yourself and needing someone like us.

Sweeping, Vacuuming, Mopping

Move your feet. Too often people plant their feet and push & pull with their arms. This can
not only create redance stepspeated twists and torques on the spine, but lends itself to bending forward and twisting too far, especially while reaching. Combining a forward bend and twist can injure a disc or strain a muscle, sometimes resulting in nerve pain and sciatica. So, dance. Put on some music and move your feet. If you keep your shoulders and hips pointing roughly the same direction while staying upright and keeping your feet moving, you are much less likely to end up painful, sore or injured.

Cooking and Washing Up

Hinge at your hips. We all know that cooking and cleaning up is not a static job. There is walking, turning, reaching and bending, even if you’re just going from the fridge to the microwave. So, as above, keep those feet moving. If you have to stand still for more than a few minutes, place one foot on a low stool, or on the bottom shelf of an open cabinet.

And when you need to reach under the counter, bend at your hips and knees, keeping your back straight. And don’t confuse vertical with straight. A proper squat should keep the knees at or behind the toes and have you hinge at your hips, not hunching forward in your back and neck. And proper squatting technique has an awesome side effect; it uses your glutes and will help keep your bottom firm.

squat

 Working on a Laptop or Tablet

Sit up and straighten your neck. People are working from home more often and spending a great deal of time looking at screens these days. Raise them up. If you spend more than 30 minutes a day working on a laptop, consider raising it up and getting a wireless keyboard and mouse to separate the screen from your hands and to allow you to keep your neck upright. If you’re reading this on a tablet (or a ‘gasp’ phone), lift that puppy up! Get your head upright, look down with your eyes and give your neck a break. It has to hold the equivalent of a bowling ball up for over 16 hours a day. At least give it a fighting chance!

Other Stuff, like Straightening Up, Doing Laundry and Making Beds

There’s a theme. We could go down a list of other activities and break them down, but you’re probably already noticing a theme. Keeping your spine straight (not necessarily vertical), avoiding twisting & reaching, moving your feet and changing positions are all going to come up again and again. So whether you are picking up for guests, washing clothes, making beds, adjusting your car seat or writing thank you notes, maintaining good posture and changing your position frequently are good ideas.

You’re planning to use that spine of yours for quite a few more years, so take care of it now. It’s never too late to start. And your older self will thank you for it.

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We were reading through “Diagnostic Testing and Treatment of Low Back Pain in United States Emergency Departments: A National Perspective” on MedScape and were struck by a couple items.

“Diagnostic testing was performed in nearly 1 of every 2 patients with low back pain and opioids were administered to nearly two-thirds of the sample.” http://www.medscape.com/viewarticle/732744_4

Most low back pain can be evaluated clinically and manually without imaging studies. A clinician familiar with back problems is usually able to determine the etiology (root cause) of the back pain, and then decide on an appropriate course of action. For example, in physical therapy graduate programs, neurological testing — sensation, reflexes, strength, etc. — is recommended (required really) when there are symptoms past the gluteal fold into the thigh or leg. If no loss of strength and function is present, then treatment and education may proceed.

Then the question of opioids comes in. While a physical therapist cannot prescribe medication, all treatment interventions are considered in the context of desired results. Pain control is a laudable goal, but healing, resolution, self management education, and return to function might be considered more desirable in the long, and even near, term.

“Savings may be realized if visits can be shifted to primary care settings, where typical charges and propensity for diagnostic testing may be less.”

We’d like to see people offered a solution to their problem, not simply more tests and treatment to mask the symptoms. What do you think?