More than 20 million Americans suffer from back pain caused
by the derangement of an intervertebral disk. After the common cold, back pain
is the second-most common cause that Americans call in sick, costing businesses
as much as $100 billion every year. With the goal of preventing this
all-too-common ailment,
"The back is a complex structure with many delicate parts.
But with some common sense — including proper lifting, good posture and exercise
— it's possible to avoid common back pain," says Dr. Paul C. McCormick, director
of the Spine Center at NewYork-Presbyterian Hospital/Columbia University Medical
Center and professor of neurosurgery at Columbia University College of
Physicians and Surgeons.
Lifting
· Make sure the object
is properly balanced and packed correctly so the weight won't shift when
lifted.
· Before you lift, test the weight of every object by pushing it — a
small size doesn't mean a light weight. And get help, if you need it.
· Take
your time lifting. Rushing will strain your muscles.
· Bend at the hips and
knees, not the lower back. Maintain proper posture with back straight and head
up. Use your legs to lift.
· Never twist. Keep the shoulders in line with the
hips and face the object. Pivot at the hips, not the back.
· Get a good grip
by using handles or gripped gloves. And avoid slippery or uneven surfaces.
·
Keep the weight close to your body.
· Look before you lift to make sure you
know where you're going to place the object.
In the Office
· In good sitting
alignment, the feet are supported, the hips should be level with or slightly
above the knees, the spine is vertical or slightly reclined, and a small arch in
the lower back is maintained.
· If sitting at a computer, the shoulders
are relaxed down away from the ears; the elbows are by the side, bent to about
90 degrees; the wrists are neutral (not bent up, down or away from each other),
and the head is facing front without protruding forward.
Exercising, Stretching and Good
Posture
· Regular cardiovascular exercise will make injury less
likely.
· Do stretching and strengthening exercises to increase back and
abdomen flexibility.
· Maintain good body weight and don't smoke.
·
Maintain good posture, even while sitting. Don't slouch or hold your head too
far forward. Hold in your belly to keep it from putting excess force on the
spine.
· Sleep on a mattress that is firm, not sagging, but not too hard. Do
not sleep on your stomach.
Treatment
The vast majority of
patients with lower-back pain improve spontaneously by avoiding pain-provoking
activities. Back pain is nearly always caused by strain or sprain of muscles,
ligaments or soft tissue. Patients are not encouraged to stay in their bed for
longer than 48 hours — lack of activity can delay recovery.
Indications that a serious injury has occurred include
abnormal bowel or bladder function, bilateral sciatica (pain down both legs),
weight loss, history of cancer, fever, IV drug use, steroid use, an older
patient, fever and severe pain. In these cases, patients are referred for a
diagnostic workup that may include X-ray, MRI and CT scan. When a diagnosis is
made, treatment can include physical therapy, complementary medicine
(acupuncture, magnetic therapy, herbal medications and more), and surgery for
serious conditions like chronic sciatica, spinal stenosis (narrowing of the
spinal canal) and spondylolisthesis (a degenerative arthritic condition that
causes the misalignment of the vertebrae).
"We offer a range of state-of-the-art microsurgical and
minimally invasive surgical options for treatment of spinal conditions. These
techniques have improved the safety and efficiency with which patients with
spinal disorders are treated," says Dr. Roger Härtl, a spine specialist at the