Preventing Low Back Pain and Sciatica

You can reduce your risk of developing low back pain and sciatica by reducing the stress on your back. Guidelines for reducing stress on your back include:

• Support your back when lifting, standing, and sitting.
• Practice good posture.
• Lose weight if you are overweight.
• Exercise regularly.
• If you smoke, quit.
• Manage stress.

Support Your Back When Lifting, Standing, and Sitting

Guidelines include:

• Do not lift heavy objects alone.
• Plan ahead and ask for assistance with lifting or moving heavy objects.
• When lifting, squat down next to the object, hold the object close to your chest, maintain a straight back, and use your leg muscles to slowly rise.
• Do not bend or twist your back.
• Avoid sitting for long periods. When you do sit, choose seats with good lumbar support, and use a footstool to raise your knees to hip level. You may be able to use a standing desk at intervals, to help avoid prolonged sitting.
• Avoid standing for long periods. If you need to stand, place a low footstool in front of you and alternate placing each foot on it for a period of time. This will take some of the load off your back.
• Do not drive for long periods. Take a break every hour to stop, get out of the car, and stretch your back.

Practice Good Posture

Poor posture and slouching can put pressure on your lower back. Stand and sit straight, and avoid sitting up in bed. If possible, find an ergonomic specialist to help teach you good posture and body mechanics, as well as help you redesign your workplace to reduce strain on your back.

Lose Weight If You Are Overweight

Maintenance of good weight is important for your overall health. While scientific evidence is inconclusive as to how much obesity contributes to back pain in general, extra pounds can increase pressure on the spinal muscles and disks. Follow the dietary and exercise plan recommended by your doctor. To lose weight you have to consume fewer calories than you expend. To maintain a healthy weight, eat an equal number of calories to those you expend. Even more exercise than minimum recommendations may be required to lose weight (see below).

Exercise Regularly

An aerobic program will improve your physical fitness, strengthen your back muscles, and help you maintain a healthy weight. Choose exercises or activities that you enjoy and will make a regular part of your day. For most people, this could include walking or participating in another aerobic activity for 30 minutes per day. The 2008 USDA Physical Activity Guidelines Advisory Committee Report recommends at minimum two hours and 30 minutes a week of moderate aerobic activity, and strengthening exercises at least two days a week. Exercise also can help you manage stress. Check with your doctor before starting any exercise program.

If You Smoke, Quit

Smoking may contribute to degeneration of the discs in the spine. Also, smokers risk possible re-injury to the back during a coughing attack. Smoking can adversely affect healing if you are having a back surgery. To heal properly, you should quit smoking two weeks before a spine fusion and stay tobacco-free for six months afterwards.

Manage Stress

Stress can increase muscle tension. Take time out to relax, exercise, and practice relaxation techniques. If you need support or assistance in reducing stress, you may want to try some of the following techniques:

• Counseling
• Stress management classes
• Relaxation techniques
• Breathing exercises
• Meditation
• Yoga

References:

Conn's Current Therapy 2001. 53rd edition. W.B. Saunders Company; 2001.

Freedman MK. Saulino MF. Overton EA. Holding MY. Kornbluth ID. Interventions in chronic pain management. 5. Approaches to medication and lifestyle in chronic pain syndromes. Archives of Physical Medicine & Rehabilitation.89(3 Suppl 1):S56-60, 2008 Mar.

Leboeuf-Yde C. Body weight and low back pain. A systematic literature review of 56 journal articles reporting on 65 epidemiologic studies. Spine.25(2):226-37, 2000 Jan 15.

Pain. National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/disorders/chronicpain/detailchronic_pain.htm#Spine . Accessed October 27, 2008.

Textbook of Primary Care Medicine. 3rd edition. Mosby, Inc.; 2001.

2008 Physical Activity Guidelines Advisory Committee Report. USDA website. Available at: http://www.health.gov/paguidelines. Accessed October 26, 2008.