The Many Ways to Avoid, or Deal with, Back Pain
You stoop to pick up a bag of groceries, but a sudden noise makes you turn your head. And then you feel stabbing pain. It can be a simple gesture like bending, or lifting something heavy that can bring that pain on.
Neck and back problems are common; they fall into the superfamily of musculoskeletal issues. In 2017 low back pain was the number one reason why people lived with a disability.
These days, back and neck problems are even more common. With more people working from home and sitting in unusual or suboptimal positions, back problems are almost inevitable. “Most workplaces got really good at — at the least — providing their employees with a better ergonomic set-up,” explained Karen Erikson, DC, “And literally overnight everyone had to start working out of their living room, their kitchen counter or their dining table, or their sofa.” This was not good for collective back health. “We really started to see a whole new different kind of injury from people not having good setups,” said Dr. Erikson, a chiropractor in private practice in New York.
Neck and shoulder pain isn’t just annoying, they can become chronic issues. People change the way they move to adapt to and avoid pain. There are many treatment options here. Traditionally, someone might see a physical therapist or chiropractor to either work on strengthening the affected body parts or to help fix misalignments, but recently a new approach is being used.
One study from 2020 followed 149 people with back pain. Some of them received motor skills training and others participated in strength and flexibility exercises. People getting motor skills training (MST) were taught to perform day-to-day activities without activating their back pain. Motor skills training can also be about re-learning how to do certain activities. A big distinction between MST and other treatments is that MST focuses on specific activities that could be painful or hard to do, not on movement as a whole.
The researchers found that people who did the MST had better long term outcomes. Both groups had improvements but people getting MST seemed to be able to practice on their own and were more likely to keep using it. Of course, this might not be true for all people, but when patients were retrained on how to do common activities without activating their back pain, their lives seemed to improve.
A 2018 study looking at a 26-year-old with lower back pain found that 12 weeks of MST helped him reduce pain, improve function, and take less ibuprofen. He specifically wanted to work on sleeping, sitting at his desk, and standing to do the dishes.
MST can be performed alongside other interventions, like massage therapy, physical therapy, or chiropractic adjustment. The World Health Organization from 2019 said in a bulletin that international clinical guidelines for managing low back pain are steering away from pharmaceuticals and invasive therapies and instead advocating spinal manipulation, yoga, acupuncture and so on.
Patients might find it better to avoid bad back habits before they start. Now, with so many working from home, people are fighting two issues, poor posture and not enough movement. “So when you sit…your body should be like a chair, the weight should be on two feet and two sitz bones,” said Dr. Erikson, “But a lot of us kind of slump forward, we round our spine so it’s not erect, it causes a lot of stress on the discs … we see an increased incidence of headaches of chronic neck and shoulder pain and stiffness.” Add cellphone-staring to the list of bad habits.
Poor posture and phone gazing are just part of the bigger story: We don’t move very much. People can spend 10 to 12 hours a day in the same position, she said. “We’re just not really not using our bodies to do a wide range of activities.”
Like, ideally, walking an hour a day. “It is so important,” she said, suggesting turning a meeting into a walking meeting to get those steps in.
Avoiding back pain isn’t all about the back, the whole body gets involved, even the stomach. “I tell my patients don’t ask the question, ‘Am I thirsty?’ ask the question, ‘when did I have water last’” said Dr. Erikson. Dehydration can cause more pain and more muscle spasms. Aim for eight glasses a day and the classic eight hours of sleep.
Dr. Erikson recommended a low inflammatory diet high in fruit and vegetables. She knows this might not be easy, “it’s been a challenge because people are going for what tastes good, they’re going for comfort,” she said, but getting a good diet is important to feeling good.
The Cleveland Clinic’ s William Welches, DO, PhD, recommended “eating the rainbow,” in an interview with the Cleveland Clinic. He agreed on the link between inflammatory foods and back pain. Talking to Harvard Health Publishing, Fred Tabung, PhD, MSPH, explained that although the anti-inflammatory diet is not “a quick-fix pill” it does have “ high potential to help manage and even prevent inflammation, which can help soothe chronic pain.”
Generally, experts agree on lots of fruit and veggies, limited sugar, red meat, and dairy, and healthy fats like nuts and seeds.
Along with diet, general full-body exercise can help with pain. Although yoga is not a cure-all, research has shown that it can help with lower back pain. For people who might be intimidated, Dr. Erikson says don’t be, “I think that there is a kind of yoga for every fitness level,” she explained. Part of it is listening to your body.
Her advice: never get into a position that is causing pain. Sore is one thing, pain is another.
So it’s okay to get out of a position sooner than the yoga instructor prefers, and to reduce the number of suggested repetitions. “One day of hard workouts is not worth several days of intense soreness,” she said.
“I always tell my patients, you have to go home in your body so don’t do something that you’re going to feel the next day,”
For those looking to break a sweat, Dr. Erikson likes “the plank” as a good all-purpose core exercise, “It’s so simple, you don’t need a lot of space, but really, really helpful,” she said. The muscles of the core don’t just contribute to a six-pack of abs, they work to stabilize the back. A strong core can actually help fend off back pain.
Telehealth is also an option for back pain. For any type of treatment, MST, physical therapy, or chiropractic care, it won’t be the full experience, but patients can be evaluated and to some extent, treated.
Of course, sometimes back pain is more serious. A numb limb, a radiating pain down an arm or leg, or loss of grip strength are reasons to seek professional help. But in general, seeing someone for back pain is a good idea because an untreated injury can cause damage over time, even if it feels like it went away on its own. Don’t live with pain, she said. “There are real solutions … you just need to take action.”
Medically reviewed by Yvonne Stolworthy, MSN, RN.