Ninety percent of acute spine pain is not caused by trauma. Most pain starts when doing normal daily activities. When we ask patients what they did to create their pain the most common answer is "I don't know."
This indicates that there is an underlying process to spinal dysfunction that may exist for many years before your pain first occurs. Small micro-traumas occur over many years. When your spine can no longer compensate, you experience sudden pain. You cannot experience severe sudden onset pain in the absence of trauma, without having an underlying undetected cause. You have been unknowingly abusing your spine over some period of time for this scenario to occur.
Here are some of the more common ways that we stress and abuse our spines on a daily basis, as well as practical suggestions for change:
1) Sleep position: Never sleep on your belly. This puts too much pressure on your lower back and neck. Side sleeping is acceptable as long as you keep your neck aligned with your spine and ensure that your pillow is tucked tightly into where your neck and shoulder meet. Using a pillow between your knees will help align your lower back. Do not prop your head up with too many pillows. Another acceptable position is on your back using a cervical pillow to support your neck. If you have GERD or difficulty breathing in this position, we recommend a bed wedge instead of just propping up your head and neck.
2) Mattress: When selecting a mattress, you want it supple enough to contour to your body's curvatures and yet firm enough to support those contours. If in doubt, we recommend getting a firmer mattress. All mattresses soften over time and if you initially purchase one that is too soft, it will always be too soft. If you purchase a mattress that feels too firm you can buy a foam topper to soften it until the mattress breaks in. The infinitely adjustable air mattresses are a great option also. Make certain that you get a return policy just in case you are not satisfied.
3) Sitting: Always sit with your back against the back of your chair. If your chair doesn't have a lumbar support you should purchase one from GRC. Never sit with your legs crossed over your knees because this creates unnecessary torque on your SI joints and lumbar spine. Your feet should be flat on the floor, or on a platform if you have shorter legs. When at the computer your arms must hang at 90 degrees with your elbows close to your body or on an arm rest. You should not be reaching for your keyboard or mouse. It is ESSENTIAL that the middle of your monitor is at eye level. If the monitor is too low it will force you to hunch over. The common exception to the monitor height guideline is if you use bifocals to view the screen. If so, the screen should be lower, compared to eye level, than described above.
4) Wallets: You should not sit with the wallet in your back pocket. It can cause pelvic misalignment as well as pressure on the sciatic nerve.
5) Laptops: Laptop computers are ergonomically challenging. The keyboard is too close to the screen forcing you to hunch over. If you use a laptop regularly you should use an external keyboard and prop up the laptop screen, or use an external monitor and use the laptop keyboard.
6) Lifting and bending: You must lift with your legs, not with your back. This is accomplished by keeping your back as straight as possible and bending your knees and hips. If you have knee problems, bend your knees as far as possible before bending over. Your leg muscles are much stronger than your back muscles. You will also put a tremendous amount of pressure on the spinal discs if you bend forward. While lifting any object, you should keep that object as close to your body as possible.
7) Fitness: Getting and keeping fit will enhance your spinal health and minimize the risk for disabling back pain. At GRC we encourage ongoing fitness. Ask your doctor about a referral to Dr. Kali LaRue, at STAR Physical Therapy, for a home-based core stabilization program.
8) Hydration: Drinking water is essential for keeping your muscles, tendons, ligaments, and joints flexible and mobile.
9) Footwear: Purchase good supportive footwear with adequate arch support that fits properly. Many people have faulty foot posture that will eventually cause back problems. If you have fallen arches you should consider getting orthotics. Ask one of the GRC doctors about your footwear.
Adhering to these recommendations will help you recover faster as well as maintain your spinal health for years to come.