"Don't ignore back pain for more than three days."
If you begin to experience back pain, give your back plenty of rest, says neurosurgeon Dr Richard Parkinson. However, if the pain persists beyond a few days, see your GP and if they are satisfied that there are no medical issues, consult a physical therapist.
One exception to this rule is if you have any nerve pain, numbness of weakness down your arms or legs. These are signs of a more urgent problem and you will need to see a spine specialist to avoid nerve injury.
When resting your back, avoid heavy lifting, sitting for long periods of time and sports that require sudden twists like tennis, golf, squash and kayaking. If your back pain is due to arthritis or a disc tear, an effective way to rest your back is to lie down with a couple of pillows under your knees so that your knees and feet are elevated in a tabletop position. Some people find lying down on a hard floor is helpful but you can also try this position on your bed.
"Follow the 30/30 rule for a healthy back."
A healthy back is a mobile one with a wide range of motion, says osteopath Dr Geetha Soosay. Back pain can be triggered or made worse by staying sedentary. Sitting and holding the same position for long periods of time reduces blood flow and causes muscle tension and stiffness. It also forces the discs in your lower spine to bear a greater load than when you’re standing and the weight is distributed more evenly.
So for every 30 minutes of being sedentary, get up and move for 30 seconds. The 30/30 rule is important because intermittent movement stimulates blood flow to your spine and the muscles that support your back, ensuring your spine and surrounding tissue stay strong and healthy.
The more active you are, the less pressure it placed on your lumbar, so give your back a break by standing, stretching and walking around. Set a reminder on your phone for every 30 minutes, or give your body a wiggle after a half-hour television programme.
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"Don't keep your back in a rigid position."
According to physiotherapist Sarah Key, many people make the mistake of over-protecting their back when suffering from back pain. But keeping your back rigid, avoiding bending, or rolling over to get out of bed instead of sitting up will make it worse.
When rehabilitating your back, it’s important to move naturally. Pilates-style curl-downs are a great exercise to strengthen your back and regain the confidence to bend down and move freely. Bend your knees slightly as you slowly roll down, reaching your fingertips to your toes.
Avoid sitting bolt upright as this forces your spinal muscles to work overtime, aggravates the pain and can be just as harmful as slumping. Instead, place a bulky pillow behind your back for support, elongate your spine into a natural “S” bend and keep a hollow in the small of your back.
When you’re pain-free you’ll be able to sit erect with your core and back muscles working in unison to hold you up.
"Smoking and obesity may contribute to back pain."
Unhealthy life choices can turn an episode of acute, short-term back pain into chronic pain. Dr Ralph Stanford, an orthopaedic surgeon, notes that while smoking may not be a direct cause, several studies show it’s associated with higher rates of chronic back pain. Nicotine is toxic to your cartilage cells and may result in some loss of cartilage, which is designed to protect the intervertebral discs in your spine. Smoking also impairs blood flow in the spinal region, making it more vulnerable to injury.
Obesity is another factor linked to chronic back pain. Carrying extra abdominal fat creates a mechanical overload and puts strain on your lower back, and we know obesity is a cause of arthritis of the knees for this same reason. Quitting smoking and losing weight will not necessarily cure the pain, but by adopting these healthy lifestyle behaviours, you can reduce your risk of back pain.
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"Keep mind over matter."
Our backs are very strong and in most cases you can be assured that yours will recover – you just need to give it the right conditions to do so, says clinical scientist Professor Lorimer Moseley. This means building up your confidence to gradually do more of your everyday load. But rather than limiting this to walking around or working, focus on doing the things you enjoy like swimming or playing with your children.
Your body and brain naturally protect your back, so having the confidence to return to your favourite activities will provide the psychological care you need to heal. This can be difficult at first because your back hurts so much, but in most cases there are no scientific grounds for believing that your back is damaged.
If back pain causes you worry or distress, it’s useful to approach the pain like you would an ankle sprain. When you injure your ankle, the aim is to return it to its normal function. With time you increase your use of it and you don’t presume it will be weak forever or that it will now be considered a “bad ankle”.
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