Heath & Beauty - Free Fitness Library
Ouch! lower back pain!
You've hurt your back. The pain is excruciating.and you can hardly walk. Yet all your doctor seems to be able to offer you is painkillers and rest! You're beginning to think you'll never be able to exercise again. But don't despair - there are many things you can do to improve your situation.
WHAT ARE YOU DOING WRONG?
Back pain can be triggered by one particular movement, but, according to the National Back Pain Association (NBPA), it is often a result of cumulative damage over a long period of time. Bad posture, low overall fitness and the way we perform our everday activites can all lead to a bad back . You may be familiar with most of the tips given below, but do you actually put them into practice? If you suffer from frequent or chronic back pain, you need to make a concerted and continuous effort to do everything in a 'back friendly' way:
o posture - Do you slump around most of the time, hunching your shoulders and tensing your neck? Try to imagine that you are being lifted up by a string pulling up through the top of your head. Changing bad posture is not easy, so, if you can, get help from an alexander teacher or an osteopath. A back support belt, such as the Astro-back lumbar support, can be helpful, especially for maintaining good posture whilst exercising.Unlike older back belts, which were often too uncomfortable to wear for long periods of time, the Astro-back allows flexibility as well as providing support during all types of activities, including golf, tennis, aerobics, gardening and driving. Call 0161 794 5385 for information on Astro-back.
o sitting - Make sure your chair supports your body properly, whatever your activity. Avoid oversoft or deep chairs and opt for those which support the small of your back. You may need to use a small cushion or rolled-up towel to do this. It may be worth investing in a specially designed back cushion, such as Posture Curve's Lumbar Support Cushions. These were designed by one of Britain's leading orthopaedic physicians to help maintain the spine in almost any type of seating. The cushions are light and compact, so they can be carried around for use in the home, office, car, theatres and planes. Posture Care produces other back care aids, including neck rolls, lumbar rolls, a car seat leveller and a wedge for use in the office. Call 01395 224455 for details.
o sleeping - Sleep in any position you find most comfortable, but, if your mattress is old and sagging, buy a new one. A good, supportive (although this does not necessarily mean hard) mattress is essential if you are to avoid back problems.
o overall fitness - Excess weight adds to the stresses put upon the spine, so if you are carrying any extra pounds, lose them. It is important to keep fit and supple, with regular stretching and strengthening exercises for the spine. Muscles that are weak or lack flexibility are more easily strained. Exercises to strengthen the abdominal muscles are especially important for protecting your back. If you can, see a physiotherapist or osteopath, who will be able to recommend exercises for your specific problem.
The NBPA has a wide range of literature available, covering the right way to sit, stand, sleep, drive, lift and carry. Or consult a good back book with a section on posture, such as Sarah Key's "Back in Action" (Vermilion, £9.99). We have 10 copies of this book to giveaway - send a postcard, marked "Back in Action", with your name and address, to "Get Active".
EXPERT ADVICE
The general consensus among the experts is to keep active. Bed rest used to be the immediate answer to back pain, but Norma Montague from the NBPA stresses that no more than 48 hours should be spent in bed: "The idea is to restore activity as soon as possible. Even if your back is really hurting, try to keep moving a little as long as you can." Lying in bed for long periods can lead to muscle wasting and the formation of scar tissue, which weakens your back even further.
As a 'Get Active ' reader you are probably desperate to 'get back in action', but take it easy. If you have had a back injury, don't rush back to any old sporting activity that may have caused or aggravated your back problem. Osteopath Robin Shepherd, who lectures at the British School of Osteopathy, stresses the importance of building up gradually if you are starting exercise again after an injury: "Don't rush out and do a ten mile run because that's what you used to do before you were injured." He compares the body to a car: " Cars perform better as they are used regularly; they rust up if they are kept in the garage and just used occasionally. The same goes for bodies. For many people sport is a sudden explosive event, such as a weekly game of squash. But really you need to prepare for sport in your daily life, keeping generally fit and supple. It's important to do a small amount of exercise regularly. Always warm up and cool down properly. And before you do the activity, you should stop and think about it - is there any way you can eliminate or reduce the impact of the sport, perhaps by wearing good shock absorbing shoes or changing your technique."
THERAPIES THAT CAN HELP
o hydrotherapy - controlled exercise in warm water, allowing you to strengthen and stretch you muscles in a non-weight-bearing way. Sufferers who have had hydrotherapy are quick to extol its merits, as are the back experts. Vi Morrison had whiplash, lower back damage and sciatica following a car accident. After various examinations, injections and drugs she was still in great pain and she decided to enrol for hydrotherapy classes with the Richmond branch of the NBPA and was delighted with the results: " There were six of us, plus a chartered and experienced physiotherapist to supervise us. I slowly progressed up a slope of personal goals. I could wash and dress myself again. I could pick something off the floor.....My pain has reduced and I no longer take painkillers. I am still exercising and still improving, though I still have further to go. I am convinced that without the hydrotherapy, I would still be in the sorry state I was last year."
Unfortunately hydrotherapy is very hard to get on the NHS, especially on the long-term basis that most sufferers need, as it's so expensive. If you want to try it, join your local branch of the NBPA, who may already be running classes, or can campaign for them, at special prices.
o physiotherapy - aims to restore a person to their normal function, using techniques such as exercise, manipulation, mobilisation, heat and cold therapies and hydrotherapy. Physiotherapists also give advice on posture and how to adapt your lifestyle to minimise pain.
o chiropractic - Uses manipulation to treat disorders of the joints and muscles. Chiropractors use x-rays to help them make their initial diagnosis. Their techniques tend to involve short, sharp thrusts directly on to 'stuck' joints.
o osteopathy - works on the principle that the body usually compensates for a problem, e.g. knee damage can lead to back problems and vice versa. It consists mainly of massage and manipulation of the bones. Unlike chiropractors, osteopaths rarely use x-rays, and their emphasis is more on the soft tissues than the joints.
Many back pain sufferers report very good results from osteopathy. Anne Scott from Surrey saw an osteopath after she fell and fractured her sacrum: "I was in such pain that I had to come home from work at lunchtime and lie on the floor. It took a few sessions for the osteopathy to help, but my back is now very good and I only need to take painkillers occasionally when I do too much. At first I went once a fortnight, but now I go back every 3 months just to loosen things up again."
o acupuncture - a traditional form of Chinese medicine, where illness is seen as an imbalance of energy. It works on the basis that a network of channels - called 'meridians' - runs through the body. When these channels are blocked, pain, illness and depression can result. Practitioners insert very fine needles at specific points across the body, in order to clear the blocked energy and relieve symptoms.
34-year-old Simon Cooper found acupuncture worked wonders for his lower back problem. After injuring his back during weight training, he initially found relief from an epidural injection given by a Harley Street Specialist. Four years later, however, the pain returned: "I started to have discomfort during a cycling holiday in August this year. Then, in October, I was lifting something heavy and my back suddenly went. The pain was excruciating and went all down my leg. By the next morning I could hardly stand and I took a cab to the Acumedic Centre in Camden (0171 388 6704), which a friend had recommended. After 45 minutes of acupuncture with Dr Sun the pain had completely gone and I could get up and walk. Since then I have been going to the clinic about once a week. I still have slight soreness in my back and numbness down my leg, but the terrible pain hasn't returned since that first session, and I can lead a normal life thanks to the acupuncture. I don't do weight training anymore, but I can cycle and swim."
o alexander technique - based on the theory that bad postural habits can have an important effect on our health. It aims to correct these bad habits by re-learning how to stand, sit, breathe, walk etc. Lessons are usually on a one to one basis.
Kim Osborn, 31, decided to have Alexander lessons when back pain interfered with her exercise programme.last year: " I was spending 1½ hours in the gym 4 or 5 times a week, running and weight training, and doing 2 weekly aerobics classes. I also played tennis and golf once or twice a week. I think my back pain was probably due to doing all this exercise, but no stretching. My lower back started hurting in November and I had to stop running, although I still did weights in the gym. In December, I decided to the Alexander Technique to change my posture and help my back. I've been going twice a week since then and my back is much better. I'm now back to my old exercise programme, including running. I still have slight pain in my back, but I'm confident that it will eventually be pain-free."
o shiatsu - a form of Japanese massage that helps to rebalance and release energy. Like acupuncture, it works on pressure points and energy meridians, but instead of needles, the practitioner uses fingers and thumbs.
o reflexology - Like acupuncture and shiatsu, this works on the principle that lines of energy run through the body. Reflex points on the feet are believed to correspond to every part of the body. Practitioners use pressure on these points with their thumbs or fingers in order to release blockages in the energy pathways and encourage healing.
FINDING A THERAPIST
A few GPs will refer patients to an 'alternative therapist' on the NHS, but in most cases you will have to find and pay for treatment yourself. Generally, the only 'hands-on' therapy available on the NHS is physiotherapy. To find a therapist contact its professional body or your local NBPA branch, which will have a list of all the alternative practitioners in your area. You may have to shop around a bit. Different therapies suit different people and if one form of treatment does not help you, it is always worth trying another. If, after a few sessions you feel no improvement, you should discuss it with your therapist. A good practitioner should be willing to say if he feels he is unable to help you, or whether you just need longer.
Unfortunately, many of the therapies can be very expensive, especially if you have to have a long course of treatments. However, low cost treatment is available in some osteopathic schools and some therapists run a sliding-scale of fees.
The NBPA publishes a directory which lists orthodox and complementary therapists specialising in back pain.
EASING THE PAIN
Painkilling drugs can be useful to help sufferers deal with chronic pain, but they can also have side effects and/or be addictive. Alternatives to long-term medication are TENS units, Pain Management Clinics and hypnotherapy:
o TENS units (transcutaneous electrical nerve stimulation) are small battery-operated machines used externally, with two or more small electrodes, to alleviate localised pain. The equipment is available on the NHS, but is often in short supply, so if you know this method of pain control helps you - it may be better to buy or hire your own. To get the best possible pain relief from TENS requires some guidance on the correct positioning of the electrode pads, also on which type of TENS is most suitable for your own particular type of pain. Nidd Valley Medical (see below), who supply TENS machines, also supply a book on how to effectively use them.
o NMES (NeuroMuscular Electrical Stimulation) - This works in a similar way to TENS, but as well as pain relief it exercises your muscles, causing them to gently contract and relax every few seconds. This releases muscle spasm, helps to improve circulation and removal of the waste products which form hard painful lumps in the muscles and between the joints. Nidd Valley Medical are offering two free NMES units, Back Care 2000, (see our Giveaway section, p12-13). Call 01423 799113 for details of Nidd Valley products.
o Pain management clinics - There are currently over 200 pain clinics across the country, run by multi-disciplinary teams of staff, such as doctors, physiotherapists and psychologists. Patients usually attend for about four weeks and are generally referred by their GP or consultant. Treatments on offer vary from clinic to clinic, but include options such as drug therapy, physiotherapy, massage, acupuncture, hypnosis and TENS. To find your nearest clinic, ask your GP, or ring 0800 665544.
o hypnotherapy -this can help patients to deal with pain, by putting them in a state in which they are more easily influenced by positive suggestions made by the therapist or themselves.
BOXES
1.TYPES OF BACKPAIN
Back pain can take many forms, although most problems happen in the lower (lumbar) region, because this area is particularly vulnerable. Some of the more common problems are:
o Back sprains and strains
o disc problems (prolapsed/'slipped' discs or degenerative disease).
o Spondylosis (sometimes referred to as 'wear and tear' or osteoarthritis).
o Referred pain in the leg or arm, eg Sciatica (a sharp pain in the leg, caused by pressure on the nerve )
BACK IN ACTION
THE FOLLOWING STRETCHES AND EXERCISES CAN HELP TO RELIEVE BACK PAIN AND PREVENT FUTURE INJURIES. THIS PROGRAM HELPS STRETCH AND STRENGTHEN THE MUSCLES THAT SUPPORT YOUR LOW BACK.
EXERCISE TIPS:
1. Read through this information and
familiarise yourself with the position of
each figure before carefully performing the
exercises.
2. NEVER BOUNCE OR JERK while exercising.
All movements should be smooth and steady.
3. Discontinue any exercise that causes pain. Resume
exercises only when you can perform them without
discomfort.
4. Do the following routine 1 or 2 times a day, 3 to 7
days a week. For maximum benefit, exercise should
be performed every day.
5. Begin and end each workout with the stretching
exercises. Perform each stretch on a firm, flat
surface and hold for 30 seconds.
6. Start gradually with the strengthening portion of the
program. Perform 5 repetitions of each exercise,
increasing repetitions as you feel comfortable. Slowly
work up to 15 repetitions.
7. For the exercises that are done on both sides of the
body, complete all repetitions on one side and then
exercise on the opposite side.
STRETCHING:
Keep low back flat against the floor and
bring one knee to the chest. Hold for 30 seconds,
then switch legs.
Keep low back flat against the floor and bring both knees
to chest for 1 minute.
With low back flat against the floor, bend knees and slide
the heels to approximately 12 inches from your hips. Keeping
one foot on the floor, slowly extend the opposite leg above your
chest and support the leg with your hands behind the thigh. Hold
for 30 seconds, then switch legs.
On your hands and knees, tuck chin to chest and arch your back.
Slowly bring hips back towards your heels, letting your shoulders
drop towards the floor. Hold for 30 to 60 seconds.
STRENGTHENING:
On your hands and knees, arch entire back. Tuck pelvis forward and
tuck chin to chest while tightening the abdominal muscles. Hold for
2 to
3 seconds and repeat.
Lie on back with knees bent and heels approximately 12 inches from
hips.
Keeping low back flat on the floor, place hands at hips. Slowly curl
upper
body towards pelvis, sliding hands up thighs until hands cup kneecaps.
Hold 2 to 3 seconds, release and repeat.
Lie with your face toward floor. Tighten buttock muscles and slowly
lift
one heel off the floor 6 to 12 inches. Hold 2 to 3 seconds and repeat.
Switch legs after desired number of repetitions.
Lie on back with knees bent and heels approximately 12 inches from
hips.
With tightened buttock muscles, firmly press low back into floor and
tilt hips
toward head. Hold 2 to 3 seconds and repeat.
Lie with your face toward floor and arms extended over your head. Tighten
buttock muscles and slowly lift one leg and opposite arm approximately
6 inches
off the floor. Hold 2 to 3 seconds, slowly release, and switch sides.
Repeat 2
to 4 times.
PROPER LIFTING TECHNIQUE:
* Bend at the hips and knees - NOT AT THE WAIST.
* Begin lifting at the level of the object.
* Bring the object to be lifted close to the centre of your body
rather than lifting in a twisted position.
* Keep back straight. Lift with your legs.
The above is taken from Fit Facts. For more information on this topic
or other
health-related topics, please call or write to: THE NATIONAL EXERCISE
FOR LIFE INSTITUTE, P.O. Box 2000, Excelsior, MN 55331-9967. 1-800-358-3636
BACK FACTS
o 60% of adults suffer back problems annually.
o 30% of adults become chronic sufferers
o 85% of people suffering from back problems will not be given a precise diagnosis by their GP, but will be described as having 'non-specific back pain'.
o Only 1% of back pain investigation results in surgery. It is normally only an option when there is severe leg or arm pain present in addition to the back pain.
CONTACTS
The National Back Pain Association
16 Elmtree Road
Teddington
Middlesex TW11 8ST
Tel: 0181 977 5474
Send a large SAE and a £2 donation for an information pack. The NBPA publishes its own quarterly magazine, Talk Back and has a wide range of literature on back problems available. It can also put you in touch with your local branch of the association. There are 55 branches nationwide, which hold talks by back professionals and can arrange hydrotherapy and special exercise classes with a physiotherapist.
The Chartered Society of Physiotherapy
Tel: 0171 242 1941
Osteopathic Information Service
Tel: 01734 512051
British Chiropractic Association
Tel: 01734 757557
Council for Acupuncture
Tel: 0171 724 5756
The Shiatsu Society
Tel: 01734 730836
British Society of Medical Hypnosis
Tel: 01372 273522
The British Reflexology Association
Tel: 0886 821207
British Complementary Medicine Association
Tel: 0181 964 1205
Credit: Sally Wainwright
SEPARATE BOX:
use trannie and/or tif file from disk
If you sit at a desk working at a computer for extended periods of
time, here is a new product which will help your back as well as relieve
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The programme also gives professional tips on ergonomic office planning, keyboard and screen positioning, furniture, posture and seating.
As a special offer to Get Active Readers we have a limited number of
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Ltd to Get Active Magazine, 41 Overstone Rd, Hammersmith, London W6
0AD, or call 0181 748 7483 with your credit card details.