backcare.pdf

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Back Care

Dr. Pankaj KumarCorporate Asiad Dispensary

BHEL-New Delhi.

You never truly appreciate your back and all it does for you -- until itstarts to hurt. Then every move brings a symphony of agony, until all youwant to do is make your back pain stop.

The bones, muscles, and joints that make up your back are among yourbody's biggest support systems. When any part of that system isweakened or injured, it becomes harder for your back to bear your

weight.

Up to 80% of adults have low back pain at some point in their lives.Instead of resorting to back pain treatment after the damage has alreadybeen done, be a little proactive. Practice a few pain prevention strategiestoday, and you may not be sidelined by back pain tomorrow.

If something you are doing causes your back to hurt, stop and rest orstop altogether. Whether it is a particular exercise, prolonged sitting,bending, or twisting, listen to your body's signals. Pain is a warning.Discuss the activity with your doctor or physical therapist beforeproceeding.

Understand the Neutral Back Position

Posture at work, rest, and play affects the health of your back and neck.

Posture is a result of proper body mechanics which occurs when your

spine goes from the healthy neutral position into action.


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A healthy spine has three natural curves:-

1. The neck, or cervical spine, curves slightly inward

2. The mid back, or thoracic spine, is curved outward

3. The low back, or lumbar spine, curves inward

Picture of the human Vertebral Column & Spinal Cord

These natural curves are the result of the muscles, ligaments, and

tendons that attach to the vertebrae of the spine working together in

harmony. Without these supporting structures, the spine would collapse.

They support the spine just as guide wires support the mast of a ship.

In your spine, the guide wire system is made up mainly of the abdominal

and back muscles. The abdominal muscles provide support by attachingto the ribs, pelvis, and indirectly to the lumbar spine. The muscles of the

back are arranged in layers, with each layer playing an important role in

balancing the spine. By using these muscles together, you can change

the curves of your spine, like when you bend over to pick something up.


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Human Body Muscle Diagram

Human Muscle System

Neutral alignment keeps the muscles, ligaments, and tendons that

attach to your spine working together in harmony. This is important to

help cushion your spine from too much stress and strain. Learning how

to maintain a neutral spine position can help you avoid problems with

your spine, and help you move safely during activities like sitting,

walking, and lifting.

Controlling the tilt of your pelvis is one way to help balance your spine.

As certain muscles of the back and abdomen contract, the pelvis rotates.

As the pelvis rotates forward, the lumbar curve increases. As the pelvis

rotates backward, the curve of the low back straightens. Rotation of thepelvis is like a wheel centered at the hip joint. The muscles of the upper

thighs also attach to the pelvis and contraction of these muscles can be

used to change the curve of the spine.

The abdominal muscles work alone or with the hamstring muscles to

rotate your pelvis backward. This causes the slight inward curve of the


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low back to straighten. If these muscles cause the curve of the low back

to straighten too much, this may produce an unhealthy slouching

posture.

In the other direction, the hip flexor and back extensor muscles rotate

the pelvis forward. This increases the curve of your lower back. If this

curve is increased too much, another unhealthy posture may result.

A balance of strength and flexibility is the key to maintaining the neutral

spine position. This balance ensures the best muscle function. Like a

car, an imbalance may lead to wear and tear, eventually damaging the

various parts of the car.

Muscle imbalances that affect the spine have many causes. One

common cause of muscle imbalance is weak abdominal muscles. As the

abdominal muscles sag, the hip flexors become tight, causing anincrease in the curve of the low back. Another common problem results

from tight hamstrings. As the hamstring muscles become tight, the pelvis

is rotated backwards. This produces an abnormal slouching posture.

Put Safe Posture Into Practice

1. Don't Be a SlouchWhen your mother scolded, "Don't slouch!" she was unwittingly givingyou good medical advice. Holding your spine in an unnatural position orbending the wrong way can strain the muscles and ligaments thatsupport it, leading to back pain. Maintain a healthy back by practicinggood posture. Avoid slumping in your chair, hunching over a desk orwalking with your shoulders hunched. Hold your stomach in, your headstraight, and your shoulders and hips in one line. Keep your kneesslightly bent and your weight balanced evenly on your feet. Stand upstraight! Don't lean forward or backward. Keeping one foot forward of theother, with knees slightly bent, takes the pressure off your low back.

2. Sit Up StraightHealthy sitting posture is based on the neutral spine position. When yousit, raise your chair until you're at a comfortable distance from your deskwithout having to reach or slouch. Flatten your back and buttocksagainst the chair, keeping your knees slightly higher than your hips andyour shoulders back. Choose a chair with good lumbar support, or put a


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rolled-up towel behind the small of your back. Always use a chair with abackrest and place your feet flat on the floor or on a footrest. Changeyour sitting position every few minutes. Every 30 minutes remove thesupport to give you a change of position. Sit in the same good posturewhether you're working at your desk, watching TV, or driving in your car.

If you have to sit for long periods of time, get up every 30 minutes or soto stretch your back. If youve been sitting for a long period of time, dontjust jump up and move. Get up slowly and walk around to give your backa break. The neutral spine position is also important when getting upfrom a chair. Holding your spine safely in neutral, the pelvic wheel turnsforward, placing the "nose over the toes". With the feet placed shoulderwidth apart, stand upright. Use the buttock and thigh muscles to pushyourself up. Do not twist or bend too far over at the waist, or you will puttoo much strain on your lumbar spine.

3. ReachingStand on a stool to reach things that are above your shoulder level.

4. Walking

Proper body mechanics are also important while walking. Try to maintain

the neutral spine position while walking. In the neutral position, your

legs and arms swing naturally during forward motion. Conditions that

alter the normal way of walking, and cause a limp, can severely stress

the spine. While walking, always try to maintain your spine in theneutral position.

5. Moving Heavy ItemsPushing is easier on your back than pulling. Use your arms and legs tostart the push. If you must lift a heavy item, get someone to help you.

6. Take a Load OffNever try to lift anything that you know is too heavy for you. The only

thing you'll accomplish is a sore back. To avoid low back pain later, usethe right form when lifting. Kneel down and get close to the item youwant to pick up. Tighten your abs so they support and protect your back.Then lift with your legs, not your back, and avoid twisting. Two smallobjects (one in either hand) may be easier to handle than one large one.Keep the object close to your body while you're carrying it.


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7. Rest EasyGet rid of your featherbed or waterbed and replace it with a firm

mattress that offers plenty of back support. Avoid sleeping on yourstomach or back, which can cause back pain. Lying on your side instead

takes about 55 pounds of pressure off your back. Prop up your kneeswith a couple of pillows to reduce the pressure even more. Sleeping onyour back puts 55 lbs. of pressure on your back. Putting a couple ofpillows under your knees cuts the pressure in half. Lying on your sidewith a pillow between your knees also reduces the pressure.

8. Strengthen Your Support SystemKeep your back strong and limber by exercising it at least two or three

times a week. Walk, swim (especially back stroke), use exercise bikes anddo other low-impact exercises. Add some abdominal exercises and weight

lifting to strengthen the muscles that support your back. Take 10 to 15minutes to warm up before each exercise to prevent back injuries.Alsotry yoga or tai chi to stretch your muscles and improve your balance soyou're less likely to injure yourself and cause back pain. If you sufferfrom back pain, talk to your doctor before you start exercising, sincesome exercises may not be recommended and can be harmful.


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Images and maps J. Crimando &GWCC, 1998.

These easy exercises can help strengthen the muscles of your back:-

Warm-up Before Activity. Cold muscles and cold joints put any muscle

or joint at risk for injury. Take time to warm-up, and youll reduce the

risk of back pain and injury.

Lie on your back with your knees bent. Slowly lift each knee to your

chest and hold for 5 seconds. Repeat 10 times on each leg.

Lie on your back with both knees bent and your feet flat on the floor.Squeeze your buttocks and slowly raise your hips into the air. Hold for 5

seconds, and then slowly lower your buttocks back to the floor.

If you feel any back pain while exercising, stop what you're doing. Seeyour doctor to talk about back pain treatments that will help you feel and

function better.


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9. Lose WeightExcess weight takes a toll on the whole body and the back is noexception. Try carrying a 25 lb pack on your back and I think youllunderstand how excess weight can affect back pain and back injury. If

you're several pounds heavier than your doctor recommends for yourheight, losing weight is an important part of pain prevention. Combineexercise with a healthy diet to get down to a lighter frame that will beeasier for your back to support. Keep within 10 lbs. of your ideal weightfor a healthier back. . Lose any excess weight. Use our Healthy weightcalculator to find out if you're a healthy weight for your height.

10. Bone UpWhile you're changing the way you eat to lose weight, add in nutrientsthat build bones and prevent fractures. Make sure you're getting enough

calcium, vitamin D, and phosphorous from a supplement and foods likeskim milk, low-fat cheese, and lean chicken.

11. Ditch the StilettosLadies, high heels might make your legs look sleek, but they're murderon your back. Walking around on wobbly heels all day can destabilizeyour posture and leave you in some serious back pain. Leave thetowering heels in your closet and instead wear low (1 inch or less),

comfortable shoes that support and cushion each step.

12. Lighten Your LoadHumans weren't meant to be pack mules. When you leave your house inthe morning, only carry what you need. Take a few books out of yourbackpack and remove all nonessential items from your purse. Carry yourbag on both shoulders to even out the load on your back. Try to carryloads in a rucksack - avoid single sling bags.

13. Stub Out Your SmokesNicotine, in addition to a long list of other health offenses, restricts bloodflow to the discs that cushion your vertebrae and support your spine. Ifyou're not going to do it to clear the air and prevent lung disease, then

stop smoking to prevent back pain.


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Get help if necessary! If the load is too bulky or heavy, do not hesitateto get help or use a hand truck! Do not be too tough or too busy to get

help. Will power does not take the place of a reasonably safe lift.

Tips to Relieve Stress and Tension

Whether you are at work or at home, it is common to feel stress and

tension. Today, people are often called on to do more with fewer

resources. They are faced with more responsibility and more deadlines to

get their tasks done. The health of your neck may be at risk with these

mounting pressures. But scientists have helped us learn that we have a

defense against these mounting pressures the "Three R's" for easing

tension and reducing neck pain at home and work:

Rest taking frequent breaks during the work hour, and choosealternate activities to get your mind ready for a new job task such as

deep breathing, walking, napping, or exercising.

Relaxation take a load off. Lie back. Turn down the lights, and listento your favorite tape or CD. Breath slowly and deeply, allowing your

abdomen to rise and fall rhythmically. Using visual imagery can also

aid in relaxation. Try to visualize each muscle relaxing one after

another.

Recovery repeated and prolonged activities can take their toll if yourbody does not get a chance to recover. Recovery helps repair sore,aching tissues along the way, keeping them healthy.

Here are some additional tips you can use to avoid tension at work and

keep your back and neck healthy:

Be Relaxed try to keep your muscles relaxed. To stay relaxed, lookrelaxed.

Pace Yourself keep an even keel. Avoid sudden changes in yourworkload. Try to avoid last minute "panics" to meet deadlines.

Take a Break take a thirty second "microbreak" every twenty tothirty minutes to do some deep breathing and a few exercises. Take a

few minutes each hour to do some exercises, get a drink, or go bug a

coworker. Use your lunch break to take a nap or a walk.

Change Positions avoid holding your neck, trunk, or limbs still for along time. Plan ways to get the job done using different positions. Sit


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for a bit, then stand for a bit. Or simply readjust your approach to the

task.

Rotate Duties rotating or sharing your tasks can be fun by offeringa new work setting while giving your body a chance to recover.

Avoid Caffeine and Tobacco caffeine (in coffee, tea, soda, andchocolate), and tobacco can increase stress, reduce blood flow, and

increase your awareness of back and neck pain.

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