En español | If a stint in the garden, or an overlong plane ride, sends your back into spasms, you're not alone: 80 percent of adults will suffer from back pain at some point in their lives, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases.
Long work hours in one position can make us ache, as can day-to-day stresses that make us unconsciously stiffen. Inactivity can lead to weakness and stiffness.
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Even the simple habit of walking upright — our human birthright — adds to our back problems. "It puts a lot of stress on the body's core, which contains the spine," says Julie Silver, M.D., assistant professor at Harvard Medical School's Department of Physical Medicine and Rehabilitation and author of You Can Heal Yourself. As your spine ages, "you may get arthritis or slight bulges in the disks, or narrowing of the spinal canal, which can put pressure on the nerves."
Treatment options can, of course, include medications and surgery. "If you can get similar outcomes with less invasive and potentially safer interventions, those should be your first choices," says Adam Perlman, M.D., executive director of Duke Integrative Medicine at Duke University in Durham, N.C..
Talk to your doctor about some of these nondrug options for back pain:
- Work with a pro. "Physical therapy can focus on strengthening core muscles" — the major muscles of the stomach and back — "and improving flexibility as well as stabilizing the spine," says Silver. She suggests physical therapy twice weekly for four to eight weeks, plus an individualized home exercise program.
- Get moving. "Do activities — long walks, biking, swimming — where you raise your heart rate and break a sweat at least three times a week," says Norman Marcus, M.D., a pain medicine specialist at New York University School of Medicine and author of End Back Pain Forever: Without Surgery or Drugs. "That helps back pain by blowing off stress and increasing the capacity of muscles to withstand prolonged activity. Without endurance, your muscles fatigue more easily and you're more likely to get injured."
- Stay strong. "As we get older we start to lose muscle," says Marcus. "Weight training helps us preserve muscle, including those that support the spine." If you're unfamiliar with weight training, Marcus recommends working with a physical therapist or exercise trainer who can arrange a personal program for you.
- Find your comfort zone. "The first thing to ask about exercise is what can you tolerate, what makes you feel comfortable?" says Silver. "Swimming and biking are good because they decrease stress on the spine, unlike running or playing tennis." The more uncontrolled the movements — sudden stops and twists in tennis, for example — the more stress on the spine. "But you can't categorically talk about exercising for back pain," says Silver. "Pay attention to what helps and avoid what hurts."
- Stay flexible. Yoga, Pilates and tai chi, a gentle form of martial arts, strengthen core muscles that support the spine and also increase flexibility, says Silver: "Decreased flexibility can throw your back out of alignment, causing pain." According to a 2011 Australian study of tai chi, 18 forty-minute sessions over 10 weeks reduced troubling back symptoms by almost 20 percent and pain by 13 percent. And a 2011 study at the University of Washington found that yoga reduced back pain, although no more than other stretching exercises.
- Practice relaxation. Anything that lessens stress is also likely to tamp down pain, says Perlman. Even something as simple as deep breathing — focusing on the breath coming in and out — can reduce the release of stress-related hormones like cortisol and help you relax. Meditation, progressive muscle relaxation and biofeedback all accomplish much the same thing. According to a small 2009 University of Pittsburgh study, 81 percent of adults 65 and older with back pain who meditated one-half hour a day five days a week for four months felt their pain and daily function had significantly improved.
- Overhaul your posture. Poor posture strains your spine and puts added pressure on the nerves. Ideally, keep a slight inward curve in your lower back and at your neck, and an outward curve in your upper back, says Silver. She suggests asking someone to photograph you at your desk or doing household tasks. Share the photos with a doctor or physical therapist who can address posture problems.
- Opt for massage. Therapeutic massage is relaxing, increases blood flow and may lessen inflammation, says Perlman: "Start with a weekly massage for a month to see if it makes a difference." In a 2006 study by Perlman and his colleagues, massage for knee arthritis lessened pain and benefits lasted at least eight weeks.
- Soften your floors. To reduce stress on your spine, put anti-stress or anti-fatigue mats, typically made of one-half inch layers of vinyl or rubber, wherever you stand for long periods, like in the kitchen or where you dress, suggests Silver. You can find anti-stress mats on the Internet or in big box stores.
- Ice up. "When you have pain that's just started from the muscle, ice is generally more effective than heat," says Marcus. "Leave the ice, wrapped in a light cloth, on the painful spot for three to five minutes. Once it's numb, take the ice off and move." Ice makes the nerves fire less, reducing pain and allowing the painful muscle to move more easily.
- Skip bed rest. "Every day in bed, you lose one to three percent of muscle strength," says Marcus. "That makes you weak and stiff. Maintaining your activity is the best thing for back pain." Skip the back brace as well — or use it only infrequently for an hour at a stretch. It too weakens muscles.
- Flick the cigarettes. "One of the major reasons for back pain is diminished oxygen to the muscle, normally caused by lack of blood flow," Marcus says. Because smoking constricts the blood vessels, it reduces the flow of blood — and oxygen — and increases pain.
- Shift positions. Whether you're lying, sitting or standing, shift positions often, says Silver: "Don't stay one way. Move around and listen to the voice of your body telling you when it's comfortable."
Dorothy Foltz-Gray is a freelance writer who lives in North Carolina.