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Caring for your Back

Most research tells us that 80% of us will experience lower back pain at some stage in our life.  This may be caused by a single incident such as falling from a horse or a motor vehicle accident.

However most commonly pain is the result of repetitive stresses on the spine that overload the discs, muscles or ligaments or joints.  These "lifestyle factors" may include one's occupational demands, the way we sit or stand, the amount of bending or stooping or lifting we do, recreational pursuits, and even the way we sleep.

So what can we do to keep our spine healthy and prevent ending up on the physio table?

Warm Up
Before getting into the gardening or doing manual work, it pays to warm up with a brisk walk or a hot shower plus some stretches for the lower back and leg muscles.  This gets the muscles ready to work and reduces the risk of strain.  

Keep Fit
Control your weight with a good diet and stay fit with regular exercise such as walking or swimming.  At least 30 minutes, 3 or more days per week of moderate intensity exercise is a great guide that has been shown to help nearly all systems of the body.

Maintain Good Posture
Always try to sit well, with the bottom fully back in the seat.  Aim to preserve the natural hollow in the lower back, using a small cushion if necessary, and keep the spine straight.  Prolonged slouching can overstretch and weaken the tissues of the lower back, making injury more likely with subsequent lifting or twisting, so try to get up and move around every 20 minutes.  Morning back stiffness can also be improved in a lot of cases by improving sitting habits or by performing a few stretches in the evening (which is a lot cheaper than a new mattress!).

Reverse Your Curve
If you have been sitting or bending for a while, take frequent breaks to arch your spine back the other way.  Similarly if standing for prolonged periods, or sleeping on the stomach, which places the spine into a sustained arch, stretch back the other way, say by bending the knees up towards the chest or by squatting down.   If twisting on a tractor, regularly twist back the other way when you can.  And always beware of difficulty straightening up from bending, as well as pain that spreads further from the spine with repeated bending - these are very common symptoms of a lumbar disc bulge.  

There are endless exercises that can "undo" the stresses of repeated or sustained activities.  Physiotherapists are experts in diagnosing and treating back pain, but for an excellent self-help guide, seek out "Treat Your Own Back" by New Zealander Robin McKenzie.

Lift Correctly
Keep the back straight by bending at the hips and knees.  Keep loads close to the body, and stabilise with your abdominals by gently tightening the pelvic floor muscles and drawing your navel in towards the spine.  Avoid twisting or fast, jerky movements, or lifting in awkward positions.   Remember "A Long Spine in a Strong Spine" - try to maintain a lengthened spine while lifting or carrying.  This simple cue helps engage your core muscles and keeps the spine in an optimum position to withstand compressive loads. 

Finally, if you are injured;  Stay Active
Try not to rest in bed too long.  German studies of strict bed rest used to simulate the effects of weightlessness on astronauts demonstrate very rapid loss of strength in the anti-gravity muscles that support our spine and keep us upright.  Excessive bed rest can also make us stiffer and so it can hurt more when we do get moving again.

Keep Warm
Whilst an ice pack can help ease the pain and inflammation of an acute injury, applying a heat pack after the first day can help to reduce associated muscle spasm that tends to seize us up.

Seek Help
See your doctor or physio if you develop constant pain including night pain, leg pain (especially below the knee), numbness or tingling or weakness in the leg(s), if you are also unwell or have a fever, or if pain persists for more than a few days despite rest from painful activities and simple painkillers. 

Peter Biskup
APA Titled Musculoskeletal Physiotherapist

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