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Best Treatment For Back Pain: Build Your Core Strength

Issue 6.13

As an interventional spine specialist, I am commonly asked the same question from my patients: “How could I have prevented this back pain?”  Degenerative disc disease, facet (low back joints) arthritis, spinal stenosis and sciatic pain are conditions that come with an aging spine.  It is not a question of IF you are going to get one or more of these diseases but WHEN.  Our spines are going to wear out no matter what you do.  But, you can prevent or delay these diseases by taking care of yourself.  You can avoid requiring prescription medications and x-ray guided epidurals by me if you do four things to save your spine:  avoid impactful movements to the spine, lose abdominal weight, maintain good posture during lifting and build good core strength.

Jarring of the spine is common for the “Weekend Warrior”.  Activities such as trying back flips on a snowboard or catching air on your four-wheeler can jar the spine and accelerate degeneration.  Most of my patients don’t engage in such strenuous activities.  However, some activities can be too impactful to the spine and cause degeneration.  The most healthy low impact exercise is swimming.  My patients that are swimmers have the healthiest spines.  Biking causes little impact to the discs and back joints as well.  If you choose to jog, I prefer that you jog on soft surfaces, as jogging is somewhat impactful to your spine.  In other words, I would prefer that you swim rather than jog, but certainly jog as opposed to becoming a couch potato! Pickle ball and tennis can be somewhat impactful to the spine as well, however, if you work your way into these sports slowly, you will have the core strength required to prevent too much impact during your play.

Losing weight is always easier said than done. Because of the mechanics of our body, belly weight adds a tremendous amount of strain and pressure to the joints of the spine.  From our knowledge of physics and biomechanics, we estimate that one pound of fat on the belly equates to ten pounds of torque or pressure on the spine and discs.  That means that losing 5 pounds of belly fat would decrease the strain to your spine by 50 pounds!

Poor posture is much more common than good posture, especially when lifting.  We tend to keep our legs straight and completely bend our backs.  When pulling weeds, picking up your grandchild, or retrieving your birdie shot from the cup, you’re better off bending your legs and lifting with your legs while maintaining a good “lumbar curve”.  Having a good lumbar curve means to curve your lower back IN not OUT like a scared cat.  Or in other words, a scared cat has a bad lumbar curve.

The most important way to prevent spine pain is to have great core strength.  Earlier I mentioned that my swimmers are my patients that seem to have the best core strength, but Pilates, pickle ball and even walking can help you have adequate core strength.  Two great exercises that I recommend are the Bird-Dog and Planks.  Bird-Dogs are done by getting down on all fours (your hands and knees) and then raising a single arm and the opposite leg up in the air.  Planks are done by getting down in a position similar to the push up but going down onto your forearms.  You can then roll over to the left and subsequently the right and hold each position there as well.  The goal is to be able to hold both the Bird-Dog and the Plank position for 90 seconds, but that is not as easy as it sounds.  Do three reps of each of these exercises twice a day and hold each position for 5 seconds to start.  After a week or so you’ll notice that you can go for 10 seconds and slowly work your way up as your core strengthens.

In conclusion, I’m counseling what every doctor counsels: eat right and exercise.  Your parents were also giving good advice when they told you to sit up straight and eat your vegetables.  Both gave you sound advice to prevent spine problems.  Remember to avoid impact, lose weight, practice good posture and build good core strength.  If you do these four things, you may avoid having to see me as a patient.

Dr. Court Empey is a board certified interventional pain and spine specialist and founder of Desert Pain Specialists in St. George, Utah.  (435) 216-7000.

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