10 expert tips to alleviate, reduce and prevent back pain

The majority of us will experience lower back pain at some point. Working from home and reduced exercise opportunities over the past year have not helped our backs. We can do our best to prevent back pain, but when it does happen, what can we do to manage our pain and prevent it from happening again?

ack pain can be caused by one or a combination of factors including herniated discs, arthritic small joints in the back, poor muscular strength and control, emotional stress, nerve irritation or poor bone health to name a few. Nearly all (98pc) of back pain is not serious and should resolve in six-12 weeks. However, if your pain doesn’t improve you should seek medical attention from your GP or chartered physiotherapist. Here are some ways to help you manage your back pain and reduce its recurrence.

1. Get your walking shoes on

Low impact exercise like walking has multiple health benefits and can reduce the recurrence of lower back pain. You should aim to walk up to 30 minutes at a moderate intensity five days per week. Each person will have a different starting point, but you should aim to build up your time and intensity over a number of weeks. Listen to your body: your protective instinct will kick in and your mind will tell you to stop, rest and protect, but movement is key. No one exercise type is more effective in managing pain, so pick one you enjoy, can afford to maintain and fits within your lifestyle. Walking is free, low risk and a great way to help reduce your back pain.

2. Pace yourself

If you have back pain you must pace your activity levels to avoid flare ups. This means keeping a consistent level of activity and avoiding sudden peaks in your exercise or daily life. Consider breaking up physical tasks into smaller, more manageable chunks. It may take longer but your back will thank you for it. Repetitive movement tasks, such as vacuuming, ironing, painting, mopping and gardening often act as aggravators for people with lower back pain. It is not about avoiding these activities, but rather taking your time to divide these tasks up, pacing your activity levels.

3. Mindful movement

There are lots of great free online resources offering helpful activities like gentle stretching, restorative yoga, and Pilates. Theses allow you to incorporate some guided movement into your weekly routine. Depending on your level of back pain and current physical condition, you should start with a beginner class incorporating an easy, slow approach. You shouldn’t feel any acute pain during or after exercise and if you do, you need to ask yourself if this is the right level of difficulty for you. Often people lack strength and control around their pelvis and lower back. This means you might require a gentle build up to more complex exercises and would benefit from a progressive exercise program, something a chartered physiotherapist can help you with.

4. Musical chairs

Sustained postures, those you hold for a long time like sitting or driving, can encourage stiffness. A stiff spine can become a painful spine. Change your body position every 25-30 minutes at work or at home to avoid the onset of pain and your back becoming stiff. This is particularly important for those who find getting up from sitting difficult and painful. Walk around while you make work calls, put your mobile in another room to make you get up regularly or leave the remote beside the TV so you have to get up to change the channel.

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Stephen O’Rourke works at The Poynton SpineCare Institute

5. Sleep health

Sleep is a vital element of managing back pain, since it gives our bodies time to recharge, recover, and prepare for the next day. Sleep also helps to reduce stress and anxiety, which can be both triggers for pain and impact how we deal with it. You should aim for a regular sleep schedule of about eight hours. Eight is the magic number!

There is no magic sleep posture or mattress, it is all about comfort and quality. Sleep disturbance is common in people with lower back pain. Give yourself the best possible chance to get a good night’s sleep by limiting screen time, winding down from your day, and using relaxation techniques, meditation apps, or audio books.

6. Apply heat

Heat can relax your lower back muscles, particularly if they are in spasm. Heat opens the blood vessels, bringing more rich nutritious blood to the area and helping with healing. Your body can interpret danger when in pain. Heat acts to sooth and reassure your body in turn helping to relieve your pain. You can apply heat by placing a warm (not hot) hot water bottle, wrapped in a cloth to avoid direct contact with your skin, against your lower back for 10-15 minutes.

7. Medication use

Medication for pain management is not a long-term solution for lower back pain as it will not help to speed up recovery or prevent the pain from recurring in the future. However, it may help to improve your sleep or allow you to continue to engage in work or life activities. Pain medication should be used in conjunction with other treatment strategies and as a short-term option only. Exercise is a much safer and cheaper option for long-term back pain management.

8. Fear of movement

People who have back pain often avoid movement or change the way in which they move to accommodate their pain. They can adopt poor movement patterns as a result. Our backs were designed to move, bend, twist and lift and are much stronger than you think. There is growing evidence that the world of manual handling and ‘keeping your back straight’ may not be the best way to move or lift. Likewise, the notion of good or bad posture is also becoming a thing of the past.

Fear and avoidance of movement reinforces your back pain and stiffness, reduces your back’s opportunity to move and strengthen, and can increase the intensity and duration of your back pain. We all move differently, so find a way that works for you. Also, it is safe to slouch and slump. Sometimes adopting what we think is ‘good posture’ all day, reinforces our back pain and spasm.

9. Managing your mind

In most instances, it is perfectly normal to have back pain. As we saw above, many factors influence why you are experiencing back pain. However, the mind is a powerful machine and has a huge influence on how we interpret and cope with pain. Fear of movement, fear of ‘damaging’ your back, and feeling down or stressed can all feed into our pain pathways and increase our experience of pain. So, if you only address the physical factors of your pain, you are doing only half the job. Try to better understand the triggers of your back pain to help you manage it more effectively. Stress, anxiety and tiredness can all trigger and enhance our pain, so make sure you are also managing your mind too.

10. Home office Set up

The pandemic reduced our opportunity for non-formal exercise and forced many of us to work from the kitchen table. It is important that you replace your usual commute to work with lunch time walks or activity throughout the day.

It is also important that you adopt good ergonomic principles for your home work-station set up. Your screen should be at eye level, and you should have a good supportive chair that allows your feet to rest flat on the floor with your hips far back in the chair. Investing in a sit-to-stand desk that can be adjusted to suit your height and give you opportunities to work in a standing position throughout the day might also be a good idea.

Avoid prolonged sitting or working from your laptop on the couch or in bed. Your employer may provide you with an online ergonomic assessment to review your home office set-up or provide more appropriate office furniture.

Stephen O’Rourke is senior spinal and musculoskeletal physiotherapist, The Poynton SpineCare Institute, Dublin