Author: Dr. Vasilios Kountis
First off, Happy New Year! Just like the spring, the New Year will often motivate people to bring about a change and a feeling of something new in the year to come. If you’ve been living with chronic back pain in 2015, now is the perfect time to make a few simple changes to try and get 2016 off to a much better start. Remember that life begins when pain ends.
Take a look at these simple modifications we can make and try adding at least one of these to your list of resolutions:
- Walk at least several times weekly.
Regular low impact aerobic exercise is thought to reduce inflammation in your body, strengthen your muscles and provide expedited healing by sending oxygen-rich blood to painful areas.
Some of my patients with chronic low back pain have found that walking as a meaningful, low-impact aerobic activity is the segway to improve their functional abilities. For success with a walking routine, I advise you to:
- Invest in the correct pair of walking shoes. To do this, go to a local running specialty shop. Ask the sales staff to watch you walk and help determine your level of pronation, the angle at which your feet turn in stride. Finding a shoe that matches your stride may help distribute weight across your body evenly, reducing stress on your lower back.
- Build walking into your daily schedule so you can’t easily skip it. For example, walk to the train everyday or walk during your lunch break. With today’s technological advances you can easily monitor how many steps you take per day either through a Smartphone app or one of the many watches that many companies sell on Amazon.
- If walking is difficult due to leg weakness and/or balance, speak to your doctor about getting a cane or walker and walk inside (such as the Staten Island mall) where there are fewer tripping hazards.
- If walking is too harsh on your spine, consider walking on a track or treadmill that affords a more padded, forgiving surface. This will be less painful on your spine. If a treadmill is still too harsh, consider walking in a warm pool where the water will support most of your body weight.
Depending on your level of fitness, you may want to start out walking only a few minutes at a time, and gradually—over a period of several weeks and maybe even months—try to walk for at least 30 minutes at least 3 or 4 times each week.
Studies have shown as many as 66 percent of individuals with chronic back pain are also living with sleep disorders. If you’re struggling with getting to sleep or staying asleep, some of these ideas may help:
- Practice sleep hygiene – a routine or series of habits engaged in before bed each night — to train your brain and body into readiness for sleep. This may include such steps as regulating the time you go to bed and wake up, taking a hot bath before bed every night, blocking out noise with a fan or sound machine, or what the lighting and temperature are in your room each night. Too much stimulation in your bedroom, such as a television, can significantly impair your ability to obtain restful sleep.
- If you haven’t fallen asleep after 30 minutes, get out of bed and do something else. Waiting in bed to fall asleep may boost your stress levels, making achieving sleep even more difficult.
- Consider taking a natural, over-the-counter sleep aid, such as melatonin. Melatonin is generally considered more helpful if you have trouble falling asleep. This makes it an appealing option for jet lag or if you have a changing schedule, such as shift work.
- If melatonin does not help you, consider discussing a prescription sleep aid such as Restoril (temazapam) to help you achieve a restful nights sleep. Typical dosing starts at 15 mg at bedtime or 7.5 mg at bedtime if you are over 65 years of age.
Each person will have their own personal preferences to fall asleep, and there is no right or wrong method for everyone. Discuss taking any new medications, such as those described above, with your doctor before use.
Studies have shown that smokers experience back pain more frequently than non-smokers. Smoking is certainly a risk factor that accelerates the rate of degenerative disc disease in your spine. Remember, we don’t want to accelerate the aging process any faster.
Quitting smoking is highly challenging for most of my patients but is definitely worth the effort—here are a few suggestions may make the process smoother:
- If you associate other habits, such as drinking coffee, with smoking, replace those habits with new ones. For example, if you buy coffee and smoke every morning, buy tea instead.
- Consider using medications to help curb your cravings, such as Chantix or nicotine replacement patches. One advantage for Chantix is that quitting smoking is a progressive, transient process while on this medication.
- As with any habits for the first few weeks of not smoking, I encourage limiting your exposure to friends or family who smoke, in order to resist temptation.
Most importantly, don’t put off quitting. Set a date and stick to it. Quitting smoking is one of the best things you can do for your back.
Sitting less is key to improving back health; one study found that just 66 fewer minutes sitting each day significantly reduces back and neck pain while also improving your mood.
A lengthy commute and a desk job doesn’t have to mean sitting all day. Some of my patients reduce their time spent in a chair with the following methods:
- Use a standing desk at work as opposed to a traditional desk. The discs of your lower spine are compressed up to 3x as much while sitting, so standing at work can relieve pressure on the spine.
- Get up every hour, even if just to get a drink of water. In addition to breaking up the day, this habit will keep blood flow to the muscles in your back more active.
- Give up your seat on the bus or subway to someone else. Standing on public transit may not be ideal, but it can be good for your back after sitting for most of the day.
If at all possible, my last recommendation is to resist the urge to sit down immediately upon arriving home. Using part of your afternoons or evenings to be active is not only a great start to the New Year, but can be very helpful for your back.
- Pronk NP, Katz AS, Lowry M, Payfer JR, “Reducing Occupational Sitting Time and Improving Worker Health: The Take-a-Stand Project,” 2011. Prev Chronic Dis 2012;9:110323