Unless you choose to stop walking erect, the odds are you'll experience low back pain at some point in your life. But there's a lot you can do to reduce how often, how much it hurts, and how long it lasts.
• Maintain a healthy weight. If you are overweight, every additional pound puts more strain on the muscles and ligaments of the lower back. Depending on where it is carried, the extra weight also can stress the spine unevenly, creating an unnatural curvature. A big belly pulls the pelvis forward, which strains the lower back.
• Eat a healthy diet. Make sure you get enough calcium and vitamin D. People with a calcium deficiency are prone to osteoporosis. Those deficient in vitamin D required almost twice the dose of painkillers, according to a 2008 study. We get vitamin D naturally from sunlight, but if you aren't out in the sun much, you need to take a supplement.
• Eat fish. The omega-3 fatty acids reduce inflammation. Eat more fruits, vegetables and whole grains, fewer processed foods. Avoid additives such as monosodium glutamate (in Chinese food) and aspartame (in diet soda). They tend to activate neurons that increase sensitivity to pain.
• Don't smoke. Smokers were 1.26 times more likely to have low back pain than non-smokers, according to a 2010 Finnish study. Smoking accelerates degeneration of spinal disks. Low back and neck arthritis are three times more common in smokers than in non-smokers. Smoking also reduces blood flow to the lower back.
• Don't slouch. Poor posture strains muscles and stresses the spine. "You can increase the pressure on your back by 50 percent simply by leaning over the sink incorrectly to brush your teeth," said Mary Ann Wilmarth, chief of physical therapy at Harvard University. "Keeping the right amount of curvature in the back takes pressure off the nerves and will reduce back pain."
• When standing, keep your weight balanced on your feet. It should be possible to draw a straight line from the earlobe, through the shoulder, hip, knee, and into the middle of the ankle.
• When sitting in an office chair, don't slump forward. Knees should be even with the hips, or slightly higher. Both feet should be flat on the floor.
• Stretch. Yoga and stretching exercises diminished symptoms in people whose low back pain was moderate, a 2011 study at the University of Washington found. Stretching lengthens and strengthens muscles, which makes them more resistant to injury. The deep breathing and relaxation yoga promotes also reduce stress, a risk factor for low back pain.
• Exercise. Low-impact aerobic exercises such as jogging, walking and swimming increase blood flow to tissues and flush out waste. You should also do core strengthening exercises to increase the strength and flexibility of your abdominal and back muscles. When your core muscles are weak, you're more likely to hurt yourself if you make a sudden movement. Stretch before and after working out.
• Relax. Stress is the source of most low back pain, says John Sarno, professor of clinical rehabilitation medicine at New York University. Emotional issues trigger tension in the body and ultimately deprive nerves and muscles of oxygen, he says. We tense our muscles when we're under stress. Tense muscles can trigger low back pain, or make it worse.
• Let go of your grudges. A 2005 study at Duke University indicated people who practiced forgiveness had fewer aches and pains than did those who nursed their grievances.
• When you go to bed, sleep on your side. It keeps your airways open, and sleeping on your side follows the natural curvature of your spine. If you sleep on your back, you can reduce strain on your spine if you put a pillow under your knees, and a small rolled-up towel under the small of your back. If you sleep on your stomach, change. If your mattress is old and soft, get a new one.
• When you lift a heavy object, lift with your legs. Keep your back straight, bend your knees, keep the object close to you. Don't bend over without supporting your back. If you've got something heavy to take out of the trunk of your car, don't reach for it. Pull it to the edge of the trunk before you try to lift it out.
• Don't sit for prolonged periods. Sitting upright in a conventional chair puts stress on the disks in the lumbar spine. The ill effects of sitting can largely be mitigated by standing up, stretching and/or walking around for a minute or so every 30 minutes. When you watch TV at night, stand up and walk around a little during the commercials.
• When you drive, the harm caused by sitting is aggravated, because vibration also is a risk factor for low back pain. There isn't much you can do about your commute, but if you're taking a road trip, stop at least once an hour, stretch and walk around. It'll take a little longer to get to your destination, but you'll enjoy it more once you arrive.
• Wear comfortable, low-heeled shoes. The normal S-curve shape of the back acts as a shock absorber, reducing stress on the vertebrae. Wearing high heels causes lumbar (low-back) spine flattening and a posterior (backward) displacement of the head and thoracic (mid-back) spine. High-heeled shoes cause you to lean forward, and the body's response to that is to decrease the forward curve of your lower back to help keep you in line. This stresses the facet joints that stabilize the spine, compresses nerve roots and accelerates degeneration of spinal disks.
Younger women can wear high heels from time to time with little ill effect. But older women who are overweight, and/or have arthritis should not wear them.
Jack Kelly: firstname.lastname@example.org or 412-263-1476.