Louise Chang, MD
You’ve just helped your friend carry loads of heavy boxes into his new apartment and now your back is hurting. Not only that, but you’ve planned a long car trip for the next few days. All of a sudden, you’re filled with trepidation at the thought of all those hours spent sitting.
No doubt, back pain can cramp your lifestyle, not to mention causing lost days at work or other consequences. Such fall-out often spurs the legions with chronic back problems to learn proper body mechanics to ease pain, prevent flare-ups, and protect the back.
Although poor body mechanics can cause back pain, don’t always assume that they’re to blame, says Scott D. Boden, MD, director of the Emory Spine Center in Atlanta and a spokesman for the American Academy of Orthopaedic Surgeons.
“Certainly, if you are doing a lot of lifting with bad mechanics, you can increase the risk of back injury or a strained muscle,” Boden says. “But I think it’s also important to understand that many back problems and even back injuries occur just with normal mechanics. The assumption that ‘I must have done something wrong’ really isn’t always true. Sometimes, somebody can just bend over to tie their shoe and they could end up with a disk herniation or an inflamed or irritated nerve root.”
However, good body mechanics -- defined as correct ways to move your body and back -- can certainly help. Here are a few pointers on how to lift, sit and stand properly.
Lifting: “You really want to lift with your legs, not with your back,” Boden says. “You want to squat down and pick it up and stand up, as opposed to bending at the waist.”
“Another thing that can be particularly dangerous is lifting and twisting at the same time,” he says.
For example, you might be lifting a box from the floor to a table behind you. “If you’re lifting and turning at the same time to put the box up on the table, there’s something about the combined lifting and twisting that is probably somewhat risky mechanics,” Boden says, “as opposed to bending at the knees, lifting up the box and literally turning your whole body with your feet, rather than twisting your back.”
Be realistic, too, about what you can handle, Boden says. “Know your limits and get help when you’re lifting something that you know is too heavy.”
According to the Nicholas Institute of Sports Medicine and Athletic Trauma (NISMAT) at Lenox Hill Hospital in New York, these are step-by-step instructions for proper lifting:
Sitting and Standing:
Not all back pain patients are alike. Some gain relief from standing, while others feel better sitting, Boden says.
It depends on the cause of the back pain, adds Boden. People with disk cartilage problems tend to have more problems when they’re sitting and actually tend to feel better when they’re standing. The increased pressure in the abdomen, which occurs by virtue of sitting, rather than standing, is why those people get more symptoms while they’re sitting.”
People with disk problems should avoid prolonged sitting, Boden says. When they do sit, using a good lumbar cushion or reclining the seat backward can help take stress off the spine, he says. For example, people who get back pain while driving may want to tilt the seat backward and use lumbar support, then adjust their mirrors for comfort and safety.
For those who have more back pain while standing, the culprit is often a different problem: arthritis in the tiny facet joints on the back of the spine, Boden says. People with this problem tend to lean or hunch forward when they walk, or they lean onto shopping carts. “They’re trying to take pressure off those facet joints,” Boden says. These patients usually feel better when they sit.
Although people can make accommodations for their specific back problem, there are also general rules for proper sitting, standing, and lifting to protect your back, according to NISMAT.
If you must stand for a prolonged period of time, try these tips:
If you find yourself stuck in a chair for extended periods of time, try these tips:
Push, don’t pull
NISMAT also recommends that whenever possible, people should push objects rather than pull. For example, if you need to move a piece of furniture, stand close to it, tighten your stomach muscles, and push with both arms. Don’t lean forward and never push or pull with a bent back.
Boden agrees that it’s better to push than pull. “When you’re pushing, you tend to use more of your stomach muscles than when you’re pulling,” he says. With the latter, “you tend to put more stress on your back.”
SOURCES:Scott D. Boden, MD, director, Emory Spine Center, Atlanta; spokesman, American Academy of Orthopaedic Surgeons.Nicholas Institute of Sports Medicine and Athletic Trauma (NISMAT) at Lenox Hill Hospital in New York: “Physical Therapy Corner: Protecting Your Back.”
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