Here are some top tips for preventing and managing back pain - including back pain when driving, at work, posture, inversion therapy, and kinesiology taping for the lower back.
On this page:
- Preventing back pain through posture
- Preventing back pain when driving
- Preventing back pain at work
- Kinesiology taping for back pain
- Inversion therapy
Back Pain & Posture
For many people back pain is directly related to poor posture, in both standing and sitting. The majority of people will have at least one, usually more, postural abnormalities. After all, if you go back a few evolutionary steps, we walked on all fours! Evolving to walk on two legs has placed a large amount of stress on our spines.
How does poor posture contribute to back pain?
- Poor posture places additional strain on the muscles, ligaments and discs of the back.
- Over time this additional strain can lead to structural changes to the discs, muscles and ligaments surrounding the spine.
- These structural changes are usually what causes mild to moderate back pain.
- Pain most often comes from strain to muscles and as a result of muscle imbalances.
- Poor posture is sometimes due to inherent factors. A leg length discrepancy can mean one hip is higher than the other. This can cause lower back pain due to some muscles having to work harder to compensate. This can be corrected by wearing a heel wedge.
- Biomechanical factors such as overpronation of the feet can also cause back pain. Over-pronation causes the shin to roll inwards, followed by the thigh, which in turn alters the position of the pelvis.
What are muscle imbalances?
All muscles have an optimum length and tension. When your posture is good the muscles surrounding and supporting your back are at this optimum length. When your posture is poor some muscles will be shortened and tight, others (usually the antagonist) will be lengthened and weak. For example, those who spend all day hunched over a desk often develop shortened, tight chest muscles, and weak lengthened back muscles.
Similarly in those with a lumbar lordosis (excessive curvature of the lower back) The hip flexors (rectus femoris, iliopsoas) and lower back become tight and short, and the glutes (bum muscles) and abdominals become loose and weak.
What is good posture?
A good back posture does not involve a perfectly straight spine. The spine has natural curves which help it to transmit forces and so the key to good posture is maintaining what is known as a “neutral spine”. The following is a list of the key points for a neutral spine in standing, from head to toe:
- The head should be held up straight, with the chin tucked in. Earlobes are level so you know you are not tilting the head to the side.
- Lift the sternum (breast bone). Imagine a piece of string attached to the sternum, pulling it towards the ceiling. As you do this you should notice your shoulders move back and down.
- Maintain a slight hollow at the lower back as this is a natural curve of the spine.
- Hips should be level.
- The neutral spine should be maintained when standing and sitting.
In addition, when standing:
- Knees should be straight and feet at shoulder width, toes pointing straight forwards.
- When standing sideways on, it should be possible to draw a line straight through the centre of your feet, knees, hips, shoulders, and earlobes.
- Keep both feet flat on the floor.
- Make sure your chair has good lumbar (lower back) support or use an additional lumbar support.
- Ensure the object to be lifted is close to you so that you are more stable.
- Have your feet at shoulder width to provide a solid base of support.
- Activate your core muscles to help stabilise the spine.
- Keeping the back straight throughout, use the legs to push yourself up.
How can I improve my posture?
Posture can be improved by following a rehabilitation program which should include:
- Core strength exercises
- Stretching tight muscle groups
- Strengthening weak muscle groups
- Altering your working position (If you work mostly at a desk)
- Correcting any biomechanical abnormalities
Here are some simple exercises you can do at your desk to help improve your posture:
- Sit comfortably in your chair, with both feet on the ground. Relax your shoulders and look straight ahead. Pull your chin in towards your head and hold for 10 seconds initially, increasing to 30 seconds. Repeat 3 times.
- Again, sitting in your chair, rest your hands on your thighs. Slowly squeeze your shoulder blades together. Hold for 10 seconds, increasing to 30 seconds. Repeat 3 times.
- Whilst sitting at your desk practice activating your core muscles.
Back pain and driving
If you suffer back pain either during or after driving long distances, then you might ask yourself the following questions: Why does driving cause low back pain? What is the best driving position? What can help ease low back pain when driving? How do I know if my seat is positioned correctly?
Driving is a frequent aggravator of lower back pain and can even be the initial cause of pain. Read on to find out how to support your back whilst driving.
Why does driving cause lower back pain?
- When driving for prolonged periods the lumbar curve is all but lost, placing extra strain on the vertebrae and discs.
- The spine is subjected to considerable vibration and jolting.
- Modern cars have a lower roofline and so reduced internal space. To allow this the seat is often lowered and tipped back which causes the legs to be straighter, placing a strain on the hamstrings, in turn pulling on their pelvic attachments and resulting in the pelvis rolling backward.
- Strain is also placed on the cervical spine (neck) due to the seat being tipped back and the driver having to flex the neck by up to 20 degrees in order to look straight ahead.
What is the best driving position?
- Ensure as much of your thighs are supported by the seat as possible.
- Don't sit too far away from the pedals as this may put additional strain on the upper back and neck.
- Adjust the steering wheel so that you can reach it with bent arms with hands in the 10 to 2 position.
- If you have a lumbar support adjust it so it presses gently on the lower back at belt height.
What can help ease low back pain when driving?
- Lumbar support is important. If your car seat does not supply enough lumbar support then an in-car lumbar support can be purchased.
- Automatic cars place less strain on the back as constant clutch use in a manual places pressure on the lumbar discs.
- If you only find you get back pain on longer journeys, don't try to complete the journey in one go.
- Stop regularly, get out of the car and move around.
- After long periods of driving your back is weaker and more susceptible to injury, so resist the temptation to bend and stretch.
Why am I getting shoulder and neck pain?
- This is usually due to tensing your neck and shoulders and gripping the wheel too tightly.
- Try to relax when you're driving.
- Make sure you are close enough to the wheel so that your elbows are slightly bent.
- In some cars, the steering wheel can be slightly offset from the centre of the seat. This means the driver has to hold the steering wheel at an angle to the body, placing more stress on the neck and shoulders.
How do I know if my seat is positioned correctly?
Here are two simple tests you can carry out yourself to see if your seat is in the correct position:
- Put the palms of your hands together, with the elbows bent and the wrists touching the chest. This position will point your fingers out towards the steering wheel at a right angle to your spine and will allow you to see if the wheel is offset. If your fingers are not pointing to the centre of the wheel then the wheel is more than likely offset.
- Place both hands on the steering wheel and look down between your arms, at your legs. You should see equal amounts of each leg. Often the right leg will be partially obscured by the right arm, suggesting the shoulder girdle is rotated to the left in relation to the pelvis.
Preventing Back Pain At Work
If you sit at a desk for work for long periods and suffer from back pain, the cause of the back pain might be the way you are sitting or the way your desk is set up. The first line of treatment for this type of back pain is to carry out an ergonomic assessment. This can either be done by a health and safety officer at your work or by yourself.
Ergonomics is the process of optimising human well-being and performance. This involves assessing and improving safety, comfort, productivity, and ease of use of equipment.
In the workplace, ergonomics usually relate to the employee's workstation, where a high number of cases is a desk and computer.
Ergonomists assess a workstation for suitability to the employee and the job, and make changes to the desk, chair, computer, and other equipment position, to make the set-up more user-friendly. They may also introduce new pieces of equipment, such as wrist supports and footrests.
How Should My Desk be Set-up?
In order to set-up your desk, chair, and computer correctly, and avoid developing poor posture and injuries, follow these simple steps:
Ensure you have a good chair with lumbar support, head and armrests. Adjust the height of your chair so that when sitting at your desk the following are true:
1. Your thighs are supported by the chair when your feet are flat on the floor and there is a right angle at the knee
2. When you place your fingers on the middle row of keys, your forearms rest on the desk.
3. There is no bend at the wrist (i.e. a straight line from your wrist, across to your hand and fingers).
4. Your elbows are supported by the armrests when your forearms are rested on the table. Some chairs have adjustable armrests which you can move to the right height for you. Those without adjustable armrests can be raised by wrapping foam around the rest until it is the right height and tape it in place.
5. You may require a footrest under your feet if your desk is too high to have your forearms supported on the desk and feet flat.
Adjust the back support so that when you sit upright the lower back is supported fully. If the curvature of the chair does not match your back you may require an additional lumbar support Ensure there is at least a 2" (5cm) space between the back of the knee and where the chair seat stops.
- Now that your chair is correctly positioned, adjust the height of your computer monitor. The top of the monitor should be at eye level, meaning you keep your head straight and look down slightly with your eyes. Monitor height can be adjusted using boxes, books etc.
- Check that the monitor is directly in front of you.
- Move the chair close to the desk until you are in a position where the elbows (when the forearms are resting on the desk) are directly under the shoulders.
- From this position, the screen should be 22-26" (55-65cm) away from you. If not, position it at this distance. If you had it closer than this you may need an eye examination.
- Your desk should be kept clutter-free to allow for all of your equipment to be positioned correctly.
- If when your chair is positioned correctly your desk is too low or high, consider purchasing a new desk. This may seem like drastic and expensive action but it may save you hefty treatment bills later down the road!
Mouse and other equipment
- The other equipment on your desk should also be positioned to provide maximum comfort and practicality:
1. Position your mouse as close to you as you can whilst maintaining the elbow beneath the shoulder, the elbow supported on the armrest and the wrist on the desk.
2. When using your mouse, move the arm whilst keeping the forearm rested on the desk. Don't use the wrist to move the mouse as this can lead to RSI.
3. Position your phone and any other equipment which is not permanently in use to the left-hand side, within arms reach.
Kinesiology Taping for Low Back
A simple Kinesiology taping technique (play video) demonstrated by Sports Physiotherapist Neal Reynolds, which can help relieve low back pain. This kinesiology taping technique for the back is designed to deactivate the muscles in the low back helping to relax them.
Inversion therapy involves hanging upside down to apply gentle traction to the spine. We explain the benefits of Inversion Therapy and how it can help with back pain.
Inversion was invented as early as 400 B.C. when Hippocrates (the father of medicine) first watched a patient hoisted upside down on a ladder for a dose of 'spinal traction'. Not only can Inversion Therapy help to treat back pain but it can be used to reverse the negative effects of aging on the spine.
Effects of Inversion Therapy
Discs separate vertebrae, allow movement and provide shock absorption. Dangerous exercises or constant pounding from running can cause the discs to be compressed. The centre of the disc contains a jelly type liquid which can protrude out and put pressure on the nerves (known as a slipped or herniated disc). Inverted, your body weight applies mild traction to the spine which becomes slightly longer.
This increases the space between the vertebrae and reduces the pressure on the discs. Every nerve in the body leaves the spine through the spaces between the vertebrae. Increasing the space between the vertebrae reduces the pressure on the nerve roots and discs, which means less back pain.
By oscillating up and down on an inversion table a pumping action is created for fluids around the spinal discs forcing waste out and drawing in fluid around the discs. Inversion helps to relax muscles which increases blood flow through the muscles which in turn maintains the muscles in better condition and less likely to cause painful spasms.`
The cardiovascular system consists of the heart and blood vessels. The heart pumps blood around the body. Inverting can help the heart to supply blood more easily to the brain.
The lymphatic system also circulates fluid around the body, mainly to remove waste products from the muscles and other tissues. Unlike the cardiovascular system the lymphatic system has no pump. It relies on muscles squeezing fluid through the lymph vessels around the system. Inversion may assist the passage of lymph fluid up the body and so aid recovery from training by fast removal of waste products.
How often can/should an athlete Invert?
This really depends on why they are inverting. If it is to aid a back problem then initially two to three times a day is advisable. As the problem improves then frequency will be reduced. It is a good idea to include it as part of a general training regime and invert a couple of times a week at least.
What are the possible dangers of Inversion Therapy?
Although this activity is safe we recommend seeking professional medical advice, for example, from your doctor before using inversion therapy equipment. The following are contraindications for inversion therapy (should not be done): pregnancy, hernia, glaucoma, retinal detachment, conjunctivitis, high blood pressure, recent stroke, heart or circulatory disorders, spinal injury, cerebal sclerosis, swollen joints, osteoporosis, unhealed fractures, surgically implanted supports, use of anticoagulants, ear infection, and obesity.