SO YOUR back hurts. It has been hurting for days and weeks and at times has bothered you a great deal. You have noticed an ache low in your back when ever you sit long hours at your desk or in your car, and when you get up from your desk or get out of your car your back seems stiff. Could it be old age? Is it arthritis? Or do you have some other dread disease?
Let's look at the common causes of low back pain and learn what to do to help prevent it.
Degenerative Disk Disease
Because it is so very prevalent we will first consider degenerative disk dis ease. This is a plague to mankind throughout the world, but more so in highly developed countries.
The spinal column is composed of rigid blocks, the vertebrae, separated by somewhat mobile intervertebral disks. In your mind's eye I would like you to picture a large tree that has been felled and sawed into sections so that the height of each is approximately equal to its diameter. Then we will take these blocks of wood and stack them one on top of the other, placing a good, solid automobile wheel, complete with tire and tube, between the blocks of the tree trunk. The tubes will be inflated properly with air. This will give you a fair idea of the spinal column: the blocks of wood represent the bony sections, or vertebrae, and the wheels, tires, and tubes are like the intervertebral disks. Obviously, if these are then stacked in alternate fashion they will balance nicely and carry weight well.
There is one distinct difference, how ever, between this model and our spinal column, and that is that our spinal column is designed to be mobile. It has a slight curve in the lumbar (waist) area and another slight curve in the cervical (neck) area. Accentuation of these curves can produce disease.
Let's look primarily, now, at the lumbar curve and see how we abuse this area of our back. It is at about the waist line and is increased mostly by two problems:
1. Improper posture, with weak muscles.
2. Obesity.
There are many slender people who have abominable posture and deplorably weakened muscles. What muscles are at fault when the abdomen begins to protrude and the back begins to sway? Many believe that their best back muscles are those adjacent to their spine along the backbone. This is not true. The best back muscles are the abdominal muscles. In our usual sedentary way of life they are seldom used and hence become soft and flabby, allowing the intestines to produce a weight that makes the abdomen protrude even when one is not obese. This protuberant abdomen then shifts the center of gravity for ward and the individual automatically curves his lumbosacral spine into an excessive swayback in order to prevent himself from falling. This causes the upper thoracic (chest) spine to be dis placed backward approximately the same amount that the abdomen is dis placed forward, and increases the sway in the lumbar spine. Then the muscles along the back of the spinal column be come shortened while the abdominal muscles become lengthened. In an obese person this process is markedly aggravated because the center of gravity is not only shifted forward—and frequently severely—but in addition the individual now is carrying much more weight on a leaning tower of blocks. What does this do to the intervertebral disks? It produces so much increased weight along the back side of the disks that the fibers there degenerate, becoming thin, soft, and mushy, and tend to bulge. This then prepares the way for the disks to protrude or herniate.
Unlike the steel wheel, the central portion of an intervertebral disk is a soft material, known as the nucleus pulposus. It is compressible and acts somewhat as a shock absorber. When the tirelike part of the disk becomes thin, the nucleus pulposus can be readily pushed into the thinned-out area of the tire, and this protrusion produces what is called a herniating disk, or a "herniating nucleus pulposus."
The major problem now is that this protruding disk bulges out against nerve roots that are leaving the spinal cord and compresses them. This produces a neuritis, which, in turn, causes pain all along the nerve; in fact, there is frequently severe pain from the low back all the way into the toes. At times this is so intolerable that surgery is necessary to relieve pressure on the nerve root and so remove the cause of pain. Frequently, however, the pain can be relieved by physical therapy measures, proper exercise, and weight reduction, along with proper posture training.
To understand the common causes for degenerative disk disease leads to an understanding of how to prevent it. Maintaining proper posture and strong abdominal muscles can prevent swayback or lumbar lordosis and the tend ency toward degenerative disk disease. But, how can we achieve good posture and strong abdominal muscles? The amount of activity in a sedentary life does not produce strong abdominal muscles or good posture. Something must be done to alter this.
Helpful Exercises
Active exercise every day should produce benefit. What is a good exercise the sedentary individual can use to develop strong abdominal muscles? I believe that the best advice that can be given everyone is to do as much brisk walking as possible.
When you walk briskly, and I do mean briskly, the abdominal muscles alternately contract and relax. Their tone increases, so that their elasticity is improved and the abdominal contents are held in appropriate position. This shifts the center of gravity backward where it should be. The vertebral column assumes a more vertical alignment and the back muscles, which have been shortened, begin to lengthen, allowing the pressure on the intervertebral disks to be more evenly distributed. A conscious effort should be exerted to keep the lumbar spine flat while standing. This can be accomplished either by placing one foot on an elevated stool or chair when in a standing position or by an effort to keep the buttock muscles somewhat tightened. I suggest that you imagine that you are holding a coin be tween your buttocks and do not want it to drop. This conscious effort will help flatten your lumbar spine. In addition, it tightens up the posterior longitudinal ligament, a leatherlike strap extending along the backs of the vertebrae that helps support any prior sagging or bulging of a mildly degenerated disk.
Since most people do sit-ups improperly, I suggest that you do sit-backs. You can do this no matter what your beginning abdominal strength is. Here's how: While you are sitting on the floor with your feet flat on the floor and your knees bent, begin to lean backward as far as you can. As you do this you will notice that your abdominal muscles be gin to tighten. Lean back as far as you can and hold this position while you count slowly to five. You will notice that your abdominal muscles will quiver and fatigue rather quickly if you have not been exercising them. This muscular quivering and fatigue, however, is good for you, and you will gradually develop increased abdominal muscle strength. You should repeat this exercise ten times. That is, sit back as far as you can for five seconds. Resume a normal sitting position and then repeat the process for five seconds. Each time lean back as far as you can, and hold this position for five seconds. In time you will begin to notice that you can lean back farther and farther, and your feet will want to come away from the floor. Place them under a couch or chair to give you some counterweight.
Another good way to strengthen your abdominal muscles while sitting in a chair is as follows:
With your hands on the front edge of your chair and your back straight, lift both knees up toward your chest. All of your weight will then be resting on your straightened arms on the edge of the chair. Your abdominal muscles will be tight and trembling. Hold this position as long as you can and then relax. Do this each time you sit down in your chair and it will gradually develop stronger abdominal muscles and a tighter internal muscular girdle.
Oh, yes, don't forget that the smaller the waistline the less the strain on the low back. And don't forget that God made man upright. Take out the sag and look the part of a man made in the image of God.
