Back Pain

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Back Pain

Advice for Desk Workers, Moms and Others

Women and men suffer from about the same amount of back pain, but while men most often get long-lasting back pain from lifting too much, women often ache from sitting too much.

"The second highest incidence of back pain is reported by sedentary workers, most of whom are women who sit at desks--often in front of computers all day," says Sheila Reid, P.T., coordinator of rehabilitation services at The Spine Institute of New England in Williston, Vermont.

Most commonly, people suffer from lower-back pain, which is generally caused by straining or spraining muscles and tissues that connect bones and cartilage. A sudden action in which you use muscles that are tired or out of condition is particularly likely to cause sudden pain.

Childbearing and child rearing also put a heavy load on women's backs, say women doctors. During the last two trimesters of pregnancy, the fetus literally can shift the center of gravity of your back, increasing the curve of your spine, so that your back may really hurt, says Deborah Caplan, P.T., a teacher of the Alexander Technique for posture and back pain in New York. Afterward, it can get worse.

"Soon after pregnancy and when children are toddlers, women experience back pain from bending and lifting," says Caplan. Women have two-thirds the muscle mass of men who are otherwise the same size as they are, says Rose Hayes, Ph.D., an ergonomist (specializing in the study of technology design and people's needs) for the United States Postal Service. "They need more muscle power to do the same work."

While most women would think carefully before lifting a 50-pound weight in a gym, they think nothing of picking up a toddler and a 10-pound bag of groceries while still carrying a briefcase crammed with books and papers, says Dr. Hayes. And that can cause back-muscle strain.

SUFFER NO MORE

If your doctor has confirmed that what you're experiencing is from muscle spasms or chronic lower-back ache, and not a herniated disk, you'll be relieved to hear that there's plenty you can do.

What Women Doctors Do Yoga Works Judith Lasater, P.T., Ph.D. As a yoga instructor and physical therapist in San Francisco, Judith Lasater, P.T., Ph.D., says that she twists her body into all kinds of unusual positions and always feels fine. Here's what the author of Relax and Renew: Restful Yoga for Stressful Times has to say. "Yoga not only works to stretch and strengthen muscles, but it can also help women be aware of their bodies and emotions. It can help you lessen back pain by making you aware of what brings it on," she says. Other remedies for back pain include hot-water bottles, ice or a heating pad applied to the side of pain; gentle stretching; and sitting with a pillow supporting the small of your back. To prevent back pain at work, move around every half-hour.

Stay calm. Most lower-back pain goes away within a few days or a week, even if you do nothing, says Mary Ann Keenan, M.D., chairman of the Department of Orthopedic Surgery at Albert Einstein Medical Center in Philadelphia. Take a deep breath and calm down as much as you can. It'll help ease the distress, and it may speed your healing.

Take the day off. If your back hurts, you won't feel up to doing much of anything. So don't try. Go to bed and give yourself some much needed respite, says Carol Walker, M.D., an orthopedic surgeon in private practice in Atlanta.

Rest for a day or two, but no more. Too much rest, however, can do more harm than good, say back care experts. "Even if you don't feel A-OK, you need to get active within a day or so," says Dr. Walker. "If you stay in bed for longer than two days, your circulation will slow down, your muscles and joints will stiffen and you'll actually increase your chances of another back injury."

Turn on the heat. To soothe the ache, apply a hot-water bottle or heating pad to the site of the pain, says Reid.

Or ice it. "Sometimes women find that ice is the best way to relieve inflammation," Dr. Walker says. Put an ice pack on the site of the pain for five to ten minutes at a time--say, every hour--for a day or so.

Go OTC. Any over-the-counter pain reliever containing aspirin, ibuprofen, acetaminophen or ketoprofen can ease back pain, says Dr. Walker.

Try gentle stretches. "Gentle stretches can actually help you heal more quickly," says Dr. Walker.

While lying down, try bringing up your knees to your chest, suggests Reid. Then, put a little pressure on your knees. Stretch, then relax. Repeat a few times unless you feel pain. If you do, stop.

Stop smoking. If you smoke, quit. Studies have shown that people who don't smoke are more likely to experience long-lasting relief from back pain, including less persistent problems overall than those who do smoke, says Carol Hartigan, M.D., a physiatrist who specializes in spine rehabilitation at the Boston Back Center of New England Baptist Hospital and the New England Spine Center, also in Boston. What's more, smoking makes the disks in your back age faster and stiffen up, because it keeps oxygen and blood from getting to your back, says Dr. Walker.

FOR PREGNANT OR NURSING WOMEN

Back pain is a common complaint among pregnant women and new mothers. Here's what to do.

What Women Doctors Do Comfortable Clothes = Less Pain Barbara A. Stuart, M.D. After spending long days as medical director of a family planning and sexually transmitted diseases clinic in Bremerton, Washington, Barbara Stuart, M.D., noticed that bending forward all day to examine patients put a strain on her lower back. Here's how she solved the problem. "I bought a slew of loose slacks and comfortable below-the-knee dresses to wear to work," she says. "That way, when I need to examine a patient, I don't have to worry about keeping my knees together, and I can pull my office stool right up to the patient. The closer to my patients that I sit, the less I have to bend forward, lessening the strain on my back." The lesson for women in other professions: Get close to your work--your back will thank you. And wear low heels. Anything higher than 1½ inches is hard on your back.

Ask your obstetrician for an exercise prescription. Exercise is key to supporting your back, says Dr. Walker. "The stronger your muscles, the more likely they'll be able to support the weight of the fetus," Dr. Walker says. Walk, run, swim--any aerobic exercise that you can do as often as is comfortable--can help your back.

Support your back. When you're nursing, put pillows behind your back for comfort and bring your baby to your breast rather than strain your back by bending over your infant, says Caplan. "If you're nursing in a chair, make sure that it's a chair with good back support."

Use a glider. To help your back while nursing, try a gliding or platform rocker with arm support--available from the same store where you bought your baby's crib. "It will take the pressure off your back and let your arms rest while you nurse your baby," says Dr. Hartigan.

Use a footrest. While you're shopping, pick up a small footstool to use at home. Propping up your feet gives them a rest and keeps your back in a comfortable, supported position, says Dr. Hartigan.

BACK CARE AT HOME AND AT WORK

Once you've had an episode of back pain, chances are that it's not an experience that you would care to repeat. Here's what women doctors say that you can and should do to protect your back against future attacks.

Stay close to your loads. Think about it: The closer you stand to whatever you're picking up--be it a child, a bag of groceries or a box of office supplies--the less strain you put on your muscles, says Dr. Hayes. Here's the right technique.

Beginning in a standing position, squat from your knees rather than bending from the waist to pick up the load. Plant your feet firmly in front of you, one foot slightly ahead.

Once you have your arms around it, keep the load as close to your abdomen as possible while lifting and lowering. And use both hands so that you lift symmetrically.

Lift first, turn second. It seems natural: You grab a bag of groceries and turn to load them into the car--or lift an infant up and out of a crib--in one quick movement. Don't do it, says Dr. Hayes. Over time, twisting can lead to herniated disks. Instead, lift your load, hold it close to your abdomen, and then turn, using your feet to get you where you want to go instead of swiveling your hips.

Wear free-flowing clothing. "If you need to lift things, wearing long, full skirts or roomy slacks gives you much more freedom of movement than tights skirts that cram your knees together," says Caplan.

When To See A Doctor If back pain lasts a week or more, or if pain strikes intermittently every day, see a doctor, says Carol Walker, M.D., an orthopedic surgeon in private practice in Atlanta. And see your doctor immediately if you experience pain radiating down your leg, or if your leg feels weak or numb.

Wheel your belongings. Briefcases are heavy. So are big purses slung on shoulder straps. "Dangling from one shoulder, those big loads create an unequal stress on your spine, which can hurt your back," Dr. Hayes says.

Just carry the minimum in a purse, she says. For the rest of your belongings, try switching to a fanny pack or backpack or cart your belongings in a suitcase on wheels, as do many travelers and flight attendants, says Dr. Keenan.

Or buy a luggage cart (a lightweight metal frame with wheels) from a discount store.

Adjust your work station. "A good chair should be fully adjustable and fit the person who sits in it as well as the tasks that she performs," says Annie Pivarski, ergonomics and injury prevention program supervisor at Saint Francis Memorial Hospital in San Francisco.

To get the best back support, your feet should be flat on the floor and your lower back supported by the back of the chair. Your knees should be slightly lower than your hips or level with them, and you shouldn't have to crane to see your computer, says Reid.

Move around. Every half hour, move around to keep your muscles and spine from stiffening, says Reid.

Try a lumbar pillow. Buy one at a medical supply store or just roll up a towel behind your waist for greater lower-back support while you sit at your desk, says Caplan.

Wear low heels. Low-heeled shoes can sometimes help with arch support, but more than 1/2 inches will misalign the curvature of your back, which can lead to back pain, Dr. Walker says. If you must wear heels, save them for special occasions.

(For practical ways to prevent osteoporosis, another possible cause of back pain, see page 407.)