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Nutrition, Fitness and Lifestyle Choices for Back Pain

By Patrick Roth, M.D. ; Updated August 14, 2017

Listing lifestyle choices that may result in improved back pain may be misleading. The Internet is full of “commonsense” choices to improve back pain, but none are actually evidence-based medicine. More valuable are philosophical tenets to provide an overview.

Take Ownership of the Treatment for Your Pain

Perhaps the biggest mistake that back pain sufferers make is to look for someone else to get rid of the pain. A better strategy is to live with the pain as best you can. Try to return to the activities of daily living. Most of the time the pain will get better without any treatment. If the pain is too severe to follow this advice, then seek medical help, but only with the idea that whomever you choose for help has the responsibility to teach you how to help yourself.

Don’t Let Pain Be Your Guide

The common, well-intentioned and practical-appearing tenet “let pain be your guide” when attempting to restore function is misguided and can paradoxically cause pain! In fact, this innocent assertion has often resulted in back pain because it is used to justify passivity. A more appropriate tenet would be “tolerate the pain and methodically regain function.”

Don’t Blame Your Job for Your Back Pain

Until the middle of the 20th century, there was virtually no long-term disability from back pain. The past 60 years have seen a steady increase in time spent out of work despite a simultaneous reduction in the number of jobs that truly require “heavy” labor. In other words, the easier our jobs have become physically, the more likely we are to have periods that we cannot work due to back pain.

Most people would assume that the “wear and tear” of our job leads to the “wear and tear” that is seen in our disc spaces so clearly revealed with the MRI image. This assumption is, as you might now surmise, wrong. In fact, the wear-and-tear changes in our discs are largely genetically determined. Furthermore, the wear and tear at work may be a positive influence rather than a negative one. Finally, pain in the back has little correlation with the appearance of the laborer’s discs. It is more highly correlated to his job satisfaction and attitude.

Strengthen Your Back

The last thing anyone with back pain wants to do is exercise the muscles of the back. Most people have a deep conviction that such behavior will result in more pain. In most cases, back strengthening, along with strengthening the rest of the core, will result in fewer episodes of back pain and episodes that are less intense and of less duration. The back strengthening does not have to wait until the pain has fully subsided. It can usually safely be started when there is still some pain.

Learn How to Bend

If you ask anyone that routinely does squats or deadlifts how to bend, they will show you how to keep your back straight when you bend. Learning how to “hip hinge” as opposed to “back bend” when you are bending, getting out of a chair or picking something off of the floor will protect your back. This is easier with a strong back and will take some practice.

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