In the 10 years since Teri Henrikson first hurt her back, very little has changed about her doctor’s advice on how to treat it.
Exercise. Every day. For life.
Because when it comes to treating back problems, prevention really does remain the best medicine — and not just because it’s typically free.
Although scientists can clone sheep and decipher man’s genetic blueprints, they have made few significant advances in the field of lumbar medicine.
“The good news is there’s a wide variety of treatment options available. The bad news is nothing appears to work extremely well for many people,” says Daniel Cherkin, a researcher at Washington’s Center for Health Studies, who has investigated the efficacy of spine treatments.
Sure, there are cortisone and acupuncture, physical therapy and surgery.
But back strengthening and stretching programs, “that’s the state of the art right now,” says Dr. Gary Stein, chief of the spine clinic at Santa Teresa Kaiser Permanente.
As a result, nearly two-thirds of primary-care physicians responding to an online survey said they now recommend exercise as a treatment for patients with lower back pain. Exercise beat out heat therapy, rest, physical therapy, over-the-counter oral analgesics and even ice as their option of choice in the Market Measures Interactive poll.
Of course, leg lifts, spinal twists and pelvic tilts probably will never replace all methods of back care. Yet the U.S. public would be much better off if we strengthened our spines as often as we exercised our remote controls, physicians believe.
“We’ve got 26-year-olds with fully herniated disks,” explains Dr. Vijay Vad, an assistant professor of rehabilitation medication at the Hospital for Special Surgery-Cornell University Medical Center in New York.
And the primary culprit, he believes, is our increasingly sedentary lifestyle. Not only do we neglect to stretch our backs on a regular basis but we also keep them confined to chairs most of the day.
“The body was not built to be sitting for prolonged periods of time,” says Vad, who calls Silicon Valley the “dot-com and bad-disk city.”
“Sitting and bending forward toward your computer is probably the worst thing for your disk.”
So office workers should change their mentality, viewing sitting as an athletic endeavor rather than a sedentary one. Just like in running a marathon or entering a swim meet, preparation is key.
Americans need to train to sit down all day.
Henrikson now does. Even though her job as membership director for the Southwest YMCA keeps her on her feet at times, the 30-year-old spends part of her mornings and evenings lying on her back.
She performs exercises to stretch and strengthen her spine and perfect her posture, and on days when she skips the process, she certainly feels it, she says.
“These things help minimize my pain.” Without them, says Henrikson, who herniated her disk at age 20, “I think I’d be on disability and wouldn’t be able to work and lead a healthy life.”
That’s now a reality for many Americans. An estimated four of five adults will experience back pain at some point in their lives, according to the American Academy of Orthopaedic Surgeons. While for many the pain will be acute and will dissipate without requiring treatment, others can face frequent recurrences and chronic pain.
In fact, more than 17 million visits are made to physicians each year because of back problems. Back pain sends more people to their doctors than any other ailment except coughs.
Would adequate exercise eliminate everyone’s woes? No, but it could greatly reduce incidence rates, Vad says.
Several studies of first-time back pain patients have found that those who do not exercise regularly after their injury have a great chance of recurrence.
In one, 80 percent of those who avoided exercise needed additional medical care, compared with 20 percent of exercisers.
It doesn’t matter how old — or young — you are. If you don’t exercise now, your back could regret it later.
“Your classic high-risk disk person is a 36-year-old office worker who works 12 hours at her desk at a computer station, is about 25 to 30 pounds overweight and has a low level of aerobic fitness,” Vad says. “That’s a prime time to bulge a disk.”
Not all exercises are recommended for everyone, however. And those who have already had problems would be well-advised to seek out a specialist before beginning a fitness program.
But generally, as far as exercises go, there are certainly some that are better at preventing pain — or easing it — than others.
“Walking, swimming and biking are three activities I think are very good for your back which are conducive to rehabilitation,” says Dr. Philip Fontanetta, a fellow of the American Academy of Orthopaedic Surgery. “The things that require twisting or turning — golf and tennis — are certainly less conducive to getting over an episode.”
Back-specific strengthening exercises are also recommended for preventive measures, as are stretches that enhance flexibility.
Brad Pluckhan, a Los Gatos, Calif., chiropractor who teaches back-strengthening classes at the Southwest YMCA, believes that 20 minutes of stretches is sufficient. “But I don’t tell people to do it three times a week. I tell them to do it every day,” he says.
And they are relatively few people who wouldn’t benefit from the exercise.
“It’s not just for people who are hurting,” he says. “It’s like changing oil in your car. If you don’t do the little things correctly with your health, unfortunately it catches up with you.”
