BY RYAN FIORENZI & DR. R.J. BURR, UPDATED FEBRUARY 12TH, 2017

First of all, make sure that your back pain isn’t something more serious. According to the National Institutes of Arthritis and Musculoskeletal and Skin Diseases, although many of these issues are more rare than just back pain, there are several issues that will cause back pain such as disk breakdown, spasms, tense muscles, ruptured disks, scoliosis, spondylolisthesis, arthritis, spinal stenosis, pregnancy, kidney stones, infections, endometriosis, fibromyalgia, tumors and stress.

You should see a doctor if you have:

  • Numbness or tingling
  • Severe pain that does not improve with rest
  • Pain after a fall or an injury
  • Pain plus any of these problems:
    • Trouble urinating
    • Weakness
    • Numbness in your legs
    • Fever
    • Weight loss when not on a diet.

Your back pain may be coming from your lifestyle — here are several changes you can make that may reduce or get rid of your pain.

1. Get an Adjustable Desk, Standing Desk, Treadmill or Exercise Desk

Many users of different types of standing desks find that their back pain is reduced or eliminated.

Gina Trapani wrote an interesting article for lifehacker about her experience standing at her desk for half of her work days. She explains, “My back feels great. My posture is better than ever. My default work position is standing on flat feet, with my shoulders back, and my back slightly arched…I lost 3-5 pounds in the first couple of weeks from standing alone. I’m way more active throughout the day, pacing, dancing, fidgeting. Because I’m used to standing all day at work, standing in line anywhere for long periods of time on weekends doesn’t bother me in the least.”

Just make sure that you’re doing it smart by following these tips:

-Use An Anti-Fatigue Mat

A good anti-fatigue mat will reduce fatigue from standing. We’ve tried several, and our top choice is the Topo from Ergodriven. It’s more expensive than most mats, but it’s unlike any anti-fatigue mat we’ve tested because of it’s unique surface. The edges are raised, and there’s a raised half-sphere in the center, which encourages movement, and it stretches your calves when you lean on the edges.

Check prices on the Topo

If you’ve haven’t read about the experiement that Dan Fois did for New York Magazine, check it out. He stood for 30 days straight, all day, every day! As you can imagine, his calves got very tired and sore. Part of the way into his experiment someone mentioned that if he stretched his calves that he would be a lot less sore, and he said it made a big difference.

top anti fatigue mat for standing desk topo

If the Topo is out of your budget, our runner up choice is the Sky anti-fatigue mat.

top rated anti fatigue mat for standing desks

Check prices on the Sky Anti-Fatigue mat

-Don’t Stand All Day

It’s the process of standing up and standing that prevents all of the issues that can develop from extended periods of sitting. Many experts recommend an 80/20 ratio of standing to sitting, but you have to find what works for you. A good general rule is to switch to standing every 20 minutes, and sit when you feel tired. Or if you prefer sitting to standing, get up and move around every 20 minutes.

What’s referred as “half-kneeling” is an effective option which improves balance and core stability while maintaining proper upper body ergonomics at a seated desk. Simply, kneel on one knee with your other leg in front of you, foot flat and knee bent and 90 degrees. Use a cushion, rolled up towel, or better yet an anti-fatigue mat to keep your kneeling knee comfortable on a hard floor.

-Orthotics

If you wear orthotics, use them while standing. You can get orthotics from a drug store, but they’re not customized for your feet, and won’t help you as much as custom orthotics. You can get custom orthotics from a podiatrist or some chiropractors, but they’ll cost $275 or more. We found a company that will make custom orthotics for you for around $100. They send you a mold that you step into, you send the mold back to them, and you’ll receive your orthotics in the mail a few weeks later.

Check prices on custom orthotics from Archcrafters

-Take Your High Heels Off

Most chiropractors and massage therapists will tell you that high heels are terrible for your back and your feet, so don’t wear them while standing at your desk. Many experts recommend wear them rarely or to not wear them at all.

-While Standing, Keep Moving

You can stretch, squat, do leg lifts in different directions, rest one leg on a chair, dance, as long as you’re not immobile. Standing and being immobile is better than sitting and being immobile, but it’s still sedentary.

-Stand Barefoot

Simple standing barefoot with a relaxed, splayed foot is a simple strategy that can be very helpful for most people (as long as you don’t have fallen arches and require arch support).

2. Stop Leaning Forward to See Your Screen

If your computer screen is lower than eye level, you’ll have a tendency to tip your head forward, which will lead to neck and upper back tension. If your screen is too low, you can prop it on books or a box to raise it up (if your setup doesn’t look good, put some kind of cover over the box or books). Just make sure that it’s stable.

Also make sure that you can see your screen well. If your screen is too far away, you’ll have a tendency to crane your neck forward. If your screen size is too small, you can adjust it a few ways. One way is to go into your settings on your browser. If you use Chrome for example, go to the main menu and adjust the zoom so that your screen is big enough to see it without losing your alignment. Another is to go into the display settings on your computer and adjust them so everything on the screen is larger.

3. Keep Your Elbows Close to Your Body When You Type

This is one of the reasons why laptops cause issues for some people. If your elbows are close to your body when you’re using your laptop, then your screen is in your lap, so you’re looking down at your screen (bad for your neck and upper back). If you get your screen higher up, then you have to reach for your keyboard (which can strain your shoulders and upper back). The solution — connect a keyboard to your laptop using a usb cable or wireless connection. This way you can keep your keyboard close, which will greatly reduce the strain on your upper back, and you’re not creating issues by looking down at your screen.

4. Focus on Alignment

This can be a minor or major project, depending on your situation. Some doctors, chiropractors, or experienced strength coaches may be able to assess your body to see where your issues are and give you recommendations on what you need to do to get back into alignment.

One thing that you can do that can make a significant difference over time is to make correcting your posture a ritual that you do several times throughout the day. Since most people tend to slouch, your ritual will include a few parts:

  • Stick your chest out.
  • Roll your shoulders up towards your ears, then backwards behind your ears, then down.
  • Tuck your chin back toward your neck and imagine growing your spine long, up toward the ceiling.

If you have a pose from yoga that you like, or if you have a recommendation from a professional, use that posture. But the only way you can train your body and your nervous system is lots of repetition, doing this several times per day for months or longer. You can develop the habit of doing this right when you wake up in the morning, when you get out of your car on your way into work, when you get to your desk, when you walk away from your desk, etc.

You can also involve your friends or loved ones to help. Ask them to remind you every time they see you slouching. Just be prepared to hear about it a lot!

5. Visit a Chiropractor

A good chiropractor will perform a thorough history and movement assessment of your body then suggest appropriate treatments and strategies helping you achieve and maintain proper alignment and control of your body in everyday life. X-rays may or may not be necessary depending upon your case as most posture and alignment issues are functional problems — how you control your body — opposed to structural — what your bones look like in an image like an x-ray. If your chiropractor is only taking images and manually “putting you back into alignment,” we suggest you find a chiropractor utilizing a functional approach. Chiropractic adjustments are a helpful treatment when applied to the appropriate case.

6. Strengthen Your Posterior Chain

If you suffer from minor posture problems, strengthening your posterior chain (your hamstrings, glutes, lower back erector muscles, latissimus dorsi, trapezius, and rhomboids) will correct many people’s poor posture. The advice that many of us heard when we were young to sit up or stand up straight isn’t enough. You need to strengthen your muscles to keep your body in postural balance.

And you don’t need to lift large amount of weight to accomplish your goal, using resistance bands two to three times per week can do the trick. Just remember to keep your form while exercising. At the point that you start losing your form, take a break until your next set, or reduce the amount of resistance you’re using. There are a lot of exercises you can find on youtube.

Check prices on resistance bands

Yoga can also be effective in strengthening and stretching your muscles. Look for a class in your area that works for you, or you can follow a yoga dvd.

Check prices on yoga dvds

Another option that looks very similar to yoga, but was designed specifically for your back, is called Foundation. Developed by a Dr. Eric Goodman, who is a chiropractor, strength coach, and personal trainer, many people have gotten rid of their back pain with this program. Following just the basic exercises from the Foundation book got rid of my back pain for 6 months. I later bought the Foundation dvds, and doing these exercises along with all of the other things I did for my back, my pain that I had for 8 years was gone. I’m a martial arts instructor and it was one of my students that told me that this program got rid of his back pain. I started doing the program, and I told one of my students in his late 40s about Foundation. He was recently in the hospital due to his back pain. He did the exercises for a few weeks and said his back never felt so good! He went on to win a national Brazilian Jiu-Jitsu tournament soon after.

Foundation is an amazing program, and the exercises look similar to yoga postures (I think that most of them came from yoga, but were modified specifically for the back). But you have to do the program. If you make it a habit of doing them a few times per week, or find some way to work it into your schedule (such as doing a routine every morning when you wake up), then you will benefit.

Check prices on the Foundation book
Check prices on the Foundation dvd set

7. Posture Devices & Trainers

Using these devices may not fix your posture by themselves, but they can help retrain your mind and nervous system to keep your chest out, your shoulders back, your back straight, and your head pulled back over your torso.

a. Posture Corrector – Middle Back Exerciser Stand Up Str8

This product is for someone who is unable to go to the gym and do rows, which will strengthen your middle back. The Middle Back Exerciser is convenient in that you can take it with you when you travel, and you can use it anywhere.

posture corrector

Check prices on Stand Up Str8

b. Back-Up by Nada Chair, or Dr. Toso’s Back RX

This is a strap that wraps around your lower back and connects around your knees, which creates a frame that keeps your back straight.

Nada chair posture device

Check prices on Back-Up by Nada Chair
Check prices on Dr. Toso’s Back RX

c. UpRight

This a small device that you stick to your lower back and vibrates when you start to lose your posture.

UpRight posture device

Check prices on UpRight

d. LUMO

This device is similar to UpRight in that it vibrates when you slouch.

lumo

LUMO

Check prices on Lumo

e. True Back

This a non powered traction device that you lay on where your spine floats in a channel. The thirty suspension points  support your body weight and create pressure to the muscles which are located each side of the spine which enables the muscles to relax, increasing blood flow. While lying on it your back is passively stretched in opposite directions while being supported in the correct position.

true back posture corrector

Check prices on True Back

f. Inversion Tables & Inversion Chairs

An inversion table is designed to decompress your spine, increasing space and circulation to the vertebrae. According to Edward R. Laskowski, M.D., you have to be careful with inversion tables as your heartbeat slows and your blood pressure increases when you remain inverted for more than a couple of minutes — and the pressure within your eyeballs jumps dramatically. For these reasons, you should not try inversion therapy if you have high blood pressure, heart disease or glaucoma. And some people find that it causes too much stress on their ankles and knees.

You also have to be careful because some people find them difficult return back to a non-inverted position. One technique to get upright )that requires a little bit of calf and hamstring strength) is to pull your body towards your feet as you swing forward. But the safest and smartest way is to never use an inversion table alone.

Dr. Robert Rose, a chiropractor with over 30 years of experience, says that when you invert completely upside down, your pelvis tends to tilt. He recommends not inverting 180 degrees — 45 degrees is enough to decompress your spine. He also recommends inverting for a short period of time, then returning to the neutral position, then inverting again.

If you’d like to see if inversion could help you, talk to your doctor to make sure it’s safe. If you get the ok, start inverting very gradually. Dr. Christina Lasich MD recommends no more than 15 degrees for a few minutes, and gradually inverting further. She also recommends using an inversion chair, as opposed to a table, shown below.

top rated inversion chair

Dr. Lasich says that inversion chairs put less pressure on your ankles and knees, you can use it by yourself, and it’s better for blood pressure equalizing. And her main reason for using the inversion chair vs. an inversion table is that the chair provides better support and control for the lumbar spine and pelvis.

Check prices on top rated inversion chairs

8. Massage

The nonprofit Group Health Research Institute in Seattle conducted a study that was published in the Annals of Internal Medicine. The 400 participants suffered from lower back pain were divided into 3 groups. One group were given a relaxation massage once per week, another got a structural massage, which is aimed at releasing tension in specific tissues and joints. The last group took painkillers, and reduced the amount of activity they were doing.  The results — a weekly massage reduced back pain better than using only medications and exercises, and the effects of the 10-week treatment lasted for six months.

If you’re suffering with lower back pain, you may find that the problem isn’t actually in your lower back, it’s in your glutes. According to an article written by Paul Ingraham on painscience.com, the spot to massage is on the top edge of the gluteus maximus muscle where it slices across the top of the buttocks on a diagonal line, from the low back dimple to the bump of bone on the side of the hip (greater trochanter). It’s referred to spot #12. A good massage therapist can find the spot where you experience a lot of pain-that’s where you need the most attention.

If the tightness isn’t addressed, it can become more serious. According Ingraham, researchers in Taiwan in 2006 scanned patients with high levels of tightness in this area (referred to as “contracture”) with an MRI machine.

The MRIs showed that contracture causes your gluteus maximus to form a tough, fibrous, ropy band of muscle, while the rest of the muscle atrophies. Also, the tightness of the muscle pulls the IT band backwards (which can be an important factor in a common runner’s knee problem, iliotibial band syndrome).

9. Stretching

According to Harvard Health Publications, back pain can be caused or made worse by weak back and abdominal muscles. A stretching and strengthening regimen should focus on the back, abdominals, and glutes (butt). Strong abdominals, extensors (which run along your back), and iliopsoas muscles (which run from the lower spine to the hips), help keep good posture and support your back. The muscles of the upper legs also need to be strong and flexible because when they are weak or tight, it puts a strain on the supporting muscles of the back.

Flexible muscles are less prone to injury, while less flexible muscles and connective tissues restrict joint mobility, which increases the likelihood of sprains and strains. Stretch regularly but gently, as bouncing can cause injury.

10. Make Sure You Have Proper Support in Every Place You Sit

If you sit at work, your chair should encourage you to have good posture. The American Chiropractor Association recommends the following:

  1. Your feet should be flat on the floor, and if they don’t reach, use a footrest.
  2. Don’t cross your legs.
  3. Your ankles should be in front of your knees.
  4. Keep a small gap between the back of your knees and the front of your seat.
  5. Your knees should be below or at the level of your hips.
  6. If you have a backrest on your chair, adjust it so your lower and mid-back are supported. If not, create support (such as a rolled up towel).
  7. Relax your shoulders and keep your forearms parallel to the ground.
  8. Don’t sit in the same position for long periods of time.

If any of the chairs you use don’t have good support, you can put a small pillow or rolled up towel just above your hips between you and your chair, giving your spine a slight curve.

When driving, make sure your lower back is supported. If it’s not, you can buy a McKenzie Lumbar Roll or even a rolled up towel. It might take a little bit of searching to find something that puts your spine in a good position.

Check prices on the McKenzie lumbar roll

11. Quit Smoking

If you smoke, or know someone who does and has back pain, here’s another reason to quit. According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, smokers may be preventing nutrition getting to the discs in their back. They also can strain their back due to more coughing, and smokers heal slower than nonsmokers, so recovery will be slower.

12. Add More Movement to Your Lifestyle

Humans are designed to move, and there are many things you can do to live a movement-based lifestyle. For a thorough list, click here… 

13. Don’t Carry Heavy Bags and Purses On One Shoulder

Heavy purses, gym bags, or anything else that you carry on one shoulder can cause tension on one side. This is especially true for kids and teenagers that carry lots of books around school. The cumulative effect of lifting and holding that weight on one side for several years can lead to back issues.

Go through your purse or bag and look at what you’re carrying around — you probably don’t need everything in there.

If you need everything and your bag or purse is heavy, look at different ways of carrying them. You can use a bag with two shoulder straps that distributes the weight evenly, or a suitcase with wheels.

14. Don’t Bend, Reach, and Twist at the Same Time

Ann Brinkley, a holistic chiropractor in San Francisco explains “Bending, reaching, and twisting all at once is the worst thing you can do.” This is especially common during house cleaning and yard work. Be very careful, it’s how some people herniate a disc.

15. Put Your Wallet In Your Front Pocket

If you carry a wallet, even if it’s small, and you have it in your back pocket, your making your hips uneven. When your hips are uneven, you’re putting a slight curve in your spine. When your bones are out of alignment, your muscles will overcompensate by trying to do the job of your bone structure. So a muscle or group of muscles will tense up to try to keep yourself in balance. It may seem like a small thing, but over time it can create problems. I also prefer my wallet in my front pocket as it would be harder for someone to steal.

16. How Old Is Your Bed and Your Couch?

Some people have suffered from back pain for years not knowing that their bed or their couch was causing their pain. If you have an old or cheap mattress or couch, you may be putting your spine in a cramped and unhealthy position for 8 hours per night.

When I was trying to figure out what was causing my back pain, I had to look at everything that I was doing as possible culprits. My mattress was a Tempur-Pedic, and was still in great condition, but my couch was beat up-the cushions had lost their shape. I noticed that after laying on the couch for a while, my back didn’t feel great. I replaced my old couch with one that kept my spine straighter when I laid on it, and I stopped laying on the couch for extended periods. Combined with all of the other things I did to fix my back, my 8 years of back pain was gone in 6 months.

If you’re apprehensive to spend the money on a new couch and/or mattress, think about what your quality of life is worth. For me as a martial arts instructor, my back pain severely restricted my ability to teach, and the pain was depressing. And I was spending a lot of money on massages and chiropractors. Since I healed my back, I spend about half on massages and chiropractic visits, and I won’t be a candidate for back surgery in the future.

17. Don’t Sleep On Your Stomach

Some people can get away with it, but if you suffer from back or neck pain, don’t sleep on your stomach. It puts your spine and neck in a cramped position. This I learned from experience, long before I started researching how to get rid of back pain. Any time that I would sleep on my stomach, I would wake up in pain, and it would take me 2 hours of moving and stretching for the pain to go away.

To train yourself not to sleep on your stomach, place a pillow right next to your stomach, which will block you from turning over onto your stomach.

If you insist on sleeping on your stomach, put a pillow under your stomach so you’re spine is under less stress. And don’t use a pillow, it lifts your head and puts a lot of pressure on your neck.

The best sleep positions are on your side with a small pillow between your knees, or flat on your back with a small pillow under your knees.

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REFERENCES

    • http://www.niams.nih.gov/Health_Info/Back_Pain/back_pain_ff.asp
    • http://annals.org/article.aspx?articleid=747008
    • https://www.painscience.com/articles/spot-12-gluteus-maximus.php
    • http://www.health.harvard.edu/healthbeat/stretching-and-strengthening-are-key-to-healing-and-preventing-back-pain
    • http://www.acatoday.org/content_css.cfm?CID=3124
    • http://www.niams.nih.gov/Health_Info/Back_Pain/back_pain_ff.asp
    • http://chiromt.biomedcentral.com/articles/10.1186/s12998-015-0078-3
    • Liebenson, Craig (2007) Rehabilitation of the Spine (second edition). Baltimore, Maryland: Lippincott Williams and Wilkins.
About the Author

Dr. RJ Burr

RJ received his Doctor of Chiropractic Degree from the National University of Health Sciences (NUHS) and has accrued more than 700 hours of post-graduate work with an emphasis on manual therapy, rehabilitation, biomechanics, nutrition and movement restoration. He’s earned certifications in Active Release Techniques (ART) and Titleist Performance Institute (TPI) medical track, and can sit for the American Chiropractic Rehab Board Diplomate (DACRB) and Certification in Mechanical Diagnosis & Therapy (McKenzie).

RJ’s owns and operates Reach Rehab + Chiropractic Performance Center out of Plymouth, Mi.

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