Make sure it's not Something More Serious
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 rarer than just back pain, there are several issues that will cause back pain, such as disc breakdown, spasms, tense muscles, ruptured discs, 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:
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 its unique surface. The edges are raised, there's a raised half-sphere in the center, which encourages movement, and it stretches your calves when you lean on the edges.
If you haven't read about the experiment that Dan Kois 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 he would be a lot less sore, and he said it made a big difference.
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 to 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.
If you wear orthotics, use them while standing. You can get orthotics from a drug store but as they're not customized for your feet they won't help you as much as custom orthotics. You can get custom orthotics from a podiatrist or some chiropractors, but they'll cost $300 or more. We tested several different orthotics in a few price ranges; you can read our best orthotics for back pain review.
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 wearing them rarely, or not wearing them at all.
While Standing, Keep Moving
You can stretch, squat, do leg lifts in different directions, rest one leg on a chair, or dance, just as long as you're not completely immobile. While standing and being immobile is better than sitting and being immobile, it's still sedentary. Keep in mind that you may need athletic clothing depending on what you are doing.
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 option 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 is to 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 because 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 correct your posture. Since most people tend to slouch, your ritual will include a few steps:
- 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, by 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. 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 to help 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. Most posture and alignment issues are functional problems ー how you control your body ー opposed to structural problems, which relates to 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.
Since you don't need to lift a 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. There are a lot of good exercises to be found on YouTube.
Yoga can also be highly effective for preventing and reducing back pain.
Since I've learned what good posture is, I've noticed that almost everyone has bad posture, except for people who practice yoga (as well as bodybuilders, as they've strengthened their posterior chain and they focus on symmetry in their bodies). Most people are looking down at their phones a hundred times or so per day, hunching over at their desks for hours a day, and they've never learned or been trained to have correct posture. A good yoga instructor will make sure their students are practicing perfect posture and alignment while holding various poses, which will stretch and strengthen the muscles needed to hold yourself in the right position.
Yoga can help fix many common posture issues:
- Shoulders rounded forward: Yoga can open up the chest cavity as many postures will have you bending backward, which counteracts the forward leaning that most people do.
- Head tilted forward: If someone looks at you from the side, your ear is supposed to line up with your shoulder. Yoga training can help create this alignment which reduces muscular tension in the upper back and neck, as those muscles are no longer needed to constantly hold the head up. Your head weighs around 10 lb, so think about your neck and upper back muscles having to hold a 10 lb weight all day.
- Weak posterior chain: People who work out usually focus on the beach and beauty muscles. What many experts in alignment recommend is to focus on the posterior chain, which are the muscles along the back side of your body, including the lower back, glutes, hamstrings, and calves. Yoga is excellent for the posterior chain.
Look for a class in your area that works for you. There are many different styles of yoga. Some will be a hard physical workout, some will have more of a relaxation focus. A group class (or private lessons) can be much more beneficial than doing it at home, as with most classes the instructor is constantly walking around fixing postures. Don't be too intimidated to try something new. You can always read up on what to expect in your first yoga class . If, for whatever reason you can't find a class, follow a yoga DVD or online program. If you are doing it without an instructor, really focus on following the directions and doing the postures correctly.
Another option that looks very similar to yoga, but was designed specifically for your back, is called Foundation. Developed by Dr. Eric Goodman, who is a chiropractor, strength coach, and personal trainer, this program has helped many people get rid of their back pain. 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 after doing these exercises along with all of the other things I did for my back, the pain I'd had for 8 years was gone. I'm a martial arts instructor and it was one of my students who told me about this program that had gotten rid of his back pain. I started doing the program, and then I told one of my students in his late 40s about Foundation. He had recently been in the hospital due to his back pain, and he did the exercises for a few weeks and said his back had 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 originally came from yoga, but were modified specifically for the back). But you need to follow the program to get results. 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.
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.
Posture Corrector - Middle Back Exerciser
This product is for someone who is unable to go to the gym and do rowing, which strengthens the middle back. The Middle Back Exerciser is convenient in that you can take it with you when you travel and use it anywhere.
This is a small device that you stick to your lower back and it vibrates when you start to lose your posture.
Inversion Tables & Inversion Chairs
An inversion table is designed to decompress your spine, increasing space and circulation to the vertebrae. Dr. Alf Nachemson did an extensive amount of research into inversion tables and found that sitting can increase the amount of pressure on your spine up to 250% in comparison with standing. The only thing that brings that number to 0 is inverting at 60 degrees (you don't need to go 180 degrees).
According to Edward R. Laskowski, M.D., people with high blood pressure, heart disease, or glaucoma shouldn't invert as inversion increases blood pressure, and there's more pressure in your eyes when you remain inverted for more than a couple of minutes.
There are many other benefits to inversion in addition to the benefits for your spine, including better circulation to your brain, muscular relaxation, increased circulation, and reduced stress.
The nonprofit Health Research Institute in Seattle conducted a study that was published in the Annals of Internal Medicine. The 400 participants suffering from lower back pain were divided into 3 groups. One group was 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 ー a weekly massage reduced back pain better than using only medications and exercises, and the effects of the 10-week treatment lasted for 6 months.
If you're suffering from 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 as spot #12. A good massage therapist can find the spot where you experience a lot of pain, and that's where you need the most attention.
If the tightness isn't addressed, it can become more serious. According to 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 the 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). One of the best ways to address these areas affordably is with a high-quality foam roller.
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 Chiropractic Association recommends the following:
- Your feet should be flat on the floor, and if they don't reach, use a footrest.
- Don't cross your legs.
- Your ankles should be in front of your knees.
- Keep a small gap between the back of your knees and the front of your seat.
- Your knees should be below, or at the level of your hips.
- 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).
- Relax your shoulders and keep your forearms parallel to the ground.
- 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.
11. Quit Smoking
If you smoke, or know someone who does and also 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 more slowly than nonsmokers, so recovery will be slower.
12. Add More Movement to Your Lifestyle
Humans are designed to move, and there are many simple things you can do to live a movement-based lifestyle.
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 who carry a lot 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 ー 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 it. 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, you're making your hips uneven. When your hips are uneven, you're putting a slight curve on 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 a possible culprit. My mattress was a Tempur-Pedic, and was still in great condition, but my couch was beaten up and the cushions had lost their shape. I noticed that after lying 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 lay on it, and I stopped lying on the couch for extended periods. My mattress was a good mattress, but I found that I needed a softer mattress and a mattress that slept cooler. Combined with all of the other things I did to fix my back, my 8 years of back pain was gone in 6 months and my sleep improved.
If you're apprehensive about spending the money on a new couch and/or mattress, the good news is that you can purchase a new mattress for much cheaper than even a few years ago. Online retailers often charge at least 50% less than what you'll be charged in a brick and mortar store. Check out our review for best mattresses for back pain.
And 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. 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 your 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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Back Pain Prevention Frequently Asked Questions
Here are our answers to the most frequently asked questions about preventing back pain.
What is a common way to prevent back pain at work?
The most common thing we see is desk setups that are not configured ergonomically. This forces the body to slouch. Focus on creating body alignment with proper keyboard and monitor height.
How do you fix minor posture problems that lead to back pain?
If you suffer from minor posture problems, strengthening your posterior chain (such as your hamstrings, glutes, and lower back erector muscles) will correct many people's poor posture.
Can stretching help prevent back pain?
Flexible muscles are less prone to injury, while less flexible muscles and connective tissues restrict joint mobility, increasing the likelihood of sprains and strains.
Can carrying heavy bags cause back pain?
Heavy purses or bags carried on one shoulder can cause tension on one side. The cumulative effect of lifting and holding that weight can over time lead to back issues.
Is bending and twisting potentially dangerous for your back?
Bending, reaching, and twisting at once puts the spine in a vulnerable state. This is especially common during house cleaning and yard work. Be very careful, it's how some people herniate a disc.
- Liebenson, Craig (2007) Rehabilitation of the Spine (second edition). Baltimore, Maryland: Lippincott Williams and Wilkins.