Make your back comfortable

Dear Spine-Health Member,

When you're suffering from chronic back pain or neck pain, your daily routine can get very complex—doctor appointments, insurance paperwork, time off work, treatment regimens to follow, etc. While these are obviously very important in managing your pain and recovery process, it will also help to remember the simple things you can do (or stop doing) on a daily basis to help your condition.

While some of these points may seem obvious, we believe that they bear repeating because good posture and body mechanics (the way you perform your activities all day everyday) can substantially improve the way your back and neck feel at the end of your day.

Support your spine while sitting at your desk

Sitting for prolonged periods of time can be a major cause of back pain. Sitting is a static posture, which can add a tremendous amount of pressure to the back muscles and spinal discs. Additionally, sitting in a slouched-over or slouched-down position can overstretch the spinal ligaments and increase the pressure on your spinal discs.

Sitting with your back relatively straight and with good support is essential to minimize the load (strain) on your back. Especially when you sit for prolonged periods of time, you need to provide your lower back with support for the inward curve of the lumbar spine (lordosis). See Reducing back pain while sitting in office chairs. [1]

Here are a few tips for good posture and support for your lower spine while sitting at a desk:

• Make sure your office chair is set up so your knees are bent at about a 90-degree angle. Two fingers should slip easily between the bottom of your thigh and the chair.
• The backrest of your chair should push your lower back forward slightly. If you can, get a new office chair that provides this support, or place a small pillow, rolled up towel or orthopedic support on your chair to accomplish this.
• Place some support under your feet to elevate them slightly (this takes some of the load off of your lower spine). Sitting with your knees slightly higher than your hips eliminates much of the pressure on your lumbar spine.
• Sit as close to your desk as possible.
• Your buttocks should be pressed against the back of the chair, and your back should be straight.
• Don't slouch or slump in your office chair—this puts extra pressure on your spine and stress on the lumbar discs. Use the back of the chair to provide support for your back.
• Your computer screen or reading materials should be at eye level.
• It's a good idea to have arm rests on your office chair that place your elbows at a 90-degree angle.

Some people prefer more active office chairs, such as a Swedish kneeling chair or a Swiss exercise ball, rather than a chair that provides complete support. Purchasing a good ergonomic office chair that provides optimal back support may also be helpful. For more tips, see Choosing the right ergonomic office chair [2].

If you are on the phone a lot, consider investing in a headset to take the strain off your neck, or try using the speakerphone. Avoid cradling the phone on your shoulder.

Support your spine while driving

Driving for long periods of time, or during a stressful daily commute, can be especially tough on your back. Here are some tips to help you feel more comfortable while driving:

• If your car seat doesn't provide much back support, try rolling up a small towel, pillow or commercial back support and placing it between your lower back and the seat for additional support.
• Sit with your knees slightly higher than your hips, and sit as close to the steering wheel as you can and still feel safe. Reaching increases the pressure on the lumbar spine and can stress your neck, shoulder and wrists.
• Be sure you're not sitting on anything that would throw your spine out of alignment (such as a wallet in your back pocket).
• Sit up straight and keep your chin pulled in (avoid keeping your chin and head thrust forward).

If you are in a great deal of pain, try to avoid driving. If possible, have someone else drive, and lie down in the back seat with your knees slightly bent. You may want to place a blanket or pillow under your knees to support them, as well as a small pillow under your head.

Move about throughout the day

The healthy body can only tolerate staying in one position for relatively short periods of time. You may have already noticed this when sitting on an airplane, at your desk or at a movie theater becomes uncomfortable after just a short time. Even if you are sitting with correct posture, holding the same position slowly takes the elasticity out of the tissues, and stress builds up and causes discomfort. See Good posture helps reduce back pain [3].

The best way to keep your joints, ligaments, muscles and tendons loose is to move about and stretch on a regular basis throughout the day. Here are a few easy ideas for moving around during the day:

• Stand up while talking on the phone. Be sure to stand with one foot slightly in front of the other, or place one foot on something a few inches off the ground (like a chair railing) - avoid standing straight with your knees locked.
• When possible, take the stairs instead of the elevator, park your car further away from work, or walk a few extra blocks to pick up lunch or for a coffee break.
• Stretch your hamstrings twice each day. To help you remember to do this on a regular basis, link the stretching to a part of your daily routine, such as when you brush your teeth in the morning and evening, or when you first get to work and before you head home. Flexible hamstrings will significantly reduce the stress on your lower back.
• When you return to your seat after moving around, use an alternate posture for just a few moments and some of the tissue elasticity needed to protect your joints will return.

Good posture and back support is also important at night. For more information, please see Choosing the best mattress for low back pain [4] and Mattress guidelines for sleep comfort [5].

Paying attention to your posture and movement throughout the day and while sleeping at night will really help you as you manage your pain and maintain good spine health. Please take care to check yourself on a regular basis during the day to make sure you are using good posture and providing adequate support for your spine.

Best regards,
Peter F. Ullrich, Jr., M.D., Medical Director
Stephanie Burke, President
Spine-health.com

About the Spine-health.com Newsletter: Each issue of the Spine-health.com newsletter, SpineNews Update, is written by the founders of Spine-health.com - Peter F. Ullrich, Jr., M.D., Medical Director for Spine-health.com and Stephanie Burke, President of Spine-health.com. The content in the newsletters is not peer reviewed by Spine-health.com’s Medical Advisory Board. The articles to which the Spine-health.com newsletters link have been peer reviewed by members of the Medical Advisory Board.