Babying Your Back Can be a Bad Idea

Taking it easy can increase stress on spine, study says

WEDNESDAY, Jan. 2, 2002 (HealthDayNews) -- If you have lower back pain and you baby your back, you could be prolonging the agony and even putting more stress on your spine that could result in still greater misery.

So says Ohio State University engineer William Marras, who conducted a study on back pain published in a recent issue of the journal, Spine.

Marras, who directs Ohio State's Biodynamics Laboratory, compared the lifting activity of 22 adults who were suffering from lower back pain with that of 22 adults who were not in pain. He used an electromyogram to measure which muscles were used and the impact that movement had on the spine. Marras concluded that lifting objects slowly, as people with lower back pain tend to do, increases the length of time the spine has to endure those extra forces; it doesn't make the situation any better.

Moreover, people with lower back pain tend to try to transfer some of the lifting work to muscles that aren't usually involved, the study says. For instance, injured people may employ muscles in their abdomen or sides, even though these muscles aren't necessary for lifting. That creates a twisting force. Marras likens it to a tower held up with guide wires -- the more wires you pull, the more stress you put on the spine.

The study was conducted for the Ohio Department of Workers Compensation. As a result of the study, Marras recommended to officials there that they rethink policies that recommend traditional physical therapy that is designed to strengthen the whole body.

"People with lower back pain have to re-educate their muscles so they use them in a normal fashion and in the natural sequence. Therapies like yoga and Tai Chi look like they might be much more helpful than traditional therapy," Marras says.

Above all, Marras is not enthusiastic about policies that force workers to go back to doing what they were doing before they injured their backs. "It makes no sense to stick them in the job where they were originally hurt," he says. "The injury will just get worse and worse."

Not everybody sees the issue in exactly the same way that Marras does.

Dr. Randy Shelerud, director of the Mayo Clinic Spine Center, says "garden variety back pain" is nearly ubiquitous as we age. He believes the traditional medical model, which focuses on counseling the patient about what's causing the pain, often leads them to believe that their spin is fragile, and if they're not careful, they'll injure it further. "Actually, that's not true," he says. "You might irritate it, but you won't hurt it."

He's adamant that bed rest is bad. "In a week's period of strict bed rest, you can lose as much as 10 percent of your strength and endurance. It affects your cardiovascular, neuromuscular and psychological fitness."

Instead, Shelerud recommends staying physically active and getting back to work in some capacity as quickly as possible. For patients with a physically demanding job, "We consider restricting the amount of lifting and carrying they do or the number of hours they do it."

He also believes in teaching people to use their muscles more effectively, and that mother was usually right when she told you to bend your knees when you lift.

"The smart lifter will keep an object close to the body and bring it straight up with the help of their legs and not their back bone," he says.

Both Marras and Shelerud point to excess weight as a complicating factor in back pain.

Shelerud says excess weight suggests the person's overall fitness level is low and "muscles that support the spine aren't as strong as they need to be to support the spine. Losing weight and strengthening muscles overall can make a big difference," he contends.

What To Do

This Mayo Clinic Web site offers a primer on back pain caused by a herniated disk, and possible actions that may help. It's not a substitute for a doctor, but it can aid sufferers in asking the right questions.

The National Library of Medicine, part of the National Institutes of Health, offers an extensive set of links to information on back pain.

SOURCES: Interviews with William Marras, Ph.D., professor of industrial, welding, and systems engineering at Ohio State University; Randy Shelerud, M.D., director of the Mayo Clinic Spine Center
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