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Exercises and advice for back pain sufferers

Question: I am 58 and have recently been having trouble with lower-back pain, particularly when I sit or lie on my back for a long time. Any suggestions on how I can relieve the problem? Do corsets help?

Answer: The first thing to do is see your doctor in an effort to determine the reason for your lower-back pain. However, diagnosis is often difficult. More than 100 causes have been identified for back pain, including muscle strain or injury, osteoarthritis, herniated disc, spine misalignment, osteoporosis and kidney infection.

Still, most back pain sufferers need not be pessimistic about their condition. Typically, episodes last only a week or two, and 80 to 90 percent of more persistent back pain resolves itself within six weeks. With time and proper care, back problems can usually be repaired, or at least the pain can be lessened or eliminated. Here are some of the standard self-help ways to relieve this misery and to help avoid it in the first place.

Exercise. The following is a good, standard, twice-a-day exercise routine for back-pain sufferers:

+ Lie on your back on the floor, knees bent and feet flat. Pull your left knee to your chest. Hold this tucked position for 20 seconds. Return to starting position. Repeat four times with each leg.

+ Sit on a chair. Slowly bend forward, to touch your toes, until you feel a mild stretch in your back. Hold for 20 seconds. Repeat four times.

+ Get on your hands and knees. Slowly let your back and abdomen sag. Then slowly, arch your back away from the floor. Repeat four times.

+ Lie on your back on the floor, knees bent and feet flat. With arms extended, reach for your knees until your shoulder blades lift off the floor. Don't grasp your knees. Hold for a few seconds. Repeat four times.

+ Sit on a chair. With your chin tucked and your hands behind your back, try to push your shoulder blades together. Hold for a few seconds. Repeat four times.

+ Lie face down on the floor with a pillow under your hips and lower abdomen. Bend your left knee and raise your leg slightly off the floor. Hold for about four seconds. Repeat four times with each leg. Then repeat this exercise with your leg straight.

In addition, many people find that walking, swimming and other aerobic activities relieve or even eliminate their back pain. Sit-ups, general calisthenics and weight training can help as well. These exercises stretch and strengthen the back while improving the blood supply to the spine muscles, joints and vertebrae disks. Remember, even if the pain goes away, it does not necessarily mean the problem is resolved for good. To help keep back pain at bay, you must maintain a regular, consistent exercise program.

Sleeping and sitting. Your sleeping and sitting positions can trigger back pain by throwing the spine out of alignment and by unduly stretching the back muscles. For example, lying on the stomach stresses the neck and exaggerates the curve of the lower back. Here are some suggestions:

+ Sleep on a firm mattress, or use a bed board.

+ When you sleep on your side, put one pillow under your head, another between your legs, and bend your knees.

+ When sleeping on your back, place one pillow under your head and a pillow or two under your knees.

+ When sleeping on your stomach, place one pillow under your abdomen and nothing under your head.

+ When sitting for extended periods of time, place a pillow in the small of the back for support.

+ And when your back begins to stiffen or hurt from sitting, the exercises above may provide some relief.

Corsets. The main claims for corset use are that the device supports the trunk to prevent pain-producing movements, it reduces the likelihood of back damage by transmitting the lifting force away from your back to your legs, and it serves as a reminder to stand, sit and lift properly. The down side here is that over-reliance on a corset will eventually weaken the back because stomach and back muscles do not have to work as hard maintaining posture, lifting, etc. Although a corset may be beneficial in some instances, it should not be used unless recommended by a doctor familiar with back problems.

End note. Back pain is a major national health concern. About 80 percent of the U.S. population eventually experiences the problem, with an estimated 30-million people suffering from the condition at any one time. The intent here is not in any way to trivialize back pain. Although most cases are short-lived and respond well to exercise and other self-help measures, some individuals have serious, enduring problems. And the quest for relief can involve difficult and challenging physiological, pharmacological and psychological considerations.

Patrick J. Bird, dean of the College of Health and Human Performance, University of Florida, draws on a database of more than 3,800 medical, health and fitness journals in preparing answers to questions in his column. Write with questions to Dr. Bird, College of Health and Human Performance, University of Florida, Gainesville, FL 32611. Access the Keeping Fit Web site at http://www.hhp.ufl.edu/ keepingfit/.

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