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Spinal Care Dos and Don'ts

The following are some key points to help keep your spine functioning properly.

Standing

Try to keep the normal curves in your back at all times. High heels may cause the low back to arch excessively. Wear comfortable shoes with a good arch support.

Do

  • If you stand a lot shift positions frequently and rest one foot on a low stool or shelf. This takes the strain off the lower back.
  • If you cannot use a foot stool, stand squarely, balanced equally on both feet.
  • Try to hold your head in the neutral position looking straight ahead.
  • Keep your work close to you and at a comfortable height.

Don't

  • Don't stand in one place for too long.
  • Don't bend forward with straight legs.
  • Avoid wearing high heels. The higher the heel, the greater the postural stress.

Sitting

Don't slump, this puts undue stress on your back by overstretching muscles and ligaments. Even in a chair with good lumbar support, the natural tendency is to slump forward as the back muscles fatigue. It is essential to maintain the curve in the low back either by using a rolled up towel or a lumbar support placed at the beltline. Sit with your pelvis against the back rest and with feet flat on the floor in a chair with armrests.

The ideal office chair will have adjustable height, armrests and seat pad and back. The height should be such that your knees are level with or just slightly above the level of your hips. This will help take the pressure off your lower back. The lower border of the seat back should fall just above the belt line. The arm rests should be set so that you can comfortably rest your forearms on them while keeping your elbows bent at 90 degrees.

Do

  • Avoid sitting for prolonged periods. Take frequent breaks to stand up and stretch backwards a few times to reverse the curve in the low back.
  • Place both feet flat on the floor.
  • Sit back on the chair. It is imperative that you give your back proper support.
  • Adjust your chair so your knee is slightly higher than your hip. If your chair is not adjustable you will need a footrest.
  • Your keyboard should be just under your hands when they are stretched straight out from your elbow.

Don't

  • Don't sit in a chair that is too large, too high or too low.
  • Avoid leaning forward with your back arched.
  • Don't slouch.
  • Prolonged sitting produces postural strain.

Computer Work

  • Your keyboard should sit directly in front of you.
  • The screen should be centered if you use the computer for word processing functions. For data entry, the screen may be slightly off to one side, provided the documents you will be working from are centered.
  • The top of the screen should be at eye level so that your neck is maintained in a neutral posture.
  • Place small towel rolls under your wrists to keep them in a neutral position (i.e., not forward or backward).
  • Use chair guidelines as discussed.

Driving

Do

  • Move your seat forward until your thighs rest comfortably on the seat and your feet are on the pedals.
  • Elevate the headrest until it is right behind the back of your head. This is important in case of accident.
  • Sit straight with your back against the seat back. Some cars have built-in lumbar supports. If the seat is less than adequate, your chiropractor can recommend a lumbar support.
  • Remember to keep both hands on the wheel.

Don't

  • Don't sit too far back. Reaching for the pedals or steering wheel strains the back. Stretching out the arms tires the upper back.

Sleeping

Sleep on a mattress that is comfortable and does not sag. The natural curves in your back and neck should be supported.

Do

  • Sleep in the fetal position on your side. Put a pillow between your knees to take the pressure off your lower back.
  • If you sleep on your back, place a pillow underneath your knees. A good cervical pillow is also recommended for under your neck to help maintain the normal cervical curvature. Ask your chiropractor about cervical pillows.
  • The best way to rise from bed is to turn on your side and then sit up sideways, using your arms to help you.

Don't

  • Don't sleep on anything that provides little or no support.
  • Sleeping on your stomach produces significant strain on the lower back.


Lifting

Do

  • To lift, squat down, keeping your back straight.
  • Grasp the object firmly keeping it as close to your body as possible.
  • Lift using your legs while keeping your back straight.
  • Move slowly, carefully and smoothly.
  • Once holding a heavy object, keep your shoulders and hips facing the same direction.
  • If your job requires a lot of lifting, use a lumbosacral support belt to help protect your lower back. Talk to your chiropractor about lumbar back supports

Don't

  • Never lift an object that is too heavy or awkward, get help.
  • Don't bend over or twist while lifting.
  • Avoid lifting higher than your shoulder.
  • Don't lift with arms out-stretched.


Exercise

Maintenance of trunk flexibility and strength are imperative for a healthy spine. Gentle back exercises should be performed daily and

It is necessary that the abdominals, as well as the back muscles be strong so that the front and back of the spine is stabilized. The lower abdominals are especially important because they form a muscular brace when properly activated and strengthened.

The large muscles of hip and thigh; gluteals, quadriceps and hamstrings, need to be strong so that during lifting they can be depended upon to do the work-thereby protecting the spinal joints and back muscles from injury.

Improved flexibility can be achieved through daily stretching. It is important that flexibility of the spine, shoulder girdle and pelvic girdle be optimum so that the normal curves of the spine are maintained during all activities.


Acute Injuries

Discontinue the aggravating activity. Soreness, twinges and spasms are warning signs.

Ice, Ice, Ice! As soon as possible, use crushed ice in a plastic bag, frozen peas or a frozen gel pack for 15 to 20 minutes at a time-then let the skin temperature return to normal. You may do this as often as once every 2 hours during the acute stage (i.e., usually the first 24 to 48 hours).

Find a position of comfort. Either lie:

    (a) on your back with feet and lower legs elevated on pillows
    (b) on your stomach with one or more pillows under your hips
    (c) on your side with a pillow between your knees. Use ice on your back while resting in a comfortable position.

Avoid lifting and forward bending activities, and slowly progress to gentle stretching exercises.