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Back injuries can be very painful. They can also be difficult to heal. After having one back injury, you are more likely to have another one again. It is important to learn how to avoid injuring or re-injuring your back. The following tips can help you to prevent a back injury.

What actions can I take to prevent back injuries?

Nutrition changes

Talk with your healthcare provider about your overall diet, and especially about foods that strengthen your bones.

•  Ask your healthcare provider how much calcium and vitamin D you need each day. These nutrients help to prevent weakening of the bones (osteoporosis). Osteoporosis can cause broken (fractured) bones, which lead to back pain.
•  Eat foods that are good sources of calcium. These include dairy products, green leafy vegetables, and products that have had calcium added to them (fortified).
•  Eat foods that are good sources of vitamin D. These include milk and foods that are fortified with vitamin D.
•  If needed, take supplements and vitamins as directed by your healthcare provider.

Physical fitness

Physical fitness strengthens your bones and your muscles. It also increases your balance and strength.

•  Exercise for 30 minutes per day on most days of the week, or as directed by your healthcare provider. Make sure to:
  •  Do aerobic exercises, such as walking, jogging, biking, or swimming.
  •  Do exercises that increase balance and strength, such as tai chi and yoga. These can decrease your risk of falling and injuring your back.
  •  Do stretching exercises to help with flexibility.
  •  Develop strong abdominal muscles. Your abdominal muscles provide a lot of the support that your back needs.
•  Maintain a healthy weight. This helps to decrease your risk of a back injury.

Good posture

Prevent back injuries by developing and maintaining a good posture. To do this successfully:

•  Sit up and stand up straight. Avoid leaning forward when you sit or hunching over when you stand.
•  Choose chairs that have good low-back (lumbar) support.
•  If you work at a desk, sit close to it so you do not need to lean over. Keep your chin tucked in. Keep your neck drawn back, and keep your elbows bent at a right angle.
•  Sit high and close to the steering wheel when you drive. Add a lumbar support to your car seat, if needed.
•  Avoid sitting or standing in one position for very long. Take breaks to get up, stretch, and walk around at least one time every hour. Take breaks every hour if you are driving for long periods of time.
•  Sleep on your side with your knees slightly bent, or sleep on your back with a pillow under your knees.

Lifting, twisting, and reaching

Back injuries are more likely to occur when carrying loads and twisting at the same time. When you bend and lift, or reach for items that are high up in shelves, use positions that put less stress on your back.

•  Heavy lifting
  •  Avoid heavy lifting, especially the kind of heavy lifting that is repetitive. If you must do heavy lifting:
    •  Stretch before lifting.
    •  Work slowly.
    •  Rest between lifts.
    •  Use a tool such as a cart or a dolly to move objects.
    •  Make several small trips instead of carrying one heavy load.
    •  Ask for help when you need it, especially when moving big or heavy objects.
  •  Follow these steps when lifting:
    •  Stand with your feet shoulder-width apart.
    •  Get as close to the object as you can. Do not try to pick up a heavy object that is far from your body.
    •  Use handles or lifting straps if they are available.
    •  Bend at your knees. Squat down, but keep your heels off the floor.
    •  Keep your shoulders pulled back, your chin tucked in, and your back straight.
    •  Lift the object slowly while you tighten the muscles in your legs, abdomen, and buttocks. Keep the object as close to the centre of your body as possible.
  •  Follow these steps when putting down a heavy load:
    •  Stand with your feet shoulder-width apart.
    •  Lower the object slowly while you tighten the muscles in your legs, abdomen, and buttocks. Keep the object as close to the enter of your body as possible.
    •  Keep your shoulders pulled back, your chin tucked in, and your back straight.
    •  Bend at your knees. Squat down, but keep your heels off the floor.
    •  Use handles or lifting straps if they are available.
  •  Twisting and reaching
    •  Avoid lifting heavy objects above your waist.
    •  Do not twist at your waist while you are lifting or carrying a load. If you need to turn, move your feet.
    •  Do not bend over without bending at your knees.
    •  Avoid reaching over your head, across a table, or for an object on a high surface.

Other changes

•  Avoid wet floors and icy ground. Keep sidewalks clear of ice to prevent falls.
•  Do not sleep on a mattress that is too soft or too hard.
•  Put heavier objects on shelves at waist level, and put lighter objects on lower or higher shelves.
•  Find ways to decrease your stress, such as by exercising, getting a massage, or practicing relaxation techniques. Stress can build up in your muscles. Tense muscles are more vulnerable to injury.
•  Talk with your healthcare provider if you feel anxious or depressed. These conditions can make back pain worse.
•  Wear flat heel shoes with cushioned soles.
•  Use both shoulder straps when carrying a backpack.

Summary

•  Back injuries can be very painful and difficult to heal.
•  You can prevent injuring or re-injuring your back by making nutrition changes, working on being physically fit, developing a good posture, and lifting heavy objects in a safe way.
•  Making other changes can also help to prevent back injuries. These include eating a healthy diet, exercising regularly and maintaining a healthy weight.

This information is not intended to replace advice given to you by your healthcare provider. Make sure you discuss any questions you have with your health care provider.

References:

Binh P., Ngo T., Amin Y., et. al.: Lifting height as the dominant risk factor for low-back pain and loading during manual materials handling: a scoping review. IISE Trans Occup Ergon Hum Factors 2017; 5: pp. 158-171.

Hoy D., March L., Brooks P., et. al.: The global burden of low back pain: estimates from the global burden of disease 2010 study. Ann Rheum Dis 2014; 73: pp. 968-974.

Okada T., Huxel K.C., Nesser T.W.: Relationship between core stability, functional movement, and performance. J Strength Cond Res 2011; 25: pp. 252-261.

Sinaki M.: Exercise for patients with osteoporosis: management of vertebral compression fractures and trunk strengthening for fall prevention. PM R 2012; 4: pp. 882-888.

Sipko T., Kuczyński M.: Intensity of chronic pain modifies postural control in low back patients. Eur J Pain 2013; 17: pp. 612-620.

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