Spinal Hygiene: Preventing Back Surgery
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80% of the American population presents with back pain at some point in their life, making up the far majority of the population. Did you know that according the Johns Hopkins Medical University, fewer than 5 percent of people with back pain are actually considered good candidates for surgery? 5%! So, we are talking about 80% of the population who has this problem, and only 5% are considered good candidates for spinal surgery.
What in the world are you supposed to do to resolve your problem if you are like 80% of everyone else? Just because back pain is common, doesn’t mean it is normal. You are going to discover effective, natural spinal hygiene strategies to resolve your back pain and to prevent you from having an irreversible spinal surgery.
Even if you are considered a good candidate for spinal surgery, what are the effects of this procedure? Frighteningly, more than 25% of back surgeries ended up with increased instability which can often lead to increased pain, and the need for further surgeries.
Further research has shown that increased pain is not the only problem that occurs after back surgery. Investigations have begun showing that the spinal degeneration is twice as likely to occur to individuals whom have received spinal fusions. Radiographic changes are most likely to occur after the level of the spinal fusion.
What about the individuals that have gained relief from pain after the surgery? The research shows that even in asymptomatic post-surgery patients, biomechanical alterations occur. Reviewing follow up radiographs of these asymptomatic patients, demonstrated new spinal degeneration occurring in their spines post-surgery.
My intention is not to scare you. And it is definitely not to put down spinal surgeons, these doctors are brilliant at their trade. My intention is to present the facts to you, so you are empowered to make educated decisions about your health. If you are ever told you need an invasive operation, it is best to obtain several opinions before deciding to undergo irreversible surgery.
And, my recommendation is to consider all conservative options first. You can always more forward with surgery after conservative care if you are in that 5% however, the reverse is not true. As for the rest of you, conservative care is the best option hands down, both in terms of your health and wellbeing and also in terms of financial sense. Conservative care is a win-win. This is not my opinion, this is a fact.
When you are done today, you will have a better understanding of your options to resolve back pain, and you will have an actionable advice that you can implement immediately.
Welcome to spinal hygiene 101. Let’s talk first about the anatomy of the spinal column so we all understand what I am referring to when I talk about the spine, pelvis, and the postural framework of your body.
The spinal column is located right at the base of your skull, your skull that protects which structure? Yes, the skull protects the brain, the vital anatomic structure that extends into the spinal cord. The spinal cord is also surrounded by solid bone, 24 vertebrae making up the cervical spine, the thoracic spine, and the lumbar spine. The spinal cord then branches into small extensions called spinal nerves that exit from the spinal segments and go to the organs in all parts of your body. Through this system, called the nervous system, your brain communicates with the rest of your body. It sends a message from the brain, down the spinal cord, to the spinal nerve, which leaves the spinal column and goes to the organ to control its organic function. Through this exact process is how all vital functions of the body occur.
Proper alignment of the spinal column in the cervical, the thoracic, and the lumbar spine is vitally important to protect the integrity of the nervous system. The purpose of the posture system of your body is to hold the body upright against gravity, and to protect the integrity of the nervous system tissues. Located below the lumbar spine is the pelvic girdle. The pelvis, or the hips, are the foundation of the spine. Postural distortion patterns of the pelvis result in compensation patterns among the anatomy of the rest of your body.
The body is dynamic and highly intelligent. The posture system holds you upright. To prevent falling over if you have a misalignment, the rest of the body move around the postural misalignments creating compensations. Although this stabilizes the body upright, and prevents you from falling over momentarily, if these postural distortions are not corrected, over time they cause unequal loads of pressure on the body, resulting in damage and degeneration. Often times leading to herniated discs of the spine.
As the bony framework of your posture becomes misaligned, it causes the muscles to have unequal pull and contraction. For example, if the hips become misaligned, you can the muscles on one side are more contracted, and the muscles on the other side are elongated and weak.
Let me ask you a question, if you go to the gym or do a yoga class and your hips are misaligned, and you do the exercises that you are instructed to do, but you still have a misalignment, is this going to make your posture better or worse?
What if you have a treatment done to correct the misalignment of the hips and the spine, so the load is equal on both sides, and your muscles have even contraction, does it help then to go to a yoga class? The answer is yes, absolutely, because now that the bony framework is in alignment, we can correct the muscular compensation patterns.
This is key information; let’s review it one more time to make sure we have it. If a misalignment occurs to the pelvis, the body’s natural response is to compensate by shifting the position of the spine, shoulders, neck and head. The body does this to hold us upright, so we don’t fall over and experience a traumatic injury. With misalignments of the body postural framework, our muscles become stressed unevenly from right to left, pulling on the already misaligned bones. The unequal loads on the body, if left uncorrected will result in herniated discs or degeneration.
So, to correct this problem, the first ting we do is correct the postural alignment. Once we have the body is proper posture, we want to support the proper postural position be reinforcing the musculature. The goal here is to determine which muscles are tight and which are weak. The tight muscles should be stretched, and the weak muscles should be strengthened.
Let’s identify the 10 most common causes of postural collapse and give you good strategies to resist them. We’ll go through each one in detail and provide you with actionable strategies to prevent postural decline. I think you may be surprised how simple these causes are. By far, what has the largest impact to your health is activities that are performed repetitively with improper posture. You may not feel the impact that the activity has immediately, but as you continue to perform that activity incorrectly over time, it will degenerate your spine and cause postural compensations.
Repetitive Occupational Movements
These are the movements that we do every day for extended periods of time while at work. This will differ for everyone, but there are surely certain movements that you do day in and day out that are affecting your posture. Consider hairdressers, for example. If they need to rotate their spine and reach for the scissors, they may end up doing a reaching movement 50 times per day. By simply placing the scissors within an arm’s reach, they wouldn’t have to reach and strain their spine 50 times a day.
Or how about a gardener? A gardener may be on their knees for an extended period causing strain to the lower back if they don’t keep their back straight. Or they may spend time raking the yard, so they are doing that movement for a couple hours a day. Over time, these repetitive occupational movements that are always done the same way day in and day out for prolonged periods of time will affect the posture.
Sedentary Lifestyle
The second cause of postural decline and spinal degeneration is a sedentary lifestyle. If you don’t move your joints and muscles you become stiff, and then movement feels painful. This causes people to become even more sedentary. It is a vicious cycle affecting your health.
The ill health effects of a sedentary lifestyle are so prominent that sitting has been termed as “the new smoking.” Vast amounts of people are seated for the majority of their day at work, then after work go home, eat dinner, and sit on the couch to catch their favorite television shows. Exercising is fundamental for health and wellbeing, but even more than that, you need to interrupt your sitting throughout the day by changing your posture. This stimulates your metabolism, which drops to 1/3 of its calorie-burning rate achieved while walking. Being sedentary has a tremendous effect on the obesity epidemic in the United States.
To save your spine, it is important to take posture breaks. Posture breaks are recommended every 20-30 minutes; they lengthen contracted muscles associated with sitting while stimulating inactive postural musculature.
Healthy Sitting
The next cause of spinal degeneration goes right along with a sedentary lifestyle; it is improper posture while seated for prolonged periods. When you are sitting, the pressure in the lower back is increased by about 1.7 times your body weight. And this is when you sit with proper posture, if you slouch that pressure increases further. The spine is generally strong enough to tolerate the pressure of a slouched spine for about 20 minutes, before the vertebral discs start to absorb the pressure.
To help support sustained proper posture while seated, you can use a Posture Cushion or an exercise ball. Or of course, you can invest in an ergonomic chair that supports your spine. While sitting on the posture cushion or exercise ball you should feel your core muscles activated. This supports your spine throughout the day and makes it easier to maintain proper posture.
Technology Terror
Next is slouching the shoulders forward, which commonly occurs while reading, watching TV, texting, typing on your computer, etc. You know the feeling, where you feel like you can’t even hold your body up because the shoulders are rounded forward. This is very common, and very bad for your spine. By slouching forward, your body is being compressed by gravity. You always want to maintain an upright posture, this is the healthiest postural presentation, with the least amount of compression to the vertebral discs. I want you to begin implementing a pectoral stretch into daily routines at home. When the shoulders round forward, the pectoral musculature becomes contracted. As it becomes contracted for a long period of time, it becomes more and more difficult to pull the shoulders back and straightened the spine.
Purses, Handbags, and Improper Lifting
The fifth cause of spinal degeneration is improper lifting of heavy objects and habitually carrying a heavy bag over one shoulder. Lifting with a rounded spine is one of the most common causes of a herniated disc of the lower back. To protect your spine, you really need to bend your knees, keep you head and back straight and contract your core. Any lifting habits besides this are lazy and are really hurting you.
Also carrying a heavy bag over the same shoulder every day, this too affects your postural presentation. The affects are different than improper lifting, where you feel the pressure at the base of your spine. Instead, when carrying a heavy bag your posture will become asymmetrically affected. If you always carry a bag over your right shoulder for example… First the bag is pulling your shoulder down, causing an uneven pressure to the right side of the body. As the bag begins to slip, we raise the shoulder, contracting the muscles of the shoulder girdle under stress. Again, this causes a serious asymmetry from the right to the left side of the body. You want to alternate shoulders to evenly distribute the weight. Another strategy is to get a bag with a long strap that you place on the opposite shoulder. This is the best way to support the weight of the bag.
The Wallet Dilemma
Although the ladies are usually the ones who are more guilty of carrying purses incorrectly, the men tend to be guilty of the next cause of spinal degeneration, which is sitting on your wallet. Who here is sitting on their wallet right now? Ya, it is quite common, a very common reason for people to develop lower back pain and sciatica. When sitting on the wallet, you are causing a hip misalignment. Shift the wallet to the front pocket when you sit down.
Physical Trauma
The next cause of postural collapse is physical traumas such as car accidents or sports injuries. It is important to always take precautions to avoid preventable injuries. However, the reality is that accidents happen, and we can’t always control when a physical trauma will happen. The best thing you can do is to get your body in good shape, so that if something happens, the trauma will not be so devastating. Or at least the recovery time will be quicker. The best way to get into postural shape is to do balance training regularly – this helps prevent falls, and to straighten your core musculature. With a strong core, the lumbar spine is protected.
Supportive Shoes
The next cause of spinal degeneration is wearing shoes that do not support the feet and distort natural weight distribution. When wearing high heels for example, the weight of the feet is shifted to the balls of the feet. As this occurs, the whole body comes forward. The compensation pattern is an increased curve of the lower back. If you ask any woman, she will probably admit that after wearing heels, her feet hurt, but also her lower back. Especially if she was standing for a long period of time. Although high heels are perhaps the worst, flip-flops and unsupportive dress shoes can also be quite damaging. Flip-flops have absolutely no support, causing you to contract your toes to keep them on. This causes abnormal muscular firing patterns that will affect your posture. Flat dress shoes that lack arch support may also cause discomfort causing you to compensate with the rest of your body.
Asymmetric Standing
Which leads us directly to the next cause of poor posture, standing with the weight of the torso shifted over one hip. With prolonged standing, especially in unsupportive shoes, we have the tendency to do this. I know you have all done it, but you probably didn’t realize you were doing it. When you get tired from standing, this is the result. When standing, it is always better to have equal weight distribution over both feet. Anything else is promoting postural asymmetry, diminishing the resiliency of your posture to resist gravity.
Restless Posture
And finally, the last cause is improper sleeping posture. Sleeping on your stomach with the lumbar spine in extension and the cervical spine rotated instead of sleeping on your back or side will really strain your back over time. For further comfort, while sleeping on your side, place a small pillow between your legs to keep the hips in proper alignment. Or while sleeping on your back, you can also place a small pillow in the small of the back to relieve strain of the lumbar spine. How many people have said “I slept wrong last night, while groaning from pain?” You don’t need to say this anymore, by changing your posture while sleeping; you can literally prevent pain and stiffness of your back the next morning. When you are well rested you are prepared to conquer the day.
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Kimberly Nielsen
Posture Expert
Licensed Massage Therapist, MA #75533
350 Treemonte Dr., Orange City, FL 32763