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Common Back Pain Causes

It began as a twinge. Then the pain started to radiate down my back when I biked. Bothersome became dangerous when it hurt to turn my head; do not try cycling with impaired neck mobility. Yet I saw no reason to modify my fitness routine. I pedaled. I kickboxed. I lifted weights. And after about three weeks, I paid the price. One sleepless night, pain that felt like a knife in my back pinned me to the couch.

Whether you're a week­end warrior, an elite athlete, or somewhere in between, there's a strong chance that eventually you'll deal with back pain, too. Here's why: Everyday activities that you do without thinking — sitting at the computer, slipping on a pair of shoes, crawling into bed at night — can make or break your spine health. Most aches are caused by strains (injured muscles or tendons) or sprains (damage to the tough fibrous tissue, or ligaments, located where your vertebrae connect to joints). These injuries are typically brought on by over­use, a new activity, excessive lifting, or an accident. Other times, a compressed (aka pinched) nerve, such as in a herniated disk, is to blame for the ache.

Given the prevalence of back pain, you would think we'd have treatment for it down pat. Not even close. "The challenge is that you can't see injuries to tendons, ligaments, and muscles the way you can bone fractures and herniated disks," says Jeffrey Katz, MD, a professor of medicine and orthopedic surgery at Brigham and Women's Hospital in Boston and the author of Heal Your Aching Back. Despite diagnostic advances, doctors can't pinpoint an exact cause for as many as 85 percent of back problems, which makes them tricky to treat. Spinal manipulation, for example, is controversial — some docs say it does more harm than good — but it's the only remedy that got me off the couch and back on my bike. "Chiropractic care is not without concerns; then again, neither is traditional medicine, particularly when you're dealing with a problem like back pain, which has no easy, one-size-fits-all fix," says Mark Moyad, MD, a FITNESS advisory board member and the director of preventive and alternative medicine at the University of Michigan Medical Center.
Even exercise, which a majority of experts agree is one of the best ways to maintain a healthy back and chase away aches and pains, can be problematic. "When you're sedentary, the muscles supporting the spine get weaker, and you're more prone to injury," Dr. Katz says. But "exercising with improper form — rounding the back when doing dead lifts or arching it during ab work — can place unwanted stress on the spine," notes Robyn Stuhr, a spokeswoman for the American Council on Exercise.
If you fall into the 80 percent of the population that regularly suffers from back pain, take heart: One-third of aches due to a strain or a sprain improve in a week without medical intervention (the remainder may take up to eight weeks). But unless you do some spine tuning — strengthening your back through exercise and fostering healthier habits with our advice here — your odds of a recurrence within six months are about one in three, Dr. Moyad says. Keep your back in tip-top shape by avoiding these seven spinal sins.

Back breaker: You're a screen queen

Nine hours — that's how long the average person spends hunched over or slouched in front of a screen each day. A Temple University study suggested that increased texting on our latest tech obsessions — smartphones and tablets — is creating more aches and pains in our shoulders, necks, and backs. "It's important to take breaks, do neck exercises, and occasionally hold your phone or tablet out in front of you," says Deborah Venesy, MD, a doctor of physical medicine and rehabilitation at the Cleveland Clinic Center for Spine Health. For a simple neck reliever, hold your head for 10 seconds in each of the following positions: forward, back, left, and right. Repeat this five times a day.
Sitting all day is hazardous, too. "It puts more pressure on disks and vertebrae than standing or walking," Dr. Katz says. Alleviate the tension with an office makeover. Start with a lumbar-support cushion, such as the Original McKenzie SlimLine ($19, isokineticsinc.com). Then adjust your seat so your computer monitor is at eye level, your arms and knees are bent at a 90-degree angle, and your feet rest on the floor. Finally, go to workrave.org to download a free program that flashes screen reminders to take computer breaks as often as you schedule them.

Back breaker: You ignore your core

When you hear the word core, you picture six-pack abs. But your core is composed of much more: Back, side, pelvic, and buttock muscles all work together, along with your abs, to allow you to bend, twist, rotate, and stand upright. "Your core is like a crane that supports all of your movements," Dr. Moyad says. Unlike crunches, which focus solely on abdominal muscles, core exercises — lunges, squats, planks, and others — strengthen several spine-supporting muscle groups at once.

Alexander technique
This isn't a sweaty workout. It's an approach that helps you improve your balance, posture, and movement as you work to ease tension in your body. One study found that the Alexander technique curbed pain and disability in people with low back pain.

Feldenkrais Method
Like the Alexander technique, the Feldenkrais Method is a series of gentle, guided movements that focus on balance and flexibility. You can sign up for group classes or one-on-one sessions that will boost your body awareness and expand the ways you move. A few small studies have found that the method may help with back pain.

Pilates is 
all about your core muscles, including your abs and back muscles. Some movements may be too intense for people with back pain. But exercises based on Pilates are a common form of rehab. Pilates actually started as a form of physical therapy. A review of studies found that Pilates-based exercise helped reduce low back pain for some people. But it didn’t show whether Pilates is better than other types of exercise for that.

Stretching and strength training
 The goal is to become more flexible and stronger so you can move through your day without pain. One study found that typical stretching exercises combined with weight training help with back pain.

Tai chi
 This Chinese martial art involves slow, gentle stretches and movements. In one study, people who took tai chi for 10 weeks cut their back pain by 25%.

Yoga

Many studies show that yoga can help with moderate back pain and depression.

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