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What Really Works: How to Relieve Lower Back Pain Effectively

What Really Works: How to Relieve Lower Back Pain Effectively

Eight out of ten adults experience lower back pain once in their lifetime. I am one of those people and I’m definitely not looking forward to my participation award. I know how it feels like to step out of bed and barely being able to put on your socks. Having lower back pain sucks. But 9 out of 10 patients that suffer from lower back pain don’t even know the primary cause of it.

Video Summary

Back Pain? Blame Our Evolution

Once upon a time in our fairly recent past, our ancestors felt the urgency to stand up and leave our quadruped neighbors behind. Habitual bipedalism, fancy word for regularly walking on two legs, came with a lot of advantages. With two rear limbs instead of four, we were able to more efficiently use our hands and create tools with them.

Sadly, life on two legs also brought along its disadvantages. Our spine had four supporting pillars previously, but now it only got two. The back is therefore naturally one of the weak links of our human anatomy. Our spine needs constant support from its supporting muscles to minimize the load on the spine. With no muscle support (tested on dead bodies) the back can only bear loads up to 5 pounds without collapsing [reference Panjabi 1989]. With well-developed torso muscles, the spine can take loads up to 2000 pounds. That’s a 400-fold increase.

Most people that come to me with a history of a herniated disc (that’s when the discs between the vertebral bodies are fully collapsed, really severe incident), tell me the ‘story of the pencil’. The injury with the following severe pain usually gets triggered by picking up a small, everyday object. Such as a pencil. Not as you may think by trying to lift 100 pounds – no, but by a simple thing – such as a pencil.

This tells us that damage in your back adds up over time, it’s a so called cumulative trauma disorder. Meaning back pain is a result of your daily habits.

Sitting Is the New Smoking

Whenever I sit for too long, my back hurts. In fact, 54% of Americans who experience lower back pain spend the majority of their workday sitting. But isn’t sitting something that should reduce the stress of your back? No, just the opposite.

The joints between the bones of the spine are not directly linked to the blood supply. These joints instead get nourished through a process called diffusion. Diffusion works because molecules (such as oxygen, important for cells) are constantly moving and try to get as much space for themselves as they can. A key element for diffusion therefore is a pressure difference. In the image below the left room contains more moving molecules than the right, that’s why the molecules from the left are moving to the right. This way nutrition gets transformed into the joints, whereas toxins are transported out of the joints.

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Sitting puts a lot of pressure on your spinal chord. The diffusion process therefore can’t function as efficiently. Nutrition and toxins can’t be properly transported, the joints get damaged.

    Sit Properly

    If sitting can play such a huge part in the creation of your lower back pain, how do you sit properly then?

    Is it better to sit with a straight back or should you rather lay back in your chair? Can I cross my legs when I’m sitting or should I have a symmetrical position with my feet? These are questions that I hear on a daily basis. The answer might shock you – according to recent science – all of them are right. The best sitting position is an ever-changing one. An ever-changing position minimizes the pressure on certain points of your spine and spreads it on the whole part.

      Credit: StayWow

      Stand Up More

      Even better than a sitting position is a stand up position. Standing dramatically reduces the pressure on your spine. If you’re forced to work on a desk the whole day though, you have two options.

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      Take breaks every hour of about 2-3 minutes.

      Set an alarm on your phone that goes off every hour! In that time you stand up and reach to the ceiling, on your toe tips with fully extended arms. You’re inhaling during the whole process. You do this activity for 20 seconds. Afterwards you’re walking through the office for the next 2 minutes. You might grab a healthy snack or some water in that time. The exercise relieves the pressure on your spine, while the walking makes sure that the joints on your spine are properly used.

      Or get a standing desk.

      One of the best companies on the market for Standing Desks, according to my research, is Autonomous. Autonomous offers a rather cheap Standing Desk, with the ability to change the height. Which means you can start the day standing and switch to sitting if you’re tired.

      Exercise for Lower Back Pain

      Sitting is an immobile position. Your joints are made for movement and therefore need movement to function properly. If humans are moving, all moving parts: e.g. the joints, bones and muscles get strengthened. If you’re in a rested position for too long, your tissues start to deteriorate. You have to get the right amount of activity in.

      But not too much activity. There’s a chance that going to the gym may even increase your risk of lower back pain. I know plenty of friends with chiseled bodies that suffer from pain in the spine regularly. Huge muscles do not prevent you from back pain. In your training you should focus on building up the muscles that are stabilizing your back and relieve pressure. Squats with 400 pounds don’t do the trick.

      The more weight you carry around, the more weight your spinal chord has to bear on a regular basis. That’s one of the reasons why huge, muscular guys can suffer from back pain too. One of the most important goals of your exercise regimen should therefore be weight loss.

      Here are some important tips for you to consider when starting an exercise regimen:

      Make sure you implement cardiovascular training in your workout routine.

      This will not only help you lose weight, it will also make sure that your arteries, which flow to the tissue next to your spinal discs, are free of placque and can therefore transport nutrients properly.

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      Important: If you have rather strong back pain, maybe even an herniated disc, don’t start running on a threadmill. Running is an high-impact exercise. Which means there are continuous, reocurring high pressure points on your spine. Your endurance training should therefore either be fast-paced walking or a training on the elliptical trainer for the beginning, because both have little to no stressful impact on your backbone.

      Focus on developing your whole core if you want to minimize your pain.

      There are some people that do hundreds of sit ups a day. While sit ups are a good exercise for your abdomen, it also puts pressure on your spine due to the bending movement. A sixpack workout routine is one-sided. Your abs may become overdeveloped in comparison to your back muscles. You’ve created an imbalance. A great way to train your abdominal muscles and back muscles simultaneously, is holding the plank position.

      Stretch only if you have tight muscles.

      I remember stretching every morning after I woke up. I took 10 minutes out of my day to just work on my flexibility and prevent injuries. Little did I know that I was actually promoting an injury, by doing so.

      Contrary to common belief, stretching is only partially beneficial to treating lower back pain. Stretching makes sense if tight muscles (such as the hamstrings) are forcing you to constantly bend your back. Stretching to treat pain doesn’t make sense if you’re already on a good level of flexibility. Hyper-mobility may even enforce back pain.

      If you found out that you had tight muscles that you need to stretch, try to stretch them at least three times a week. Don’t stretch your muscles right after you wake up in the morning. This is because your spinal discs soak themselves up in fluid over the nighttime. Every bending and excessive loads on your spine is much worse in that soaked-up state. Postpone your stretching regime to two-to three hours after you’ve woken up.

      Where to Start

      The key to improving your habits is awareness. Try to get aware of your back while you’re sitting down, laying down or lifting an object next time. This awareness of your body is called proprioception. For example, you have to be aware whether your back is bended or straight in this very second. Trust me, it is harder than you might think. You may need to ask a friend for the first few tries. But the change that this awareness can make in your back pain is absolutely fascinating. This consciousness of your body is one of the most important things in your recovery or prevention.

      Here are a few behavioural tactics that you need to be considering:

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      If you’re leaning forward more than 30 degrees with your upper body, support your spine with your arms.

      Ever tried to show a colleague of yours a complex issue and found yourself awkwardly leaning forward on their desk, pointing with your fingers to his paper? If that ever happens again, make sure you’re using the not-pointing arm to support yourself on the desk.

      Keep a straight back.

      Be it while exercising, stretching or standing. If you’re bending your back you’re putting stress on small areas of your spinal chord. A straight back redistributes the force to a bigger area. You’re minimizing the pressure. Remember this whenever you’re at the gym and reracking your weights, focus on having a neutral spine.

      Put symmetrical loads on your spine.

      I used to play the trumpet when I was a child. The instrument is pretty heavy. The trumpet gets transported in a big, metallic suitcase – with no wheels. Being the nature of suitcases, you only carry it with one arm, on one side of your body. This forced me to constantly lean on the other side with my upper body, while transporting the instrument from A to B. Not really the healthiest activity for your spine as you can imagine.

      If you have to carry heavy objects, carry them with both arms. Put the object in the middle of your body and keep it as close to your mass of gravity as you can. If this is not possible, try to carry the same amount on the left side than you do on the right side. This puts the stress vertically on a fully extended spine. The load is much better bearable for your spine.

      Stay Away From the Back Pain League

      Our world is getting more sedentary. We will continue to develop faster transportation, more comfortable houses and easier lives. While our technological progress definitely has its amazing benefits, it sadly has its downsides too. The danger for back pain will continue to rise on our ever-increasing motionless planet. It’s time to raise awareness.

      Featured photo credit: Pexels via pexels.com

      More by this author

      Florian Wüest

      Qualified and experienced fitness trainer and online coach.

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      Last Updated on March 30, 2020

      Why You’re Feeling Tired All the Time (And What to Do About It)

      Why You’re Feeling Tired All the Time (And What to Do About It)

      Feeling tired all the time?

      Have you ever caught yourself nodding off when you’re watching TV, listening to someone drone on during a meeting or even driving a car?

      I know I have, especially when I worked 70 hours per week as a High-Tech Executive.

      Feeling tired all the time may be more widespread than you think. In fact, two-fifths of Americans are tired most of the week.[1]

      If you’re tired of feeling tired, then I’ve got some great news for you. New research is helping us gain critical insights into the underlying causes of feeling tired all the time.

      In this article, we’ll discuss the latest reasons why you’re feeling tired all the time and practical steps you can take to finally get to the bottom of your fatigue and feel rested.

      What Happens When You’re Too Tired

      If you sleep just two hours less than the normal eight hours, you could be as impaired as someone who has consumed up to three beers.[2] And you’ve probably experienced the impact yourself.

      Here are some common examples of what happens when you’re feeling tired:[3]

      • You may have trouble focusing because memory and learning functions may be impaired within your brain.
      • You may experience mood swings and an inability to differentiate between what’s important and what’s not because your brain’s neurotransmitters are misfiring.
      • You may get dark circles under your eyes and/or your skin make look dull and lackluster in the short term and over time your skin may get wrinkles and show signs of aging because your body didn’t have time to remove toxins during sleep.
      • You may find it more difficult to exercise or to perform any type of athletic activity.
      • Your immune system may weaken causing you to pick up infections more easily.
      • You may overeat because not getting enough sleep activates the body’s endocannabinoids even when you’re not hungry.
      • Your metabolism slows down so what you eat is more likely to be stored as belly fat.

      Are you saying that feeling tired can make me overweight?

      Unfortunately, yes!

      Feeling tired all the time can cause you to put on the pounds especially around your waist. But it is a classic chicken and egg situation, too.

      Heavier people are more likely to feel fatigued during the day than lighter ones. And that’s even true for overweight people who don’t have sleep apnea (source: National Institutes of Health).

      Speaking of sleep apnea, you may be wondering if that or something else is causing you to feel tired all the time.

      Why Are you Feeling Tired All the Time?

      Leading experts are starting to recognize that there are three primary reasons people feel tired on a regular basis: sleep deprivation, fatigue and Chronic Fatigue Syndrome (CFS).

      Here’s a quick overview of each root cause of feeling tired all of the time:

      1. Tiredness occurs from sleep deprivation when you don’t get high-quality sleep consistently. It typically can be solved by changing your routine and getting enough deep restorative sleep.
      2. Fatigue occurs from prolonged sleeplessness which could be triggered by numerous issues such as mental health issues, long-term illness, fibromyalgia, obesity, sleep apnea or stress. It typically can be improved by changing your lifestyle and using sleep aids or treatments, if recommended by your physician.
      3. Chronic Fatigue Syndrome (CFS) is a medical condition also known as Myalgic Encephalomyelitis that occurs from persistent exhaustion that doesn’t go away with sleep.

      The exact cause of CFS is not known, but it may be due to problems with the immune system, a bacterial infection, a hormone imbalance or emotional trauma.

      It typically involves working with a doctor to rule out other illnesses before diagnosing and treating CFS.[4]

      Always consult a physician to get a personal diagnosis about why you are feeling tired, especially if it is a severe condition.

      Feeling Tired vs Being Fatigued

      If lack of quality sleep doesn’t seem to be the root cause for you, then it’s time to explore fatigue as the reason you are frequently feeling tired.

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      Until recently, tiredness and fatigue were thought to be interchangeable. Leading experts now realize that tiredness and fatigue are different.

      Tiredness is primarily about lack of sleep.

      But fatigue is a perceived feeling of being tired that is much more likely to occur in people who have depression, anxiety or emotional stress and/or are overweight and physically inactive (source: Science Direct).

      Symptoms of fatigue include:

      • Difficulty concentrating
      • Low stamina
      • Difficulty sleeping
      • Anxiety
      • Low motivation

      These symptoms may sound similar to those of tiredness but they usually last longer and are more intense.

      Unfortunately, there is no definitive reason why fatigue occurs because it can be a symptom of an emotional or physical illness. But there are still a number of steps you can take to reduce difficult symptoms by making a few simple lifestyle changes.

      How Much Sleep Is Enough?

      The number one reason you may feel tired is because of sleep deprivation which means you are not getting enough high-quality sleep.

      Most adults need 7 to 9 hours of high-quality, uninterrupted sleep per night. If you’re sleep deprived, the amount of sleep you need increases.

      So, quantity and quality do matter when it comes to sleep.

      The key to quality sleep is being able to get long, uninterrupted sleep cycles throughout the night. It typically takes 90 minutes for you to reach a state of deep REM sleep where your body’s healing crew goes to work.

      Ideally, you want to get at least 3 to 4 deep REM sleep cycles in per night. That’s why it’s so important to stay asleep for 7 or more hours.

      Research also shows that people who think they can get by on less sleep don’t perform as well as people who get at least seven hours of sleep a night[5] So, you should definitely plan on getting seven hours of deep restorative sleep every night.

      If you are not getting 7 hours of high-quality sleep regularly, then sleep deprivation is most likely reason you feel tired all the time.

      And that is good news because sleep deprivation is much simpler and easier to address than the other root causes.

      It’s also a good idea to rule out sleep deprivation as the reason why you are tired before moving on to the other possibilities such as fatigue or Chronic Fatigue Syndrome, which may require a doctor for diagnosis and treatment.

      4 Simple Changes to Reduce Fatigue

      Personally, I’m a big believer in upgrading your lifestyle to uplift your life. I overcame chronic stress and exhaustion by making these four changes to my lifestyle:

      1. Eating healthy, home-cooked meals versus microwaving processed foods or eating out
      2. Exercising regularly
      3. Using stressbusters
      4. Creating a bedtime routine to sleep better

      So, I know it is possible to change your lifestyle even when you’re working crazy hours and have lots of family responsibilities.

      After I made the 4 simple changes in my lifestyle, I no longer felt exhausted all of the time.

      In addition, I lost two inches off my waist and looked and felt better than ever.

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      I was so excited that I wanted to help others replace stress and exhaustion with rest and well-being, too. That’s why I became a Certified Holistic Wellness Coach through the Dr. Sears Wellness Institute.

      Interestingly enough, I discovered that Dr. Sears recommends a somewhat similar L.E.A.N. lifestyle:

      • L is for Lifestyle and means living healthy including getting enough sleep.
      • E is for Exercise and means getting at least 20 minutes of exercise a day ideally for six days a week.
      • A is for Attitude and means thinking positive and reducing stress whenever possible.
      • N is for Nutrition and means emphasizing a right-fat diet, not a low-fat diet.

      The L.E.A.N. lifestyle is a scientifically-proven way to reduce fatigue, get to the optimal weight and to achieve overall wellness.[6]

      And yes, there does seem to be an important correlation between being lean and feeling rested.

      But overall based on my personal experience and Dr. Sear’s scientific proof, the key to not feeling tired all of the time does seem to be 4 simple changes to your lifestyle.

      L — Living Healthy

      Getting enough high-quality sleep every day is the surefire way to help you feel less fatigued, more rested and better overall.

      So, whether you’re sleep deprived or potentially suffering from fatigue or Chronic Fatigue Syndrome, you probably want to find a way to sleep better.

      In fact, if you aren’t getting enough sleep, your body isn’t getting the time it needs to repair itself; meaning that if you are suffering from an illness, it’s far more likely to linger.

      As unlikely as it sounds, though, fatigue can sometimes make it difficult to sleep. That’s why I’d recommend taking a look at your bedtime routine before you go to bed and optimize it based on sleep best practices.

      Here are 3 quick and easy tips for creating a pro-sleep bedtime routine:

      1. Unplug

      Many of us try to unwind by watching TV or doing something on an iPhone or tablet. But tech can affect your melatonin production due to the blue light that they emit, fooling your body into thinking it’s still daytime.

      So turn off all tech one hour before bed and create a tech-free zone in your bedroom.

      2. Unwind

      Do something to relax.

      Use the time before bed to do something you find relaxing such as reading a book, listening to soothing music, meditating or taking an Epsom salt bath.

      3. Get Comfortable

      Ensure your bed is comfortable and your room is set up for sleep.

      Make sure you room is cool. 60-68 degrees is the ideal temperature for most people to sleep.

      Also, it’s ideal if your bedroom is dark and there is no noise.

      Finally, make sure everything is handled (e.g., laying out tomorrow’s clothes) before you get into your nice, comfy bed.

      If your mind is still active, write a to-do list to help you fall asleep faster.[7]

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      Above all, be gentle with yourself and count your blessings, some sheep or whatever helps.

      This article also offers practical tips to build a bedtime routine: How to Build a Good Bedtime Routine That Makes Your Morning Easier

      E — Exercise

      Many people know that exercise is good for them, but just can’t figure out how to fit it into their busy schedules.

      That’s what happened in my case.

      But when my chronic stress and exhaustion turned into systemic inflammation (which can lead to major diseases like Alzheimer’s), I realized it was time to change my lifestyle.

      As part of my lifestyle upgrade, I knew I needed to move more.

      My friends who exercise all gave me the same advice: find an exercise you like to do and find a specific time in your schedule when you can consistently do it.

      That made sense to me.

      So, I decided to swim.

      I used to love to swim when I was young, but I hadn’t done it for years. The best time for me to do it was immediately after work, since I could easily get an open swim lane at my local fitness club then.

      Also, swimming became a nice reason for me to leave work on time. And I got to enjoy a nice workout before eating dinner.

      Swimming is a good way to get your cardio or endurance training. But, walking, running and dancing are nice alternatives.

      So find an exercise you love and stick to it. Ideally, get a combination of endurance training, strength training and flexibility training in during your daily 20-minute workout.

      If you haven’t exercised in a while and have a lot of stress in your life, you may want to give yoga a try because you will increase your flexibility and lower your stress.

      A — Attitude

      Stress may be a major reason why you aren’t feeling well all of the time. At least that was the case with me.

      When I worked 70 hours per week as a High-Tech Executive, I felt chronically stressed and exhausted. But there was one thing that always worked to help me feel calmer and less fatigued.

      Do you want to know what that master stress-busting technique was?

      Breathing.

      But not just any old breathing. It was a special form of deep Yogic breathing called the “Long-Exhale Breathing” or “4-7-8 breathing” or “Pranayama” in Sanskrit).

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      Here’s how you do “Long-Exhale Breathing”:

      1. Sit in a comfortable position with your spine straight and your hand on your tummy (so you know you are breathing deeply from your diaphragm and not shallowly from your chest)
      2. Breathe in deeply and slowly from your diaphragm with your mouth closed while you count to 4 (ideally until your stomach feels full of air)
      3. Hold your breath while you count to 7 mentally and enjoy the stillness
      4. Breathe out through your mouth with a “ha” sound while you count to 8 (or until your stomach has no more air in it)
      5. Pause after you finish your exhale while you notice the sense of wholeness and relaxation from completing one conscious, deep, long exhale breath
      6. Repeat 3 times ensuring your exhale is longer than your inhale so you relax your nervous system

      This type of “long-exhale breathing” is scientifically proven to reduce stress.

      When your exhale is twice as long as your inhale, it soothes your parasympathetic nervous system, which regulates the relaxation response.[8]

      Plus, this is a great technique for helping you get to sleep, too.

      N — Nutrition

      Diet is vital for beating fatigue – after all, food is your main source of energy.

      If your diet is poor, then it implies you’re not getting the nutrients you need to sustain healthy energy levels.

      Eating a diet for fatigue doesn’t need to be complicated, time-consuming though.

      For most people, it’s just a case of swapping a few unhealthy foods for a few healthier ones, like switching from low-fiber, processed foods to whole, high-fiber foods.

      Unless your current diet is solely made up of fast food and ready meals, adjusting to a fatigue-fighting diet shouldn’t be too much of a shock to the system.

      Here’re 9 simple diet swaps you can make today:

      1. Replace your morning coffee with Matcha green tea and drink only herbal tea within six hours of bedtime.
      2. Add a healthy fat or protein to your any carb you eat, especially if you eat before bed. Please note that carb-only snacks lead to blood-sugar crashes that can make you eat more and they can keep you from sleeping.
      3. Fill up with fiber especially green leafy vegetables. Strive to get at least 25g per day with at least 5 servings (a serving is the size of your fist) of green vegetables.
      4. Replace refined, processed, low-fiber pastas and grains with zucchini noodles and whole grains such as buckwheat, quinoa, sorghum, oats, amaranth, millet, teff, brown rice and corn.
      5. Swap natural sweeteners for refined sugars and try to ensure you don’t get more than 25g of sugar a day if you are a woman and 30g of sugar a day if you are a man.
      6. Replace ice cream with low-sugar alternatives such as So Delicious Dairy-Free Vanilla Bean Coconut Ice Cream.
      7. Swap omega-6, partially-hydrogenated oils such as corn, palm, sunflower, safflower, cotton, canola and soybean oil for omega-3 oils such as flax, olive and nut oils.
      8. Replace high-sugar yoghurts with low-sugar, dairy-free yoghurts such as Kite Hill Plain Yoghurt with 1g sugar or Lifeway Farmer Cheese with 0g sugar.
      9. Swap your sugar-laden soda for sparkling water with a splash of low-sugar juice

      Also, ensure your diet is giving you enough of the daily essential vitamins and minerals. Most of us don’t get enough Vitamin D, Vitamin B-12, Calcium, Iron and Magnesium. If you are low on any of the above vitamins and minerals, you may experience fatigue and low energy.

      That’s why it’s always worth having your doctor check your levels. If you find any of them are low, then try to eat foods rich in them.

      Alternatively, you might consider a high-quality multi-vitamin or specific supplement.

      The Bottom Line

      If you are tired of feeling tired, then there is tremendous hope.

      If you are tired because you are not getting enough high-quality sleep, then the best remedy is a bedtime routine based on sleep best practices.

      If you are tired because you have stress and fatigue, then the best remedy are four simple lifestyle changes including:

      • Enough High-Quality Sleep with Bedtime Routine
      • Regular Exercise You Love
      • Stress Reduction with Long-Exhale Breathing
      • Fatigue-Reducing Diet

      Overall, adopting a healthier lifestyle Is the ideal remedy for feeling more rested and energized.

      More Tips to Help You Rest Better

      Featured photo credit: Cris Saur via unsplash.com

      Reference

      [1] YouGov: Two-fifths of Americans are tired most of the week
      [2] National Safety Council: Is Your Company Confronting Workplace Fatigue?
      [3] The New York Times: Why Are We So Freaking Tired?
      [4] Mayo Clinic: Chronic fatigue syndrome
      [5] Mayo Clinic: Lack of sleep: Can it make you sick?
      [6] Ask Dr. Sears: The L.E.A.N. Lifestyle
      [7] American Psychological Association: Getting a Good Night’s Sleep
      [8] Yoga International: Learning to Exhale: 2-to-1 Breathing

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