Spine Health

10 Rules for a Healthy Back

1. Exercise regularly.

Exercise is critical to muscle strength, and strong back muscles help support your spinal column. Wall squats and leg lifts are good for your back, and many yoga poses help keep your back muscles strong.

2. Keep your back straight.

Your mother was right, good posture helps keep your spine healthy by allowing it to maintain its natural shape and keeping blood flowing. Poor posture can stress your spinal column and constrict blood flow.

3. Kneel to bend.

Bending at the waist puts pressure on your spinal column, bend your knees and lower your whole body when you need to bend, rather than folding over at the waist.

4. Don’t lift heavy objects.

Your back wasn’t designed for lifting heavy objects, use rolling suitcases, hand trucks, or other devices meant to carry the load for you.

5. Spread out loads evenly and keep them next to your body.

Don’t try to carry a heavy load on one side of your body, it puts pressure on your vertebrae, and don’t carry anything at arm’s length. If you must carry a load, keep it centered and close to your body. That goes for kids too, don’t them carry a heavy backpack slung over one shoulder.

6. When sitting, keep your back straight and support your upper body.

Keeping your back straight when sitting keeps it in its proper position and reduces pressure on your vertebrae.

7. Do not stand with straight legs.

Keeping your knees “soft,” rather than locked straight, when you stand reduces stress on your spinal column.

8. When lying down, keep your legs bent.

Keeping your legs bent when lying down allows your spine to maintain its natural shape. Lying flat (either face up or face down) forces your spine to either flex or extend and puts pressure on your discs.

9. Do sports, particularly swimming, running, or cycling.

Many sports provide a good workout without seeming like work. Get your exercise by swimming, running, cycling, or engaging in other sports that get your heart pumping and your muscles moving.

10. Train your spinal muscles every day.

Teach your spinal muscles to support your spinal column, exercise to keep them strong.

Functional Sitting Positions

Forward ready position

Perch on the edge of the chair, lean into desk while maintaining low back arch and avoid rounding shoulders forward. This position works especially well for writing.

Upright functional ready position

The typical upright posture with the back supported or, if the seat is tilted, sitting for short periods of time without using the backrest to work on postural endurance.

Semi-reclining position

Use if the chair has a reclining feature. This position may work best while talking on the phone if there is little or no need to write.

Standing

Rest one hand on the desk and bend at hips if needing to write.

Lumbar Support Cushion

A lumbar roll, small pillow or towel roll can be used.
Sit all the way to the back of the seat and place the support in the small of the back.
The support should maintain the natural curve of the back.
More support may be necessary on a softer chair.

Stress Wedge Cushion

Place the stress wedge at the back of the seat with the thickest part to the back.
Sit all the way to the back of the seat on the wedge.
The stress wedge will tilt the pelvis to help maintain the natural curve of the back.
The stress wedge can be used alone or with the lumbar support.

Computer Ergonomics

Balanced Posture Alignment

Ears and shoulders in line with hips.

Height Adjustment

Feet flat on floor, or use a foot stool.
Keep thighs parallel to floor, create 90 – 110 degree hip angle.
Ensure leg clearance from desk or keyboard tray.

Lower Back Support

Adjust lumbar support to maintain an erect sitting posture.
Add lumbar support if needed.

Seat Pan

Depth of seat should allow two finger widths behind knee.
Tilt at 30 degree angle, or add stress wedge.

Neutral Typing Position

Use an adjustable chair, keyboard tray, or desk/table to achieve the “neutral position” of a straight hand, wrist and forearm.
Arm rests ½ inch above elbows and ½ inch below the desk.
Keep upper and lower arms at a 90 degree angle.
Position mouse close to keyboard to minimize reaching and twisting.

Viewing Angles and Distance

Position monitor, keyboard and chair in a straight line.
Top of monitor screen at or slightly below eye horizon.
Comfortable distance to read monitor (typically 15 – 30 inches).
Adjust brightness, contrast and color to comfortable levels.
Avoid glare by positioning away from windows and direct lights.
Keep written work materials propped up near monitor screen on a document holder to avoid repetitive neck movement.

Laptops

Place on an elevated surface.
Add an external monitor, keyboard, and mouse.
Use a port replicator or docking station.
Keep wrists neutral.
Rest forearms or elbows on work surface to avoid strain.
Avoid using on couch or recliner

Proper Lifting Techniques

Many lower back injuries come about as a result of poor lifting techniques, something that physiotherapists are uniquely placed to address. Safe lifting techniques given below.

Squat lift

Squat, remember to:

Keep back straight
Knees behind toes
Keep knees parallel

Golfer’s Lift

The Golfer’s lift is another lifting technique that is useful for picking something off the floor
This works best when using something like a chair or table for support when bending
Kick out the unsupported leg – This helps to keep the back straight

Sleeping Position & Neck Pain

Worst Sleeping Position for Neck Pain

Without a doubt, sleeping on your stomach is the worst position for both acute and chronic neck pain. When you sleep on your stomach, you have to twist your head and neck to the side, which puts a lot of pressure on the nerves coming out of your neck.

In addition, sleeping on your stomach causes misalignment of the shoulders. Not only will this give you shoulder problems, but often we find that trigger points in the shoulders are causing neck pain.

That said, if you prefer to sleep on your side, make sure you lay on the side that isn’t painful. Draw your legs up toward your chest and place a pillow between your knees. Finally, make sure that your pillow is not abnormally elevating your head.

Best Sleeping Position for Neck Pain

If you suffer from neck pain, it’s important to make sure your neck is supported while you sleep.

The best way to support your neck is either sleeping on your back or your side. However, it’s very important to make sure you have the right pillow for your head and shoulders.

If you’re sleeping on your back, you’ll want to make sure that the pillow supports your neck, but doesn’t lift your head up too high (creating forward head posture).

An orthopedic or roll pillow are good options for people with neck pain. If you prefer to sleep on your side, again… make sure your pillow isn’t too high.

Rules of healthy sleepers

How to Find the Right Pillow for your Neck

Side sleepers

Sleeping on your side is the most common position for people to sleep in. The problems associated with this position are: scrunching your shoulder or bending your neck, putting an arm under your head or pillow, and sacroiliac pain from the top leg pulling in a downward angle.

The Fix:

Use a thick pillow, or even two pillows, to take up the full space between your neck and your shoulder. This keeps your neck straight and your shoulders back. Having the right sized pillow should take away the need to put your arm underneath it for more support and take away the numbness in your arms that can cause.

Side sleeping can also cause some trouble in the lower back, also. This is especially true for those with prior sacroiliac pain, wider hips or during pregnancy. A pillow between the knees can reduce the pull on the sacroiliac joint.

Back Sleepers

Sleeping face-up is the next most common position. This position is neutral for both your back and neck. However, problems can crop up if your neck stays bent forward all night.

The Fix:

Back sleepers need to use a very thin pillow or no pillow at all to keep the cervical spine straight. A thick pillow in this position causes the neck to flex forward, stretching neck muscles, pinching the nerves that go to the arms, and restricting your airflow.

Stomach Sleepers

The least common sleeping position has the most controversy surrounding it. Many consider this an undesirable position and recommend trying to change the habit. However, accommodations need to be made to avoid having your neck at a ninety-degree angle.

The Fix:

As shown in the picture above, position your pillow on the back of your head, so your face points down at a 45-degree angle. This keeps your nose out of the mattress allowing you to breathe, but lessens the angle of your neck, reducing strain on the ligaments and joints that can develop with prolonged extreme rotation.

Proper sleeping position – Relieve the pain

Neck pain, shoulder pain, back pain, and feet pain cause inability to sleep well. Some suggestions to find a suitable sleeping position for your health and a good night’s sleep are as below:

Back pain: If you have back pain at night, sleeping face up is the option. Put a pillow under your feet to restore natural curves and relieve stress on your spine.
Neck pain: If you have neck pain, keep in mind that the neck must always be supported during sleep. Sleep with a pillow in a face up position and a pillow under each arm will help reduce neck pain. If you like to lie on your side, choose a thin pillow under 15 cm.
Shoulders pain: Put a pillow under the head and another pillow under the stomach area. The pillow close to the belly will help stabilize the shoulder. Note that sleeping face down can cause your shoulders to be imbalanced.
Leg pain: If you have trouble sleeping due to leg pain, use a pillow to support your leg while sleeping. This will help to improve blood circulation to the feet.

What is the best way to sleep for good posture?

Sleeping on your back or side keeps your spine in the most neutral position, If you choose to sleep on your side, make sure to support your pelvis with a pillow between your knees.

Take a look at the type of pillow that you use. If you sleep on your back, you need a lower pillow. Remember that the neck is what really needs to be supported vs. your head. If you sleep on your side, there’s a bigger negative space between your head and shoulder, so you need a firmer and higher pillow.

Tuck the bottom of the pillow above the shoulders. The pillow should support your neck, not your shoulders.

Medium-firm mattress is best. A mattress that is too soft will cause the heaviest parts of your body to sink, while a too firm mattress will not support the curves of the spine.