The New World Economics Guide to Curing Lower Back Pain

September 2, 2012

A friend was asking me about what to do about back pain. This is is something I happen to know about. In late 2001, I developed extreme lower back pain, due mostly to sitting oddly on the floor for extended periods of time. (I was playing Starcraft.) Eventually "something happened," and the worsening condition could no longer be ignored. For two weeks, I laid on the floor, unable to stand, walk, or sit for any length of time. I immediately went to a chiropractor, bypassing all regular doctors and hospitals, who don't really have anything to offer.

The chiropractor developed a schedule for relieving the immediate pain. It involved four visits a week, including various treatments to reduce muscle tension in the lower back area. The office was three miles away, so I had to drive. It took maybe six or seven minutes. This six or seven minutes of driving was so painful that, when I arrived at the office each time, I would get out of the car and lie on the parking lot next to the car -- it was dirty but I didn't care -- for five to ten minutes, until the pain subsided enough that I could walk into the building. Then, I would do it again on the way home.

Over the next four years, I made roughly 150 visits to the chiropractor, gradually reducing the frequency to three times a week, twice, once, every other week, once a month and so forth. I paid for all of this out of pocket. It was worth it.

If you are in a crisis situation like I was, you need to go to a chiropractor, and you need to do it a lot. However, any good chiropractor will tell you that a few minutes per week in his office is not enough. You have to change everything you do, to relieve whatever it is that caused the back problems in the first place. The chiropractor can help get you out of a crisis situation and establish the conditions for further healing, but the healing process is mostly up to you.

If you have less dramatic back pain, I would still go to the chiropractor. It would probably take a lot fewer visits, perhaps once a week to start, but the basic process is the same.

After a few weeks, I could sit and walk enough to work, taking regular rest breaks by walking outside the office. After a few months, I could go hiking and do other outdoor sports that were not too back-intensive, if I was careful. However, it was nearly five years (mid-2006) before I even attempted to do ten situps in a row. Today, I can say that I have made a 100% recovery. I can do hundreds of situps and other back-intensive activities, and have no back pain at all.

Simply going to the chiropractor is not enough. You have to change everything that aggravates your back. Here's what you do:

Fix your bed. You spend eight hours a day lying on your bed. It had better be OK. Standard mattresses (springs/padding) wear out after about seven years. Yes, even the expensive ones. If your mattress is more than seven years old, or even five years, then you need a new one even if it looks OK. I junked my old mattress. I used an air mattress for a while, which helped, but now I prefer a memoryfoam mattress. Tempurpedic is the high-end brand here, but foam is pretty simple stuff and the memoryfoam mattresses sold on eBay for about $280 in full size are fine. You also need a good pillow. I use a memoryfoam "cervical" pillow, which is thickest under your neck.

Fix your car seat. You spend a lot of time sitting in your car. Start by moving the driver's seat all the way forward, and move the backrest to vertical. Put the lumbar support setting at maximum, if you have one. If you don't have built-in lumbar support, then maybe add a lumbar cushion. This will look and feel silly, but it will also push your hips all the way back in the seat and straighten out your spine. No more slumping while driving. After you get used to this, over a few weeks or months, then you can adjust your seat to a more typical position but which maintains your good driving posture.

Don't sit on the floor. Chiropractors say they get a rush of new business around Christmas because people sit on the floor for extended periods to wrap packages. Sitting on the floor is quite hard on your back. Don't do it for long periods of time, over thirty minutes.

Take your wallet out of your back pocket. Sitting on your wallet can lead to a pelvis imbalance.

Fix your office chair. This is one of the most important things to us office workers, or people who use their computers at home a lot. There are a zillion suggestions about this or that kind of fancy chair, or very tweaky adjustment of your chair, or whatever. I have been through most of these, and didn't get much results from them. What did produce huge results was to a) get a standard adjustable office chair, and b) remove the back. Yes, just take the back off, so you end up with a sort of stool with armrests (or no armrests). This will prevent you from slumping against the back. Adjust the height to something vaguely appropriate. That's it. Don't waste your time on fancy ergo chairs and this sort of thing. Just take the back off. If you want to get really fancy, some people have bought used running treadmills on Craigslist (often lots of them cheap there), and set up a standing desk. They put the treadmill at a very low speed, like one mile per hour, and actually walk slowly all day while doing their work on the computer. If you can do this, it might be a good solution. Walking is very good for your back. However, if that is too elaborate, just get a regular adjustable office chair and take the back off.

Fix your easy chair. At home, you probably have a sofa or easy chair that you use to watch television, read books, and maybe take a nap. The best one I've seen for back health is the Perfect Chair. It's expensive but worth it. I've had one for over ten years now. However, as back-friendly as this may look, I find that it becomes problematic after about three hours. I tried working from this chair, but the office-chair-without-the-back is actually better for long stretches. Add a lumbar cushion of some sort. Avoid any chairs or sofas that cause a slumping posture and convex lower back, which is basically all of them.

That should take care of most of the daily-habit stuff that is causing your back problems. Now let's talk about more therapeutic sorts of rehabilitation procedures.

Drink lots of water. Almost everyone these days is dehydrated. People don't notice because they are so sedentary. However, if you get at all thirsty from a three-mile run, then that means you didn't have enough water in your body to start. (If you have enough water in your body, you can do a three mile or even ten mile run without getting thirsty.) The discs in your back are like sponges. If your body is dehydrated, the discs dry out and the bones in your spine compress, squeezing the nerves emanating from your spine. The solution is to rehydrate your body properly. Drink an additional two liters of plain water daily for two weeks. Avoid diuretics like coffee, tea and alcohol.

Stretch. Tension in your muscles in your butt and lower back can pull your spine out of alignment. Various hamstring-type stretches will also stretch your lower back and butt area. Also, you can do yoga "cat stretch" type poses, where you move your lower back from convex to concave and back again. I find that twisting-type stretches also help. You might find that as little as two minutes of a hamstring-type stretch gives noticeable relief. If so, do it more.

Use a back inversion device. Look into various types of gravity boots, inversion tables and other inversion machines that allow you to hang upside down from your legs. I used a "back revolution" device. It helped. I like to do twisting stretches while inverted.

Walk. Sitting and lying down are bad for your back. Walking is good. Walking builds up the muscles around your back, and the gentle motion promotes flexibility of the spine. Your back will often adjust itself into proper alignment with some easy walking. You can feel it move. Walk without a pack, and no longer than feels comfortable. Walk a little every day if you can.

Take many breaks. If you are sitting at a desk for long periods, take five minutes every hour, or even every half hour, and take a short walk. Just a few hundred meters is enough, maybe combined with some quick hamstring-type stretches.

That's it. If it worked for me, when I was unable to sit or walk, it should work for you too.

Addendum: A couple people mentioned Dr. John Sarno, a former back surgeon, who concluded that many people's lower back pain problems were related to "Tension Mytosis Syndrome," or, more generally speaking, stress. In other words, your mind. A good introductory book is Mind Over Back Pain, available at Amazon. I think that back pain can also have more physical sources, in my case sitting in funny ways, as was shown in X-rays of my spine showing various contortions. But, many people's issues may be primarily stress-related, in which case, a different approach would be good. Certainly, there are enough people who have reported fantastic results that it is worth a look.