How to beat backache

Four out of five of us will suffer at some time – but not for the reasons we think. Alison Taylor consults the experts and sets the record straight on beds, bad posture and bending

Tuesday 20 May 2008 00:00 BST

This morning, you probably didn't think twice about slinging your overstuffed bag over your shoulder, while reaching for the keys with one hand and backing out of the door with a piece of cold toast in the other. But there may come a time when one of these simple, everyday manoeuvres will trigger a backache bad enough to call in sick, see a doctor or, at the very least, pop a few painkillers.

Four out of five of us will develop a back injury at some point in our lives and, according to research published last month by the health club LA Fitness and the charity BackCare, half of us will have suffered in the past year alone.

But a few simple changes can stop you adding to the statistics. The trick, says Garry Trainer, the osteopath, acupuncturist and author of Back Chat: The Ultimate Guide to Healing and Preventing Back Pain (Arum Press, £10.99), is to separate the misconceptions from the facts. "A lot of the advice floating around out there is unhelpful or, in some cases, even harmful," he says.

We asked Trainer, who treats Sir Paul McCartney and Gwyneth Paltrow, and other experts to set the record straight on preventing and treating back pain.

Does Lifting heavy objects strain your back?

Most injuries are caused not by what you pick up, but how. "The majority of onsets [of pain] are very innocent," Trainer says. "Switching on your computer, turning your head too quickly, even sneezing. It's about making the wrong move at the wrong time."

When lifting, follow this drill: squat, keeping your back straight; grab the object, bringing it close to your body; and stand up, making sure that your thigh and bottom muscles are taking some of the strain.

Just grabbing a pen off the floor? You still need to follow the drill, as even twisting the wrong way can harm your back. "There are so many 'innocent' movements you can make before one of them becomes the straw that breaks the camel's back," Trainer says.

Will Sitting up straight keep your spine in line?

While your mum was right to stop you hunching over, holding yourself too upright isn't as good for your back as you might think. Researchers at Woodend Hospital in Scotland found that people who sat at a 90-degree angle strained their spines more than those who reclined at 135 degrees. "The key is to vary your posture and not stay in one position for too long," Trainer says.

Lack of movement is just as problematic as lots of repetitive ones, since staying in the same position for extended periods puts a lot of stress on the discs of your spine.

"If you spend much of your day at a desk, remember to adjust your posture regularly," Trainer says. "Try this position for a good back break: lean back slightly in your chair with your feet on the ground – you should have a slight curve in your lower back. It helps distribute your body weight more evenly and takes some of the pressure off your spine. You should also sit with your pelvis slightly higher than your knees, so try a foam wedge or cushion under your bottom." Trainer strongly recommends desk breaks every 40 minutes – stand up and walk around, or do some seated stretches.

Is exercise hard on your back?

Researchers from Samsung Medical Center in South Korea found that working out at least three times a week actually reduced the risk of developing chronic back pain by 43 per cent. Exercise strengthens your back muscles and increases blood flow to the discs, helping them to withstand daily strain. It also keeps your waistline in check, which has a huge payoff for your back: overweight people are three times as likely to go to hospital with a back injury than those at a healthy weight, a recent study has found.

To get this message across, LA Fitness and Backcare have joined forces to launch the Put Your Back Into It campaign, promoting back-care exercise programmes. Low-impact aerobic exercise – such as walking, swimming or using the elliptical machine is best – and Pilates is also good. But make sure you warm up first – this increases blood flow to your back muscles, making them less likely to strain.

Is back pain is always caused by an injury?

Rather than a one-off accident or injury, it tends to be the stuff of everyday life that causes the majority of back pain. According to a study in the Journal of Advanced Nursing, simply feeling overwhelmed at home or work makes you twice as likely to suffer lower back pain. "Mental stress causes the smallest units of the muscle, the fibres, to tighten," Trainer explains. "And, over time, clenched muscle fibres wear down, upping the risk of injury. To make matters worse, your body's natural response to stress – an increase in muscle tension – can aggravate existing back problems.

"So, the next time you feel the pressure rising, make a point to get at least half an hour's relaxation, no matter how frenzied you feel. A hot bath or shower when you get home is one of the best ways to decompress, because heat can relax muscles as well as minds."

Back already in knots? "Getting a massage will help to loosen muscles and relieve pain." Find yourself a massage therapist through Massage Therapy UK (

Do Alternative treatments really work?

In some cases, alternative treatments may be more effective than conventional physical therapy and medication. A recent German study found that half the lower back patients who had two acupuncture sessions a week for six months reported a significant reduction in pain. According to Trainer, who combines acupuncture with osteopathy and massage therapy, acupuncture increases circulation to the affected area, thus modulating the pain impulses and releasing pain-relieving endorphins (they have a similar chemical structure to morphine).

Research also shows that seeing an osteopath may help you to feel better faster. These practitioners believe that back pain is caused by dislocations in the vertebrae. During an "adjustment", gentle force is applied to the spine to stretch the joints and realign them. You can find registered practitioners through the General Osteopathic Council ( and the British Acupuncture Council (

Are super-firm beds best for bad backs?

Actually, it might be the source of your pain. Finding a back-friendly mattress is like the Goldilocks scenario: a too-soft one won't offer enough support, and one that's rock-hard can increase pressure on the spine, so you need to find one that's just right for you. A study in The Lancet found that people who sleep on a medium-firm mattress experienced less back pain – and popped fewer pain relievers – than those with a harder one.

Can't afford a brand-new bed? Mattress pads, such as those available from John Lewis (from about £50), can cushion an extra-firm mattress, while placing a bedboard, like one from Medesign (£47.95; under the mattress will stop it sagging.

This health report features in the June issue of the new monthly magazine 'Shape', on sale now.

Spinal tips: what to do when you're struck down

The first 24 hours

It's difficult to come up with a diagnosis in the first day of back pain because the affected area will be inflamed. Inflammatory substances are like glue; they adhere muscle fibres together, reducing mobility. The key is to take it easy – lie flat on your back if you can. Anti-inflammatory drugs, such as aspirin or ibuprofen, are good for relieving pain. Apply ice to the injured area to prevent inflammatory substances from entering the tissue and to speed up recovery. Try using a bag of frozen peas. It's best not to apply heat at this point.

Day two

Your back may start to feel more bruised than painful – that's a sign that it's beginning to heal. Keep taking it easy, but try to walk around a bit to stimulate circulation. Always listen to your body, as it will invariably be telling you something useful. Some types of back pain (usually muscular) may start to feel better with gentle movement, but others (usually nerve types) will hurt more. If you find the pain gets worse as you move about, be sensible and go back to bed.

Day three

This is the important period as regards the seriousness of the problem. If the intensity of the symptoms is decreasing, it's very likely your back is regulating itself and there should be no need to see a specialist. If you now have an ache rather than a pain, you can start treating yourself with heat rather than ice (try applying a warm water-bottle to the area).

If, however, the pain feels worse or if it has moved to your arms or legs, make an appointment to see your GP. It's usually a good idea to use your doctor as an impartial first port of call as they can give you medication to reduce inflammation and pain, and will advise you on the next steps of treatment to take.

To enquire about an appointment with Garry Trainer, call 020-7722 6203 or visit

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