The Daily Spine
Tips for Living Well With Back Pain
Your spine can move in a number of different directions. Kinesiologists categorize the directions as flexion (bending forward), extension (bending back), side bending and twisting.
When you are still, a well aligned spine is usually in a neutral upright position, with the natural spinal curves preserved. The natural spinal curves help you to balance your body and help to absorb shock that comes from wear and tear, impact and movement.
Introduction to Spinal Flexion
A movement most of us are very familiar with is spinal flexion. Spinal flexion refers to the act of bending forward. Gravity and daily activities such as sitting at the computer, driving and carrying children have the tendency to incrementally pull the spine forward into flexion. This can happen over time, and unless you are very astute about your posture, you might not even notice it until it starts getting extreme, or it results in an injury.
Spinal Flexion and Posture, Injury and Pain
In addition to affecting your appearance, spinal flexion can contribute to postural imbalances such as kyphosis, scoliosis and sway back. If your spine is constantly in flexion, it may set you up for an injury known as a herniated disc. Herniated disc occurs when the annulus fibrosus of the spinal disc (cushion in between vertebrae) frays or breaks, and the liquid center (nucleus pulposus) squirts out. If the nucleus pulposus lands on a spinal nerve root, you'll probably have pain and other nerve symptoms (known as radiculopathy). This injury may go away on its own or with the help of physical therapy, but many people opt for a surgery known as a discectomy in order to get faster pain relief.
Spinal Flexion and Neurogenic Claudication
If you have spinal stenosis, you may have the classic symptom of neurogenic claudication. Physical therapists often give exercises that specifically enhance spinal flexion to help relieve the discomfort and pain associated with this syndrome.
Prevent Spinal Flexion-Related Back Problems
The easiest way to prevent back problems due to spinal flexion is to maintain a back exercise program. In particular, yoga and Pilates not only strengthen muscles but they also develop your spinal alignment. With these systems, you'll exercise your back in all the directions your spine can move. They emphasize balanced action and whole-body alignment to help bring your posture into neutral. Incorporating them into your regular routine may well help you reduce pain and increase back flexibility.
Working in balance and alignment means that some of the strength exercises are done with your back arched and/or twisted. Because arching, and to some degree twisting, are opposite actions to spinal flexion, such exercises may counter the tendency toward spinal flexion and thereby reduce associated risks to your back. (NOTE: There are some spinal conditions such as arthritis, facet joint problems and others that may be irritated by arching and/or twisting your back. And, twisting may irritate a herniated disc. If you are unsure, ask your doctor or physical therapist for the back exercises that are appropriate to your condition.)
Basic Back Exercises to Counter Spinal Flexion
Here are a few basic exercises that may help alleviate problems due to spinal flexion:
Elnaggar IM, Nordin M, Sheikhzadeh A, Parnianpour M, Kahanovitz N. Effects of spinal flexion and extension exercises on low-back pain and spinal mobility in chronic mechanical low-back pain patients. Spine (Phila Pa 1976). 1991 Aug;16(8):967-72. http://www.ncbi.nlm.nih.gov/pubmed/1835157