- The Washington Times - Tuesday, December 18, 2001

'Tis the season to be jolly, to pack our car trunks with presents and to shovel away any snow that clogs our driveways.Inevitably, it's also the season to grab at our lower backs in pain from one or all of the above.

Back pain doesn't have a favorite time of year. It inspires nearly 12 million visits a year to doctors, according to the American Association of Orthopaedic Surgeons.

The holidays, though, offer many risks for those prone to back attacks, from snowfalls to presents in need of hauling. Even that car trip to visit a favorite aunt can mean hours sitting in a potentially uncomfortable car seat.

So far, this December hasn't served up any snow to be shoveled but the season's stressors can leave revelers feeling positively Grinch-like.

Dr. William C. Lauerman, Georgetown University professor of orthopedic surgery and chief of its division of spine surgery, says the causes of each particular case can remain unknown.

"With acute backache, it's difficult to know for sure whether that's strained muscles or strained ligaments or bulging disks," he says.

Most back problems are self-limiting, he says, and will stop within a few weeks. The stabbing pain felt with every movement, though, is enough to make people avoid strains, particularly during the holidays.

It is difficult to determine where a backache originates, says Dr. Warren Yu, assistant professor at George Washington University's department of orthopedic surgery.

"The back is made up of a multitude of muscles and ligaments. It's hard to pinpont what structure is injured," Dr. Yu says.


Less of a mystery is how to keep your back happy.

Come December, care should be taken when hauling presents back and forth. Dr. Lauerman blames the average car's trunk.

"It's so poorly designed for the ergonomics of your back," Dr. Lauerman says. "It requires you to bend forward at the waist and lift up there's almost no way around it. Putting things into the trunk is almost as bad."

Sport utility vehicles allow objects to be slid onto the edge of the compartment, which isn't as dangerous, he says.

Much of the trouble stems from the lumbar region of the spine, five bones stacked upon each other that connect the upper spine to the pelvis. The lumbar region provides mobility and strength and assists in twisting and bending. It also is the area most prone to strains.

Dr. Lauerman says those susceptible to back pain should get someone else to do the heavy lifting for them. If that isn't an option, he suggests moderation when shoveling.

"If you have no choice cut the load down. You don't have to scrape the pavement each time," he says.


Not every backache will retreat over time.

"If they have pain radiating down their leg, that could be evidence of nerve compression or irritation," Dr. Lauerman says of back patients.

He suggests listening to one's body and taking greater care as one ages.

For less serious conditions, "cut back [on physical activity], take some over-the-counter medicine like Tylenol and use moist heat [on the afflicted area]," he says.

For lifting any item off the ground, he suggests the time-tested wisdom of bending at the knees, no matter the size of the object one is trying to lift. The object should be placed as close to one's body as possible.

Back strains can be avoided by keeping the muscles in peak form.

Venne Williams, a fitness instructor at Alexandria's Fitness First health club on South Van Dorn Street, says clients often ask her for tips on back-related exercises.

One woman says she hurt her back recently by lifting her 8-month-old baby.

"You never really know," Miss Williams says of the source of such ailments. Stress, poor posture, even being overweight all can play a role.

Typically, when we strain our back we injure our erector spinae muscles, the deep muscles felt in the lower back. When a disk is the source of the problem, Miss Williams says it typically is the fourth or fifth lumbar disk, those directly above the sacrum (a thick, triangular bone near the lower end of the spinal column).

During the holidays, people often need to stretch to reach a shelf or a hidden gift or to place an ornament atop the Christmas tree.

"If stuff is above your head, you need to step on a stool [to reach it]," Miss Williams says.

She also advises people to avoid twisting their torsos when lifting or passing along heavy items.

If your back already aches, Miss Williams says the latest thinking advises against bed rest.

"The new trend in rehabilitation is less rest and [more] mild activity," she says.

A good way to assuage back pain is to take the strain off the back for a spell. To do so, she says, lie on your back on the floor, bend your knees and place your feet on a chair. This position extends the back, which releases pressure on it and, hopefully, cuts the pain level. This can be done for 12 minutes a day.

"It puts muscles in a state where they're not at work," she says.


One way to prevent backaches in the first place is to strengthen the muscles surrounding the spine.

One exercise Miss Williams recommends involves lying flat on the floor, face down; lifting up your arms, legs and head for a count of three seconds; and then releasing.

Or a person can lie on the stomach as before, but raise the left arm and right leg off the ground, hold, then do the opposite limbs. Each can be held for three seconds. Miss Williams recommends performing two sets of 12 such exercises.

Warm-up exercises should be done before any strength training, but given that the back keeps the body erect, a simple light jog should suffice.

Don't neglect stretching the rest of the body as well. Tight hamstrings can cause back problems because the muscles connect to the pelvis, which connects to the spine, Miss Williams says.

Those seeking to develop a powerful chest should keep the flip side, their back muscles, in mind.

"If you're strengthening your [pectoral]s, you have to balance it," Miss Williams says.

Those older than 35 should get medical clearance before beginning any workout regimen, she says.

"You don't want to make the problem more severe."

Sometimes a practical purchase can help stave off back problems.

Hana Washington, manager of the Healthy Back Store in Bethesda, says sales are brisk during December, even more than at other retail outlets.

"They want to get that special gift for people who have been living with back pain," Miss Washington says. Among the more popular items are beds made from memory foam, technology she credits to the National Aeronautics and Space Administration. It provides support without counterpressure and eases back tension.

Another hot item is the Perfect Comfort Chair, which retails for about $400 and provides comfort for those who sit in front of a computer for hours at a time. Its slightly curved, concave seat back provides lumbar support.

Long car rides to see the relatives are another seasonal concern. Customers can opt for lumbar pads and seat supports to make those trips less tortured.

Even a person's bed can be a potential problem.

Miss Williams says not to spring out of bed each morning, even on Christmas Day.

Instead, she says, roll to the side, bend the knees and push up with your arms to reduce strain on the back after hours of inactivity.

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