The Importance of Good Posture in Reducing Back Pain

The spine has three primary functions:

          1. It allows for movement between the different parts of the body

          2. It bears the forces applied to it (i.e. gravity, backpack, carrying a child, posture)

          3. It protects the spinal cord and exiting nerve roots

The spine requires muscle force and ligament tension operating within a control system so that it can resist buckling upon application of force (i.e. stretch, compression, shear, torsion) and subsequently maintain equilibrium[1].[2] This task is carried out by three distinct, yet intertwined, parts:

1. Vertebrae, spinal joints and their capsules, intervertebral discs, and spinal ligaments make up the Passive Musculoskeletal System. These components produce information regarding spinal position, the load(s) placed on each vertebra, as well as the motion (or lack thereof) of each vertebra, and via transducers[3] provide the Neural and Feedback System this information in real time.

Learn more about Spinal Anatomy <--- HERE

Learn more about Vertebral Discs  <--- HERE

Learn more about Spinal Ligaments <--- HERE

2. The Active Musculoskeletal System produces the forces necessary to carry out activities of daily living while simultaneously providing the spine its required stability. This system consists of the muscles and tendons that surround the spine.

3. The Neural and Feedback System determines the exact necessities for spinal stability via transducers located in every ligament, tendon, muscle, and neural control center (spinal cord gray matter, brainstem, cerebral cortex, cerebellum, and basal ganglia) that measure the forces and motions induced in/on the body. This sub-system then uses that information to determine the appropriate individual muscle tensions within the active sub-system so that it can fulfill its part of the stability mission. 

When functioning normally these three systems work interdependently[4] with moment to moment awareness of the demands placed upon the spine (posture as well as fixed and ambulatory[5] loads) to provide it with homeostatic  biomechanical [6] stability.

The average person is now asking him/herself, “Why is this information important to me?” Well this is the scientific reasoning behind why our mothers and grandmothers were continually harping about our need to “Sit/stand up straight”. In-vitro[7] experiments conducted at Yale and UC San Francisco found that vertebral segments in the thoracic and lumbar spine(s) became mechanically unstable at loads of 4.5 pound-force (20N) and 20.2 pound-force (90N) respectively.[8] [9] The irony of this is that the normal everyday loads placed on the spine from body mass alone while standing are significantly larger (20-times greater) and even more so when carrying a backpack, purse, groceries, etc. The only reason these segments do not buckle under these forces is because of the musculature surrounding the spine and why mindful adherence to good ergonomics/posture is imperative in preventing back and neck injury/pain. Over time, the stress of poor posture can change the anatomical characteristics of the spine, leading to the possibility of constricted blood vessels and nerves, as well as problems with muscles, discs, and joints.[10]

Envision a standard broom, better yet find a broom and with one hand grip the end of the handle and lift the broom in the air until it’s vertical. You will find a mechanically advantageous position once the broom is perpendicular to the floor; at this point holding the broom aloft is almost effortless. Anatomically this is considered “neutral position” a spinal posture in which the overall internal stresses in the spinal column and the muscular effort to hold the posture is minimal.[11] Now tip the broom slightly in any direction and experience how heavy it becomes, how much stress it now places on the wrist and arm, and how difficult it becomes to hold aloft with one hand.[12] This is equivalent to slouching, slumping, cradling a phone between your ear and shoulder, looking downward too often (text-neck); habits that over time expand the spine’s “neutral zone” and are the precedent to back and neck pain, headaches, fatigue, and over time respiratory and major organ dysfunction due to decreased stature. In fact one study showed that height loss greater than or equal to 1.18 inches (3cm) “in older men is independently associated with an increased risk of all-cause

mortality and coronary heart disease”.[13]

The spine’s “neutral zone” is the inner region of a joint’s range of motion where minimal resistance to motion is encountered.[2]To experience this directly take your thumb and first finger and grip the middle knuckle of one of the fingers on your opposite hand. Relax the gripped finger and begin to ever so slightly wiggle the finger back and forth. The slight motion you feel within that knuckle is the “neutral zone” which, as you've seen in this experiment, is restricted by the ligaments alone due to your voluntary removal of the active muscle forces that truly stabilize the joint. Poor posture and/or ergonomics stretch the spine’s passive subsystem (spinal joint capsules, intervertebral discs, and spinal ligaments) beyond its elastic limits and over time induces microtrauma which results in expansion of the “neutral zone” altering the signals sent by the transducers to the neural/feedback system. This places increased demands on the surrounding musculature degrading motor control. Consequentially inappropriate muscle activation sequences occur during simple tasks (i.e. bending over to pick up a piece of paper) transferring the force of these actions to the vertebral disc.

The center of the vertebral disc contains the nucleus pulpous which is a gelatinous cushion that protects the vertebrae from the pressures applied to the spine. This cushion is surrounded by several layers of fibrocartilage known as the annulus fibrosis which resemble the rings seen inside the trunk of a tree. Unsustainable pressures applied to the disc over time due to poor posture/ergonomics will create tearing in these rings which results in disc bulging and eventually herniation if one’s body mechanics/behaviors are not corrected.

Articles and Videos to Enhance the Importance of Good Posture/Body Mechanics

Good Posture Helps Reduce Back Pain

How Poor Posture Causes Neck Pain

Ten Tips for Improving Posture and Ergonomics

Spine Anatomy Interactive Video

Herniated Disc Video

Cervical Herniated Disc Video

Lumbar Herniated Disc Video

This information is not intended as a substitute for professional medical help or advice but is to be used only as an aid in understanding back pain.

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[1] The ability to maintain the body’s center of mass over a stable base of support

[2] Liebenson, Craig. Rehabilitation of the Spine – A Practitioner’s Manual. 2nd ed. Baltimore: Lippincott Williams& Wilkins, 2007. Print

[3] A biological entity that converts energy in one form to another, e.g. the rods and cones of the eye or the hair cells of the ear

[4] Relying on mutual assistance, support, cooperation, or interaction among constituent parts

[5] Walking or moving around, or done while walking or moving

[6] The study of body movements and of the forces acting on the musculoskeletal system

[7] (Experimental Biology) Conducted using components of an organism (part of or a dead specimen)

[8] Crisco JJ. The biomechanical stability of the human lumbar spine: experimental and theoretical investigation [Doctoral Dissertation], New Haven, CT, Yale University, 1989

[9] Lucas DB, Bresler B. Stability of the ligamentous spine. Technical Report esr. 11 No. 40, Biomechanics Laboratory, University of California at San Francisco, The Laboratory

[10] Schubbe, John. "Good Posture Helps Reduce Back Pain." Spine-health: Trusted Information for Back Pain Relief. Spine-health.com, 17 May 2004. Web. 05 June 2014. <http://www.spine-health.com/wellness/ergonomics/good-posture-helps-reduce-back-pain>.

[11] Panjabi, Manohar M. "The Stabilizing System of the Spine. Part II. Neutral Zone and Instability Hypothesis." Journal of Spinal Disorders & Techniques 5.4 (1992): 390-96. Print.

[12] Weiniger, Steven P. Stand Taller ~ Live Longer: An Anti-Aging Strategy: 10 Minutes a Day to Keep Your Body Active and Pain-free. Alpharetta, GA: BodyZone, 2008. Print.

[13] S. Goya Wannamethee, PhD; A. Gerald Shaper, FRCP; Lucy Lennon, MSc; Peter H. Whincup, FRCP, PhD. "Height Loss in Older Men - Associations With Total Mortality and Incidence of Cardiovascular Disease." Arch Intern Med. 2006;166:2546-2552. Print.

Safety of Chiropractic Care - Neck Manipulation

The efficacy of spinal manipulative therapy (SMT) has been a topic of research for more than 20 years now and has subsequently been recognized as such in at least four countries which has led to increased integration of chiropractors into mainstream healthcare.[1] This greater predominance has led to questions regarding the possibility of complications due to SMT, especially with respect to manipulation of the cervical spine (neck).

This was never more prevalent than after two tragic events following chiropractic care in Canada in the 1990s which spurred rabid media attention and an adamant stance by the neurology community to avoid cervical manipulation as a treatment for neck pain.[2] These events have no less been the provocative factor for the publication of several case reports in which chiropractors have been incorrectly identified as the practitioner responsible for injuries related to SMT.[3] This fact is inescapable when reviewing two articles published in the Journal of Neurology where the authors cite 46 cases involving stroke and/or vertebral artery dissection due to “chiropractic manipulation”. Truth be told only FOUR (4) of the cases involved chiropractors the remaining 42 cases (91%) of injury due to cervical manipulation were induced by 25 -orthopedists, 6 -physical therapists, 1 -neurologist, 2 -Primary Care Physicians, 1 -homeopath, 2 -“health practitioners”, and the rest “remained unreported”.[4][5][6] Admittedly there is inherent risk, albeit minimal, associated with neck manipulation but all forms of therapeutic intervention come with risk and some are far greater than SMT.

 Take for instance the most common “quick fix” for musculoskeletal pain, non-steroidal anti-inflammatories [NSAIDs] (i.e. Advil, Aleve, Motrin, Tylenol). Medical studies published during the 1990s found that hospitalizations due to gastrointestinal complications from NSAIDs range from 32,000 - 103,000 while NSAID related deaths average out at 9,850 ANNUALLY in the United States alone![7][8][9] In fact the Food and Drug Administration reports that the largest cause of drug overdose in the United States is acetaminophen (Tylenol) which by itself is responsible for 56,000 emergency room visits, 2,600 hospitalizations, and 458 deaths due to acute liver failure EVERY YEAR![10] The one-year risks of experiencing complications due to prolonged NSAID use are simply staggering: [11]

Severe gastrointestinal bleeding:

            - Adults younger than 45 = 1 in 2,100

            - Adults older than 75 = 1 in 110

Death:

            - Adults younger than 45 = 1 in 12,353

            - Adults older than 75 = 1 in 647

These non-prescription pain relievers have become an accepted form of musculoskeletal pain relief yet their catastrophic effects have never been as scrutinized as spinal manipulative therapy which has been scientifically proven to be more effective in relieving neck pain and headache[12] with statistically infinitesimal risk of serious adverse reaction.

A population based study published in Neurology in 2006 discovered that over a 16 year period (1987-2003) the incidence rate of  strokes due to arterial dissection (ICAD and VAD) affected only 0.97 - 1.72 residents per 100,000 annually within the defined community (Olmsted County, MN).[13] These findings regarded the population in general since reliable epidemiological data was not available. A subsequent population-based case control and case-crossover study conducted by members of the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders was published in SPINE in 2008 which investigated the association between chiropractic care and stroke due to arterial dissection and compared it to primary care physician (PCP) treatment for the same issue.[14] This study examined ALL residents of Ontario (109,020,875 person years), Canada’s most populous province over a nine (9) year period (1993-2002). The researchers found only 818 cases of stroke due to arterial dissection that met the study’s inclusion/exclusion criteria. Overall, 4.4% (n=36) of the cases had visited a chiropractor and 51.0% (417) had only visited a PCP 30 days prior to hospital admission for stroke related to arterial dissection. It should be noted  though that of the 36 cases noted above, only 16 cases (2.0%) were exclusively chiropractic visits 20 (2.4%) had visited both a chiropractor and PCP with the remaining 365 cases having consulted no one for care prior to hospitalization due to stroke. In the end the researchers came to the following conclusions:

            - Stroke due to arterial dissection within the population is a RARE EVENT.

- Of the 453 cases that did consult either a chiropractor or PCP prior to hospitalization, the chief complaint upon presentation was neck pain and headache. The researchers concluded that this similarity was due to an arterial dissection IN PROGRESS which led these patients to seek relief of their pain.

- There is an association between chiropractic care and arterial dissection-related stroke within residents under the age of 45 but chiropractic care DOES NOT exhibit any excess risk of eliciting a stroke.

- There is an association in PCP care and arterial dissection-related stroke in ALL AGE GROUPS.

- Currently there exists no valid screening procedure to identify the risk of stroke in a person presenting with neck pain and/or headache.

The substantive nature of this data is enlightening but in no way exhausts the need for further investigation into this rare yet life altering event. A collaborative effort between chiropractors and neurologists during future research is needed in order to derive a feasible screening method and eliminate the confusing and conflicting information currently being given to patients regarding the treatment of neck pain and headache.

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[1] Haldeman, Scott, Paul Carey, Murray Townsend, and Costa Papadopoulos. "Arterial Dissections following Cervical Manipulation the Chiropractic Experience." Canadian Medical Association Journal 165.7 (2001): 905-06. Print.

[2] Cassidy, David, Eleanor Boyle, Pierre Cote, Helen He, Sheilah Hogg-Johnson, Frank L. Silver, and Susan J. Bondy. "Risk of Vertebrobasilar Stroke and Chiropractic Care." Spine 33.4S (2008): 000. Print.

[3] Terrett, AG. "Misuse of the Literature by Medical Authors in Discussing Spinal Manipulative Therapy Injury." Journal of Manipulative and Physiological Therapeutics 18.4 (1995): 203-10. Print.

[4] Murphy, Donald. “Primary Spine Practitioner Training Session III: Putting it all Together.” Community Spine Pathway Training. Burgundy Basin Inn, Rochester. 3&4 May 2014. Lecture.

[5] Hufnagel, A., Alexander Hammers, Paul-Walter Schonle, Klaus-Dieter Bohm, and Georg Leonhardt. "Stroke following Chiropractic Manipulation of the Cervical Spine." Journal of Neurology 246(8) (1999): 683-88. Print.

[6] Reuter, U., M. Hamling, I. Kavuk, K. M. Einhaupl, and E. Schielke. "Vertebral Artery Dissections after Chiropractic Neck Manipulation in Germany over Three Years." Journal of Neurology 253(6) (2006): 724-30. Print.

[7] Risser, Amanda, Deirdre Donovan, John Heintzman, and Tanya Page. "NSAID Prescribing Precautions." American Family Physician 80.12 (2009): 1371-378. American Academy of Family Physicians. American Family Physician, 15 Dec. 2009. Web. 08 May 2014. <http://www.aafp.org/afp/2009/1215/p1371.html#afp20091215p1371-b13>.

[8] Wolfe, Micheal, David Lichtenstein, and Gurkirpal Singh. "Gastrointestinal Toxicity of Nonsteroidal Anti-inflammatory Drugs." New England Journal of Medicine 340;24 (1999): 1888-899. Print.

[9] Tarone RE, Blot WJ, McLaughlin JK. Nonselective non-aspirin nonsteroidal anti-inflammatory drugs and gastrointestinal bleeding. Am J Ther. 2004;11(1):17–25.

[10] June 29-30, 2009: Joint Meeting of the Drug Safety and Risk Management Advisory Committee with the Anesthetic and Life Support Drugs Advisory Committee and the Nonprescription Drugs Advisory Committee: Meeting Announcement http://www.fda.gov/AdvisoryCommittees/Calendar/ucm143083.htm).

[11] Blower AL, Brooks A, Fenn GC, et al. Emergency admissions for upper gastrointestinal disease and their relation to NSAID use. Aliment Pharm Ther. 1997;11(2):283–291.

[12] Association, American Chiropractic. "Benefits and Risks of Neck Pain Treatments." Acatoday.org. American Chiropractic Association, n.d. Web. 13 May 2014. <http://www.acatoday.org/pdf/Benefits_Risks_Neck_Pain_Treatments.pdf>.

[13] Lee, VH, Brown RD Jr, Mandrekar JN, et al. Incidence and outcome of cervical artery dissection: a population-based study. Neurology 2006;67: 1809-12

[14]Cassidy, David, Eleanor Boyle, Pierre Cote, Helen He, Sheilah Hogg-Johnson, Frank L. Silver, and Susan J. Bondy. "Risk of Vertebrobasilar Stroke and Chiropractic Care." Spine 33.4S (2008): 000. Print.

A Best Evidence Synthesis Regarding the Classification and Treatment of Neck Pain

Endorsed by the United Nations on 30 November 1999 and officially launched on 13 January 2000 at the headquarters of the World Health Organization in Geneva, Switzerland the Bone and Joint Decade (BJD) is an international group of healthcare professionals that address the substantial effect that bone and joint disorders have on society, the healthcare system, and the individual. The goal of the BJD is to “improve the health- related quality of life for people with musculoskeletal disorders throughout the world by raising awareness and promoting positive actions to combat the suffering and costs to society associated with musculoskeletal disorders”.[1] This patient centered organization’s motivation has been the establishment of initiatives capable of delivering best-evidence multi-disciplinary healthcare on a global scale.

This focus was evident with establishment of The Task Force on Neck Pain and Its Associated Disorders in 2000. This fifty (50) member Task Force, with members from nine (9) countries, and representing nineteen (19) clinical and scientific disciplines/specialties was mandated with the task of publishing a report outlining the best current evidence regarding the risk and prognosis of neck pain, its assessment/diagnosis, and the effectiveness and safety of invasive and non-invasive treatment methods for neck pain. During this process they were to also identify problems with the current literature so that future studies could be developed. The goal of this seven year project was to empower the public, especially individuals who suffer from neck pain or at risk of developing it. This collaborative effort that included eight (8) universities in four (4) countries and eleven (11) professional organizations who were nonfinancial sponsors produced a document that has changed approaches and views regarding neck pain as well as its prevention, diagnosis, treatment, and management.[2]

Below is the roster of the 13-member Scientific Secretariat who conducted the screening process of 31,878 research citations on neck pain of which 1,203 articles were found to be relevant. 46% (552) of those were found to be “scientifically admissible” for utilization in this synthesis of best-evidence. Aside from this, various other members of the Task Force also conducted four (4) original research projects during its seven year tenure, two that examined vertebrobasilar stroke, one that compared the outcomes of various forms of neck pain treatment, and another that examined work absenteeism due to neck pain.

As Primary Spine Practitioners, the doctors at Life in Motion Chiropractic and Wellness have found this study to be an invaluable guideline for providing our patients with or triaging them to the most effective treatment available for their neck pain.

Eugene J. Carragee, MD, FACS	Linda Carroll, PhD
J. David Cassidy, DC, PhD, DrMedSc	Pierre Côté, DC, PhD
Stephen W. Greenhalgh, MA, MLIS	Jaime Guzman, MD, MSc, FRCP(C)
Scott Haldeman, DC, MD, PhD, FRCP(C)	Sheilah Hogg-Johnson, PhD
Lena Holm, DrMedSc	Eric L. Hurwitz, DC, PhD
Margareta Nordin, PT, DrMedSc, CIE	Paul Peloso, MD, MSc, FRCP(C)
Gabrielle van der Velde, DC, PhD (Candidate) “In other words, one finds much more information than any individual clinician would be able to find, download, print, read, and digest/assimilate should he/she be devoted to such tasks full-time for years. More specifically, the fact that not only whiplash and nontraumatic disorders but also headaches, arm pain, and generalized symptoms of cervical origin are included in the review is a major strength of this work. Similarly, it’s very useful having both nonsurgical and surgical treatments in the same publication. Moreover, grading treatments according to the likelihood of helpfulness; reporting on prognostic factors and using “suspected etiology” to evaluate treatments are some other examples of the clinical orientation and practicality of this report.” Federico Balagué MD Department of Rheumatology, Physical Medicine and Rehabilitation, Hôpital Fribourgeois – Freiburger Spital Site de Fribourg – Freiburg, Freiburg, Germany Service de Rhumatologie, Médecine Physique et Rééducation, 1708, Fribourg, Switzerland

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[1] "Background & Goals." THE BONE AND JOINT DECADE. World Health Organization, 13 Jan. 2000. Web. 25 Apr. 2014. <http://bjdonline.org/home/bjd-goals/>.

[2] Haldeman, Scott, Linda Carroll, David Cassidy, Jon Schubert, and Ake Nygren. "The Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders - Executive Summary." SPINE 33.4S (2008): S5-S7. Print.

Integrative Care for Headache Pain

Headache has been a bane of humankind for centuries and one of the most common conditions that affects the nervous system. The universally accepted premise is that pain sensitive components of the head and neck are what elicit headache.[1] It is estimated that 47% of adults will experience a headache at least once within the next year.[2]

In 1988, the International Headache Society (IHS) devised a uniform system for classifying headaches which has unequivocally aided headache research. However, the clinical application of this system is limited due to its length, intricate detail, contradictory elements, and lack of real-world observation and data.[3] In fact the World Health Organization admits that many people have their headaches inaccurately diagnosed by their health-care provider.[1] An understandable fact when primary care physicians (PCP) only receive an average of four hours of instruction on headache disorders while in medical school.[1]
This statistic in no way indicates incompetence, just inadequate training with regard to headache. A comprehensible fact given the other more fatal pathologies a PCP must learn about on an intricate level.

This does, however, lead one to theorize that the prescribed drug treatments utilized to combat headache pain may be improperly applied due to the many coinciding aspects of migraine and tension-type [4] headaches. Therefore these analgesics provide no lasting relief to the patient and out of their frustration to feel better easily leads to the development of a medication-overuse headache (MOH).[5]

An integrative approach to headache pain is the most logical way to manage this epidemic given the reasons and biologic elements that contribute to it. According to the research, especially in the case of migraine and tension-type headaches, this may be the most successful strategy to help patients overcome their headache pain.

Since the principal causative factor of headache is spine related, wouldn’t it make sense to have a physician who is specifically trained in spine related disorders be the hub of the diagnostic, management and treatment of headache pain. The doctors at Life in Motion Chiropractic and Wellness are trained Primary Spine Practitioners who can deferentially diagnosis, rule out serious pathology, and provide evidence-based management for the majority of headache patients while also integrating that care with their already established healthcare providers.

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[1] Swenson, Rand and Grunnet-Nilsson, N. 2005. The Management of Headache. In: Haldeman, Scott, et        al, eds. Principles and Practice of Chiropractic. New York: McGraw-Hill, pp. 999-1011

[2] "Headache Disorders." WHO. Ed. WHO Media Center. World Health Organization,
         Oct. 2012. Web. 12 Mar. 2014.

[3] McKenzie, Robin, Stephen May. The Cervical & Thoracic Spine – Mechanical Diagnosis & Therapy.
            Raumati Beach: Spinal Publications New Zealand Ltd, 2006. Print.

[4] Most common type of primary headache. Its mechanism may be stress-related or associated with musculoskeletal problems in the neck. [World Health Organization]

[5] Most common type of secondary headache. [World Health Organization]

An Alternative to Pharmacologic Treatment of Headache Pain - Making the Case for Primary Spine Practitioner Care

Discusses that hazards of over the counter/prescription medication use for the treatment of headache pain and offers a drug-free and evidence-based alternative that may help you overcome your headaches ALL TOGETHER. This video provides research that substantially makes the case for Primary Spine Practitioner treatment of headache pain.

Preventing Shoulder Injury

The human shoulder is designed to provide a great deal of mobility. 

It can assume up to as many as 1,600 positions. However, in order to provide this function it is dependent upon an integrated system of ligaments, muscles, and tendons for support.

Very similar to a golf ball sitting on a tee, the rounded end of the upper arm moves within the scooped out socket of the shoulder blade. But, unlike the golf ball, the head of the arm must remain in a confined space and still move freely. Pain occurs when excessive demands are placed on the stabilizing structures (muscles, ligaments, joint capsule) of the shoulder, especially when placed at higher angles of flexion (forward elevation >90°) and/or extremeabduction (sideward elevation). Studies have shown that shoulder pain in the general population of some countries has been reported to be as high as 50%.

Here are some ways to prevent you from becoming part of this statistic:

• Stretchand strengthen regularly. The stronger and more flexible the joints are, the more readily they will be able to withstand impact or repetitive forces.
• When lifting: face the object, keep the back as straight as possible, and use the legs for lifting power.
• Do not reach to place or retrieve heavy objects stored up high or behind other objects (i.e. briefcase/purse in the back seat of your car). Position your body carefully and use a stable platform/step stool for elevated objects.
• Do not “yank” on an object. Think about the task at hand and if too heavy or precarious, get help!
• For seated tasks, use a supportive chair, particularly one with adjustable arm rests and seat. Position the body so that your buttocks are back as far as possible, adjust the seat so that the hips and knees are maintained at 90°-110°, and adjust the arm rests so that the shoulder can hang naturally and the elbows are 90°-110° to the keyboard.
• Take posture breaks and stretch for 5-10 minutes every hour.
• Know when you need rest and relaxation during non-working hours and maintain good physical condition to avoid strains and sprains.

Preventing Back Injury

The spine is literally a mechanical device and when we sit, stand, lift, or bend it obeys the orders we give it and assumes the position we place it in. Ergonomics is the science of obtaining a correct match between the human body, work-related tasks, and work tools both at home and on the job. When we do not perform activities of daily living correctly, slow innocent changes occur to the support structures of our body. Physical warnings (i.e. pain) begin to intensify and become exacerbated by repetitive activities, sustained postures, and other factors such as bodily reaction/bending, reaching, or twisting. 

Low back pain is a predominant specter in our society and nearly 80% of adults will experience it at some point in their lives. Here are some tips that my just keep you from becoming part of this statisti

• Stretch and strengthen your back regularly.
• Utilize good posture at all times. This means keeping the ear lobe lined up with the shoulder, shoulder with the hip, and hip with the ankle.
• Use your body in ways that reduce stress on your back. GOOD BODY MECHANICS!!

      
       - Sitting:

• Don’t sit in the same position for more than an hour. Change positions every 30 minutes.
• If your job requires sitting, utilize an adjustable chair that maintains the normal curve of your back. If necessary use a lumbar pillow or roll for added support.
• Keep your feet flat on the floor or footrest.
• Keep the top of your computer screen at eye level.

     
       - Lifting

• The spine was designed with three curves that contribute to its strength and stability. Keeping your head level reduces stress on your back while lifting.
• Reduce the force on your spine by holding objects close to your body. Remember, whether you feel it or not, gravity is always there and holding a load away from the body can increase its weight by 10 TIMES!
• The neck was designed to turn and bend in multiple directions to allow us to take in life from all angles. However, the low back was not, so when lifting don’t twist, shuffle your feet to turn keeping your nose between your toes.