Our backs are made up of bones, muscles, nerves and various other tissues that work together to help us stand and bend. Vertebrae are the bones in the back that form the spinal column, or spine. The spinal column protects the spinal cord, which in turn controls our ability to move and feel. The vertebrae are stacked on top of each other and have a small hole in the back that surrounds the spinal cord. The spinal cord extends from the base of the brain to right below the rib cage in adults. Small nerves, or roots, from the spinal cord emerge through these vertebrae. The nerves to the lower back and legs (the cauda equina or “horse’s tail”) extend through the spinal column before emerging. There are intervertebral discs that help maintain the spaces between the vertebrae and enhance our flexibility in the lower back. These also serve to absorb shock in the spinal column and cushion bones as the body moves. The vertebrae are held in place by ligaments and tendons, and attach to muscles that enable the vertebrae to move together as we bend forward, backwards, and side to side. There are four main regions of the back: the cervical (neck), thoracic (upper back), lumbar (lower back), the sacrum and coccyx (tailbone).
Treating Back Pain
Most back pain occurs in the lumbar region, which supports all of our upper body weight. As we get older our bone strength, muscle tone, and elasticity begin to decrease. The discs in our back that cushion the vertebrae lose fluid and become less flexible. We can sprain or strain our back by lifting something heavy, or by overstretching, which can cause pain or spasm in the muscle and ligaments in the back. A severe strain or compression may even cause a disc to bulge outward or rupture, placing pressure on one or more of the 50 nerve roots in the spinal cord and causing pain.
Back pain may follow injury or trauma to the back but could also be caused by arthritis, bone thinning (osteoporosis), disc disease, infections or even abnormalities that are present from birth. Bad posture, obesity, smoking, weight gain associated with pregnancy, stress, poor sleeping posture and poor physical condition are all factors that can contribute to back pain. Repeated injuries may cause scar tissue to form that decreases flexibility and strength, in turn further weakening the back.
Most low back pain can be treated with basic first aid. Applying ice or cool compresses as soon as possible following injury or trauma for several times a day, up to 20 minutes at a time, can help reduce pain and inflammation. After 48-72 hours, heat can be used for brief periods to increase circulation and relax muscles. Warm soaks, even in Epsom salt, can relax muscles. Avoid sleeping on a heating pad since this can cause burns and tissue damage. Resting for a day or two can also be beneficial. Studies show that increasing activity as soon as possible yields better results than prolonged periods of bed rest. When sleeping and resting, lie on one side with a pillow between the knees. Over-the-counter analgesics may also help the pain and reduce inflammation.
Walking is a simple yet excellent exercise to increase circulation and strengthen back muscles. Your health care provider or physical therapist can prescribe specific exercises to improve your posture, strengthen muscles in your core and help prevent further injury.
When back pain is encountered, how do you know how soon you should seek professional advice? I advise, consulting with your health care provider if your symptoms are severe or if there is no improvement after 72 hours of at-home treatment. Seek medical help immediately for back pain associated with any fever, loss of bladder or bowel control, progressive weakness or numbness in the legs, or if pain that occurs with coughing. Delaying treatment when any of these symptoms are present may result in permanent damage.
Some back pain occurs as the result of a specific injury, trauma or strain. Other pain results from small, repetitive injuries that occur over time. During training and competition on our barrel horses, our spine absorbs impact from each movement of our horse’s body. As we ride, we use our entire body—knees, hips, back, abdomen, shoulders and neck to balance efficiently with our horse’s every move and decrease his workload. Our backs are complex structures enduring stress with every twist, turn and over-extension. Strengthening our core and our back will help us become better riders, as well as help prevent back pain and injuries in our spine.
There are a few easy steps we can take in order to have a healthier back:
- Walking or swimming for 30 minutes a day can improve flexibility and increase muscle strength.
- Yoga and Pilates are excellent ways to improve posture, and stretch and strengthen muscles.
- Stretch before any exercise or physical activity.
- Make sure work surfaces are at a comfortable height.
- Try to maintain proper posture when sitting. Keep your shoulders back and make sure your chair offers good lumbar support and is positioned at the proper height related to your work surfaces. During periods of prolonged sitting, take breaks in order to walk around and gently stretch muscles, and rest your feet on a small stool.
- Sleep on your side if possible and on a medium to firm mattress.
- Wear low-heeled, comfortable shoes.
- Don’t lift objects that are too heavy for you to lift by yourself. Get help.
- Use proper lifting techniques. Your knees should not be straight when reaching out to lift since this places increased demand on the spine. Instead, squat and keep the object close to the body when lifting in order to engage the thigh muscles. Do not twist while lifting.
- Stop smoking. Smoking constricts blood vessels, reducing blood flow to the lower spine and causing the spine to degenerate.
- Maintain a healthy weight. Excessive weight, especially around the mid-section, puts added stress on lower back muscles (and on our horse’s back muscles when riding).
- Maintain proper nutrition. A healthy diet including calcium, vitamin D, and phosphorus promotes bone health.
About Martha Smith
Martha Smith resides in Hazelhurst, Miss., a small community south of Jackson, and has been a member of the NBHA for 15 years, competing actively in Mississippi District 05. In 2006 she earned the Open 3D Mid-South National championship and has qualified for numerous NBHA World Shows. Smith now serves as adjunct faculty at the University of Southern Mississippi School of Nursing in the Family Nurse Practitioner program, teaching RNs how to become nurse practitioners.