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Lightening the load; Five things you can do to help maintain a healthy back

Treatment of low back pain has undergone a recent sea change. Experts now appreciate the central role of exercise and the importance of maintaining a healthy back. They also better understand which conditions surgery will help and which patients are good surgical candidates.

Low back pain has many different causes, including the normal wear and tear that comes with aging. While you can't turn back the clock or prevent every type of painful back disorder, in most cases there are things you can do to help keep your back healthy.

1. Stay fit

Weak back and abdominal muscles -- due to deconditioning or age -- cause or exacerbate many cases of low back pain. That's why stretching and strengthening both your back and abdominal muscles is important not only for treating low back pain, but also for helping prevent a recurrence of the problem.

Exercise strengthens and stretches the muscles that support the spine. A stretching and strengthening regimen should target the back, abdominal and buttock muscles. Strong abdominal or flexor muscles, for example, help people maintain an upright posture, as do strong extensor muscles, which run the full length of the back and maintain alignment of the vertebrae.

Stretching is a valuable component of any treatment plan for a person plagued by back problems. Most experts believe that supple, well-stretched muscles are less prone to injury. Indeed, shorter, less flexible muscle and connective tissues restrict joint mobility, which increases the likelihood of sprains and strains.

Certain aerobic activities are safer for your back than others. For instance, bicycling (either stationary or regular), swimming and walking lead the list of low-risk, high-benefit activities for most people's backs. All are low- or minimal-impact exercises that strengthen muscles which support the back. None involve awkward or stressful actions that are detrimental to back muscles.

Sports and activities such as football, tennis, gymnastics, wrestling, weight lifting, rowing (crew), running, aerobic dance and ballet involve a relatively high risk for back injury because of the extension, lifting or impacts involved. Other unnatural motions that could induce pain include back arching (during gymnastics and diving), twisting (while hitting a golf ball, swinging at a baseball, or bowling), vertical jolting (while riding a horse), and stretching your legs strenuously (when hiking or when balancing a sailboat during a race).

2. Maintain a healthy weight

Although carrying too much weight per se has not been proven to be a primary cause of back pain disorders, being overweight or obese can slow your recovery. Those extra pounds also increase the risk that back pain will return.

The heavier you are, the greater the load your spine must carry. To make matters worse, if the bulk of your weight comes in the form of abdominal fat, rather than muscle, your center of gravity can shift forward -- a condition that puts added pressure on your back. By maintaining a healthy weight, you can ease the burden on your spine.

To see if you are at a healthy (normal) weight, calculate your body mass index (BMI), which takes both your height and weight into consideration. Not only will you help your back if you maintain a normal BMI (in the range of 19-25), but you'll also lower your risk for many diseases, including heart attack, stroke, diabetes and high blood pressure.

3. Kick the habit

You've undoubtedly heard this message before: Smoking harms your health. Not only does this habit raise your risk for lung cancer, heart disease, hypertension and a plethora of other health problems, but it also jeopardizes your back.

Research shows that smokers have more frequent episodes of back pain than nonsmokers, and the more people smoke, the higher the risk of such episodes, according to one study.

Scientists believe that the nicotine in cigarettes contributes to low back pain in two ways. First, nicotine hampers the flow of blood to the vertebrae and disks. This impairs their function and may trigger a bout of back pain. Second, smokers tend to lose bone faster than nonsmokers, putting them at greater risk for osteoporosis, another common cause of back pain.

4. Lighten your load

Backpacks have become ubiquitous -- at school, at work, at play. But an overstuffed backpack can be a harbinger of back pain.

Most orthopedic doctors have long recognized that backpacks increase the risk of certain types of back pain, especially in students. A survey by the American Academy of Orthopaedic Surgeons found that nearly 60 percent of the doctors responding had treated school-age patients complaining of back and shoulder pain caused by heavy backpacks. Hauling an overloaded backpack can also cause muscle fatigue and strain and encourage the wearer to bend forward unnaturally.

If you use a backpack, you can take steps to protect yourself. For starters, use both of the pack's straps instead of slinging one strap over a shoulder. Try to carry only the essentials, and lighten your load whenever possible. Opt for backpacks that have different-sized compartments to help distribute weight evenly. And look for wide, padded straps and a padded back.

When carrying a heavy load, put the heaviest items as close as possible to the center of your back, and use the hip strap for support. For very heavy loads, use a backpack with wheels. Above all, remember to bend from your knees when picking up your pack.

5. Develop back-healthy habits

Everyday activities, from vacuuming your house to sitting in front of a computer for hours, can take a toll on your back, particularly if you aren't schooled in proper body mechanics. You can take some of the pressure off your back by following these simple tips:

*While standing to perform ordinary tasks like ironing or folding laundry, keep one foot on a small step stool.

*Don't remain sitting or standing in the same position for too long. Stretch, shift your position, or take a short walk when you can.

*When bending from the waist, always use your hands to support yourself.

*When sitting, keep your knees a bit higher than your hips and bend them at a 90-degree angle. Sit with your feet comfortably on the floor. If your feet don't reach the floor, put a book or a small stool under them.

*Because vacuuming can take a toll on your back, tackle rooms in chunks, spending no more than five to 10 minutes at a time doing this task.