That Slouching Can Be a Real Pain in the Neck--or Back

Until a few decades ago, the causes of heart disease were not well understood. Physicians, who often prescribed bed rest for their heart patients, blamed genetics and age. Thankfully, we’ve since come to understand that coronary artery disease is largely the result of lifestyle choices--which is why people like me spend so much time trying to get everyone to make healthier choices.

Well, now I’ve got another bandwagon to stand on. And you can blame Dr. Stephen Hochschuler, an orthopedic surgeon who founded the Texas Back Institute. Earlier this year, at a Relax the Back stores convention, Hochschuler told me that medical research is coming to the place with back and neck pain that we have with heart disease. He said we’re beginning to understand that spinal problems are also the result of lifestyle choices, that your back didn’t suddenly “go out” when you lifted the suitcase.

If it hadn’t been the suitcase, it might have been a sneeze, a cough or a sudden twist that sent you creaking along like Groucho Marx. Since back and neck pain is probably the average person’s most chronic complaint, this is incredibly significant news.

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When you ask chronic sufferers why they hurt, they’ll usually give you their diagnosis--herniated disk, sciatica, etc. But when you ask them when they feel pain most, they’ll usually talk about posture. For example: “My leg hurts if I sit too long.”

In truth, research shows that the basic cause of most back and neck pain is chronically poor posture. That applies even to people who have been in car accidents: If they’re slouching at the time of the impact, they’re likely to suffer worse injuries than if they’re sitting properly.

And if they’re slouching at the time of the accident, it’s a pretty safe bet that they slouch most of the time--which means that they suffer a double whammy in the accident, because years’ worth of slouching actually lowers the body’s ability to resist injury, research shows.

Since most of us spend only 10% of our lives on our feet, it stands to reason that most posture damage is done while sitting, sleeping and reclining--in other words, resting postures. Sagging and slouching are bad habits that probably began in childhood, while watching TV. But because a child’s healthy spine is so resilient, it can tolerate normal abuse without immediate pain. So we don’t associate adult pain in the neck and back with the past. But that’s exactly where it originates. Like tooth decay, spinal damage takes years to develop, researchers say.

What happens is that, over time, our sagging posture lengthens the ligaments along the spine. That makes them useless for holding the vertebrae the way they were designed to--and unable to stabilize and limit movement to prevent injury when the spine is tweaked. If your neck or back hurts, consider the pain a messenger telling you that something is wrong and needs to be corrected.

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In general, fit people are less likely to suffer back and neck pain, so if you can begin and maintain a thorough exercise regime that targets your entire body, not just the back, you’ll likely reduce many of your problems.

Hochschuler recommends a multi-pronged approach: aerobics, strength-training and flexibility. As part of your total fitness program, make sure to do some strengthening exercises aimed specifically at the midriff. Remember the girdles that women used to wear? Though they were cumbersome and ugly, what they were trying to do was secure everything in the midsection. To create a natural girdle of support, you have to target those same muscles in the front and back.

You can work your abdominals by doing a variety of exercises, including crunches and reverse curls (I described these in last week’s column). To work your back muscles, do spinal extensions by lying face down, arms at your side. Now exhale and slowly lift your upper torso off the floor, holding for 10 seconds. You can take that to a more advanced level by holding your arms out in front of you like Superman as you lift off the floor.

Of course, you have to think about nutrition and weight loss. People who are overweight can easily throw off their alignment as they compensate for all the weight concentrated around their midsections. What takes the brunt of this poor alignment? The neck and spine.

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Since most people spend their days sitting, furniture is also important. Most work stations are not designed to match your work to your body’s needs, so you spend a lot of time with your neck or back out of alignment. While it can cost a fair amount of money, if you want to solve your problem, you have to invest in a versatile chair that adapts to both you and the work at hand. Your chair needs to have an adjustable lumbar support, a height-adjustable seat back, a contoured seat, and height- and width-adjustable armrests.

Personally, I think it’s great news that we can eliminate so much of our back and neck pain. Yes, the science of prevention continues to advance, and I guess what we’re finding out is that Mom was right after all when she told us to sit up straight.

Copyright 1999 by Kathy Smith

Kathy Smith’s fitness column appears weekly in Health. Reader questions are welcome and can be sent to Kathy Smith, Health, Los Angeles Times, Times Mirror Square, Los Angeles, CA 90053. If your question is selected, you will receive a free copy of her new video, “Kickboxing Workout.” Please include your name, address and a daytime phone number with your question.