Back On Track

PREVENTING AND TREATING BACK PAIN

If you’ve got a bad back, you might not want to row the length of a lake while sitting in a bathtub.

But that’s exactly what Malcolm Burns, a Scottish physicist who works at Los Alamos National Laboratory, decided to do last summer — in spite of a decades-long struggle with a painful back.

“The plan was to row the length of Loch Lomond, which is just under 25 miles, in honor of my wife Ruth’s granddad, who has sadly died of Alzheimer’s,” Burns said. “The idea came when he and I had been chatting about these other two guys who rowed Loch Ness, and I told him I would do Loch Lomond — in a bathtub.”

Not only did Burns have to retrofit a bathtub to make it seaworthy, but he also had to worry about how his back would hold out. “The row was to be in August, so I realized in March I needed to do something. Otherwise I’d kill my back,” he said. “It was going to be a long time in a bathtub, and on a good day I don’t fit in a normal bathtub at home.”

Burns may be the only man to row Loch Lomond in a bathtub, but he is not alone in suffering from back pain. According to a 2015 study from the National Institutes of Health, low-back pain (the most common type of back pain) is the second most common cause of disability in American adults, with more than 80 percent of the population experiencing an episode of lowback pain at some point in life. And the numbers are getting worse: The prevalence of chronic, impairing low-back pain has been rising “significantly” over time, the study found.

Although many health experts speculate that an increasingly aging, sedentary and obese population may be correlated with the rise in reported back pain, those risk factors are not in play for Burns, who is young, slim and athletic. Having coped with back pain from his late teens, he gives himself this unofficial diagnosis: “I’m a lanky bugger.”

Burns sought help from physical therapist Michelle Harris of Rebound Physical Therapy in Los Alamos. “Michelle gave me exercises that were easy enough to remember that I could do them every day,” he said. “Once I got into the routine, I would roll out of bed and do them. I would add reps as I felt I could do them.”

Although Harris knew about the rowing challenge, she didn’t

give Burns any specific exercises related to rowing. “She gave me exercises to get my back in good health in general, to improve my core.” By the time the August row came around, Burns felt he had done enough good preventive care to protect his back.

In fact, some of the most common treatments for back pain — improving posture, stretching underused muscles, strengthening the core, breaking up sitting time with walking time — are also how pain can be prevented in the first place.

“People need to work more on preventive care,” said Patti Bott, a physical therapist with the Active Recovery clinic in Santa Fe. “They need to exercise more, to focus on core and posture. Don’t stop moving. People can experiment and find what they like: yoga, CrossFit, Pilates, gyms.”

Even the simple act of walking can help. “The latest saying is that sitting is the new smoking,” Bott said. The modern workplace often requires people to use computers all day, but it’s important to take walking-around breaks. “There is a ton of research out there on how much money is spent on back pain, on how many wages are lost. As a society we don’t really support preventive care, how to use proper body mechanics,” said Bott.

For some, minor changes are not enough to prevent or manage back pain. When it’s time to seek outside help, there are many options to consider. Some sufferers may fear that surgery is the only option, but according to an overview on back pain from the Mayo Clinic, surgery is rarely needed to treat back pain. Most people have better luck with less invasive alternatives, such as physical therapy, yoga, massage and chiropractic.

The Feldenkrais Method

Five physical therapists in Santa Fe practice Feldenkrais, said Connie McGhee, who is one of the five. Feldenkrais teaches people “to use the whole body differently and organize movements so that one area is not strained,” McGhee said.

She continued, “Our culture doesn’t teach people what to do to keep muscles strong. Other cultures have different kinds of daily activity. Our kids don’t play outside. They sit more. They are more passive. This kind of static positioning makes ligaments not as strong. I was in Europe recently, and everybody there walks. Little kids on scooters keep up with their parents. These kids are not overweight. They are strong. They are well aligned. Their gait is perfect.”

We are even taught problematic ways to sit, she added. “The best way to sit is to keep legs very far apart. This allows the pelvis to roll forward. But our culture, for females especially, doesn’t encourage that.” Instead we are taught to keep knees together, to tuck the tailbone under, which promotes the poor posture that can lead to back pain.

“Once people get that they are not a victim of anything, that they just need to learn how to move differently, they are motivated,” McGhee said. “They do the home program every day. They feel the difference, and they feel really happier.” She concludes, “People do get better with our work, in a way that lasts a long time.”

Massage

While low-back pain is more common, “I tend to work a lot on people with neck pain, and the neck is part of the back,” said massage therapist Melody Van Hoose, who has a practice at BODY of Santa Fe. Although she has seen an uptick in whiplash injuries in 2019 from weather-related car accidents, “so much of what I see is day-to-day postural things, like being on the computer for hours, or the forward head posture from staring at a cell phone. There’s a crinking right at the neck from looking down. That’s hard on the front neck muscles; it’s like a garden hose if you put a kink in it. Things get trapped, and people wind up with pain that travels down into their arms.”

Van Hoose recommends, as part of prevention, arranging a work area with good ergonomics, such as an angled keyboard and a chair at the right height for good lumbar support. “Be aware of [your] posture. Keep a neutral S curve in the spine, not a C curve. Take a break from sitting; walk around; do little office yoga things. Get a big exercise ball — they are not too expensive — then lie back on it and spread-eagle your arms. When you don’t do those things, you wind up in physical therapy or in massage,” she advised.

When people do end up on her table, Van Hoose helps mitigate the damage. “If you think of butter, it gets hard and ossified when cold. When you work into it, it gets liquidy and soft. Pliable. Muscles are like that. The chronic holding patterns are in the fascia, like icebergs, and massage breaks those up.” Good massage therapy is more than just working out the kinks, she added. “Massage is like a retraining. It brings awareness to the body.