Guía de autoayuda para el dolor de espalda en personas sedentarias

Author: Zhao Xiansheng, First People's Hospital of Jining, Shandong University Medical.

Fu Maoqing, Doctor of Medicine, Jining First Hospital, Affiliated to Shandong University of Medicine.

Lü Chaoliang, Chief Physician of the First People's Hospital of Jining, affiliated to Shandong University Medical, Doctor of Medicine.

Reviewer: Wei Yanchun, Shandong First Medical Hospital, Jining First Hospital, Chief Physician.

When we slouch, lean forward, or use standard chairs for extended periods, the lumbar region deforms like a compressed spring. This poor posture increases the pressure on the lumbar vertebrae by nearly double compared to a normal sitting posture, reaching up to 1.9 times more than in a standard condition, which is equivalent to carrying two large watermelons on the waist. The constant pressure not only causes the muscles to overwork but also leads to an uneven distribution of load on the joints, much like how always chewing on one side can cause toothache.

First, muscle 'strike' triggers a chain reaction.

Maintaining a position for more than half an hour reduces blood supply to the lumbar muscles by a quarter. It is akin to compressing a hose; poor blood circulation causes muscles to stiffen, falling into a vicious cycle of 'more stiffness, more pain; more pain, more stiffness.' Even more severe, the deep muscles responsible for protecting the lumbar spine can atrophy due to prolonged inactivity, forcing the superficial muscles to overwork, thereby forming a harmful cycle.

The 'cushion' at the waist accelerates aging.

Sitting for long periods can cause intervertebral discs (the cushions between the lumbar vertebrae) to lose nearly 20% of their water content daily, as if they are squeezed sponges that have lost their elasticity. When these 'cushions' become dehydrated and brittle, not only does their cushioning capacity decrease, but small cracks may also appear on the outer layer. At this point, bending or twisting suddenly can stimulate pain nerve endings inside, causing sharp pain. Many episodes of lumbar pain are actually the result of a buildup of these effects over time.

Third, a 'toolbox' for first aid in case of lumbar pain.

1. Maintain an appropriate standing posture, keeping the pelvis in a neutral position and avoiding prolonged standing or sitting without movement. When sitting, ensure your back is straight and your lumbar region has good support, avoiding slouching or crossing your legs. In daily life, maintaining the correct posture can effectively relieve the load on the lumbar region and prevent the occurrence of lumbar pain.

2. Simple stretching exercises Performing some simple stretching exercises can effectively relax the lower back muscles and relieve pain. Among the most common are the cat and cow poses (which help relax the lumbar area and back) and the knees-to-chest position (which relaxes the lower back and glute muscles), which can decrease stiffness and increase lumbar flexibility. Regularly performing these stretching exercises can help maintain spinal flexibility and stability.

Figure 1 Copyrighted image not authorized for reproduction.

3. Applying heat is a simple and effective method to relieve lumbar pain. Heat can help relax tense muscles and promote blood circulation, making it suitable for alleviating chronic lumbar pain or muscle fatigue. Tools such as hot water bags or warm towels can be used, applied for 15 to 20 minutes each time.

An intelligent exercise prescription indicates that an adequate amount of aerobic exercise helps improve overall body health, relieve muscle tension, and pain in the lumbar region. Low-impact activities such as walking, swimming, or cycling can promote blood circulation and relieve muscle stiffness. However, it is essential to avoid intense exercises, such as sit-ups, deadlifts, or golf swings, which can be detrimental to the lumbar area and cause additional damage.

5. Sleep repair methods. During sleep, it is crucial to maintain the natural curve of the spine. It is essential to choose an appropriate mattress, avoiding options that are too soft or too hard. When sleeping, placing a pillow under the knees can help maintain the natural curvature of the spine and reduce pressure on the lumbar region. Additionally, it is advisable to avoid sleeping face down for extended periods, as this position can put extra pressure on the spine.

Fourth, a guide to preventing lumbar pain: dress your back with a 'bulletproof vest'.

Sitting correctly is fundamental to preventing lumbar pain. First, choose an ergonomic chair that ensures the backrest supports the natural curve of the back, preventing excessive curvature of the spine. When sitting, keep your feet flat on the floor and your knees at the same height as your hips. Avoid crossing your legs or leaving your hips in the air; maintaining good posture helps reduce pressure on the lumbar region.

Figure 2 Copyrighted images not authorized for reproduction.

Rejecting 'sitting all the time' exerts tremendous pressure on the lumbar region. Therefore, it is critical to maintain an active posture. It is recommended to stand up and move for 5 to 10 minutes after every 60 minutes of sitting; walking or doing some simple stretching exercises can help relax the back muscles. This is especially important when working in an office, as taking breaks and moving periodically contributes to better blood circulation and prevents muscle stiffness and pain.

Core strength training is crucial for protecting the lumbar region. The strength of the abdominal, back, and glute muscles directly affects spinal stability, allowing for better load distribution across the lumbar region. Regularly performing specific core exercises, such as bridges, the cat-cow position, planks, and bird-dog, can strengthen this area, maintain spinal stability, and prevent the onset of lumbar pain.

Figure 3 Copyrighted image. Not allowed to reproduce.

Five, these signals of lumbar pain are an 'alarm' from your body, don't ignore them!

1. Back pain lasts more than 3 days without improvement.

If lumbar pain does not improve significantly after resting and applying conventional relief methods, or if the pain persists for more than three days, it could indicate an underlying problem in the spine or internal organs, such as lumbar disc herniation or vertebral fracture, among others. At that time, medical attention should be sought immediately for professional examination and treatment.

If the leg and foot feel numb as if receiving an electric shock, accompanied by pain in the lower back, as well as feelings of numbness, tingling, or weakness in the legs, it could be a symptom of nerve compression such as disc herniation or sciatica. This suggests a potential compression of the nerve roots in the spinal column, so seeking medical attention as soon as possible is advisable to prevent the worsening of symptoms.

3. Red light emergency! When there is an urgent need to urinate or defecate, and there is difficulty in holding urine, fecal incontinence, or, conversely, inability to urinate, this is a critical warning sign of spinal cord compression. This equates to a failure in the 'main switch' that controls excretion; it is necessary to go to the emergency room within 24 hours, as a delay could result in paralysis.

If you experience lumbar pain accompanied by high fever and chills, it may be a lumbar disease caused by an infection, such as a spinal infection or kidney infection. In this case, you should see a doctor as soon as possible to prevent the infection from spreading and causing more severe consequences.

5. Pain radiating 'to other places' should be cause for concern. If lumbar pain begins to extend to the chest or abdomen, or is accompanied by severe pain in the upper abdomen, it could indicate a problem with the internal organs (such as the kidneys, gallbladder, or pancreas, among others). In this case, it is necessary to see a doctor as soon as possible to rule out alterations in the internal organs.

Remember the two reasons to 'go to the hospital immediately': 1. Severe pain in the waist or abdomen without any warning (as if being stabbed); 2. Cold sweat from pain, inability to maintain an upright posture, and rapid breathing. This could be a renal calculus attack or aortic dissection, among other emergencies. Pain is just a warning, every minute counts for life safety!