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Back savers.

About 80% of Americans develop back pain at some point, making it one of the most common maladies. Fortunately, most backaches aren't serious and generally go away in a few weeks, with or without treatment. Unfortunately, in more than half of all cases the pain eventually recurs--so it's a good idea to take preventive measures. Since most backaches are due at least in part to weak or tense muscles and excessive strain on them, these measures include losing excess weight, exercising to strengthen your back and abdominal muscles, and improving your posture (see Wellness Letter, March 1992.)

One way people try to improve their posture and/or protect their backs is by using one of a variety of backrests, special pillows, and other devices now available in orthopedic-supply stores and catalogues. (Certain back products, especially those that immobilize the spine, should be prescribed by your doctor or other qualified practitioner and must be specially fitted.) Choosing an off-the-shelf back-care product is largely a matter of personal preferences and comfort. There's no scientific research showing, for instance, that a lumbar roll is better than a larger backrest, or vice versa. In fact, there's a great deal of disagreement among back experts (such as orthopedists, physical therapists, chiropractors, and product designers) about what's best for backs in general. Since backaches tend to be idiosyncratic, no single piece of advice or gadget will work for everyone, and for some backache sufferers no device will help.

Products to pamper your back

Backrests. Sitting actually puts more pressure on your spinal disks than standing; slumping or hunching over in a chair is particularly straining. A chair that supports your lower back is essential. Backrests can also help encourage good sitting posture, especially when the chair is not adjustable. Backrests come in many sizes and shapes. Some contoured models are made for use in cars; others are inflatable and can be conveniently taken into planes, trains, or theaters.

Lumbar rolls. These cylindrical foam pillows (4 to 5 inches in diameter) are placed directly in the small of your back for support when seated. Many have straps for attaching to a chair.

Seat wedges. When placed on a seat, one of these fabric-covered pieces of foam can tilt you forward and prevent you from sinking into an unsupportive chair. You can also place it behind your back to adjust the angle of a chair's backrest.

Neck supports. These pillows wrap around the neck and thus help keep your head upright and maintain proper alignment of cervical disks. There are inflatable models.

Slant boards. These angled boards, when placed on desks, help prevent neck strain and slouching while you read or write. Most are adjustable.

Pillows. Bad sleeping position is a common cause of aches and pains. If you have a stiff neck or shoulder most mornings, try a different pillow. New pillows can be expensive, and no one pillow is going to answer everybody's needs. Ideally, your neck should be straight most of the night. Some foam pillows are too high and firm, or too bouncy. Some down pillows are too soft and flat. If you generally sleep on your back or side, you might benefit from a "cervical roll," a small round pillow for neck support. This can be used by itself or in addition to your regular pillow. If your mattress is very firm and you sleep on your side, you may need a thicker pillow than you would on a mattress that allows your shoulder to sink into it. If you sleep on your stomach most of the night, try a soft, oversized pillow that goes under your chest but supports your head and neck. Try sleeping with different pillows or combinations of pillows. Or simply try a rolled-up towel as a cervical pillow. Some people prefer no pillow at all.

Bed wedges. These help you stay comfortable while reading or watching TV in bed. If you sleep on your back, you can also use a wedge to elevate your knees in order to relieve pressure on the disks in your lower back.

Bed boards. You can firm up a sagging mattress (a frequent contributor to back pain) by placing a board between it and the box spring. Lightweight folding models are available for travel.

"Back-saving" tools. One type of snow shovel or rake has a bent handle that allows you to stand nearly upright while working, thus reducing stress on the lower back. Lightweight shovels can also help. Some shoehorns have an extra-long handle so you don't have to bend over when putting on shoes.

An excellent source of back-care products is Back Designs. Its catalogue is available for $5 from 614 Grand Avenue, Oakland, California 94610; telephone: 510-451-6600.

Shopping tips

* If you have chronic back pain, discuss your options with your doctor, who may direct you to sources of back-care products.

* Try ougt different devices, models, and sizes in the store, if possible. Lumbar rolls, for instance, come in various sizes and degrees of firmness.

* Expensive isn't always better. Some of these products are really quite simple, and low-tech substitutes may work just as well. For instance, you can try a rolled-up towel instead of a ready-made lumbar roll, or a piece of foam rather than a fancy car seat or seat wedge.

(Should you heat or ice a backache or other injury? How do you choose an office chair and desk that are good for your back? The Wellness Letter will deal with these issues in coming months.)
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Title Annotation:preventing back pain
Publication:The University of California, Berkeley Wellness Letter
Date:May 1, 1993
Words:917
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