Almost all adults experience low back pain at some time in their lives. Learning the causes of this condition can help you take steps to reduce your risk for this common complaint.

Whether you have back pain as a near-constant companion or an occasional visitor, you can employ strategies to send it packing.

"All back pain can't be eliminated, but by being proactive you can make bad episodes less frequent and less painful," according to Noah Finkel, M.D., an orthopaedic surgeon in private practice in Huntington, N.Y., and a spokesman for the American Academy of Orthopaedic Surgeons.

Although back pain tends to be a universal complaint, Finkel says middle-aged people are more likely than younger and older folks to have back pain that's lifestyle related.

"Men and women in their 30s, 40s and 50s have a high incidence of back problems due to a combination of risk factors that typically appear in middle age," he says. "Addressing these underlying causes can significantly reduce the incidence of back problems."

These risks include:

• Being overweight. Overweight people have an increased risk for back pain. This is especially true for people with extra weight around the midsection, which pulls the pelvis forward, creating stress on the lower back.

  People carrying extra pounds also may experience sciatica and low back pain from a herniated disk or a pinched nerve caused by compensating for the weight.

  Maintaining a healthy weight through diet and exercise not only reduces existing back pain, but also can help prevent certain types of back problems in the future. For example, overweight and obese people have an increased risk for osteoarthritis as they age.

• Living a sedentary lifestyle. Lack of exercise can cause or worsen back pain due to increased stiffness and deconditioning.

  Sedentary people miss out on the benefits of regular physical activity, including nourishment of spinal disks, soft tissues and ligaments. When there's a lack of exercise, disks become malnourished and degenerated.

  Strengthening exercises for the muscles of the back and abdomen can help provide sufficient support for the spine.

  Participating in a regular exercise program that includes stretching, strengthening and low-impact aerobic conditioning can help heal existing problems and prevent future ones.

  "Movement and exercise also keep the spine healthy, flexible and strong," says Finkel. "Gentle forms of exercise, such as yoga, Pilates, water therapy, riding a stationary bike or walking, are especially helpful."

• Having poor sitting posture. Sitting in office chairs for hours at a time can cause low back pain or worsen existing pain.

  In addition, "most people sit wrong," says Finkel. "Sitting forward or slouching down in a chair can overstretch the spinal ligaments and strain the disks and surrounding structures in the spine. Over time, incorrect sitting posture and poor workplace ergonomics can contribute to or cause recurrent episodes of back pain."

  The best sitting position for your back is to align it against the chair back. Avoid slouching or leaning forward, and keep your knees even with your hips or slightly higher.

• Not managing stress. Most people who are under stress and don't manage it effectively tend to sleep poorly, eat an unhealthful diet and get little exercise. Add stress-related muscle tightness to the mix and back problems can result.

  Taking good care of yourself when you're stressed by doing relaxation and breathing exercises and finding time to exercise every day — even if it's nothing more than a 10- or 15-minute walk — can help prevent the inevitable.

• Lifting improperly. Whether you lift every day or occasionally, knowing how to do it properly — especially if you're out of shape or overweight — can reduce your chance of hurting your back.

  To lift correctly: Always be sure to bend at the hips, not the low back. Keep your shoulders in line with your hips to avoid twisting. Hold the weight close to your body. Don't lift anything that's too heavy without assistance.

• Smoking. Smokers are almost three times more likely to develop low back pain than nonsmokers.

  According to the University of Michigan Health System in Ann Arbor, the nicotine in cigarette smoke thickens the walls of the blood vessels. This restricts blood flow through the large and small blood vessels of the lower back and increases the amount of time for healing and recovery if you have a back injury.

  "Keeping your back healthy and strong by exercising and maintaining a healthy weight takes some time and effort," says Finkel. "But for many people, the prospect of living free of back pain is well worth it."

Risk Reducers
One of the best ways to reduce your risk for back pain is to do exercises that make the muscles in your back, stomach, hips and thighs strong and flexible.

Before beginning any exercise program, discuss it with your doctor, especially if you have or have had back pain. Then:

• Do the exercises every other day.
• Before exercising, always warm up with slow, rhythmic exercises, such as walking.
• Inhale deeply before each repetition of an exercise and exhale when performing each repetition.

Barbara Floria spoke with Noah Finkel, M.D., an orthopaedic surgeon in private practice in Huntington, N.Y., and a spokesman for the American Academy of Orthopaedic Surgeons. For more information, call 800-824-2663 or visit www.orthoinfo.org.

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