Spinal General Knowledge FAQs

I can’t get comfortable in bed. Do I need a special mattress or pillow?

You can try these tips to give your spine some extra support while in bed. Low Back Support — when lying on your side, slide a small pillow or rolled towel just above your waist, and put a pillow between your knees. When lying on your back, you can try putting a small pillow under your knees. Neck Support — neck rolls, cushions, and pillows can be used to give your neck extra support while you rest. Avoid foam pillows because the foam pushes against the pressure of your head and keeps your neck muscles from getting a good rest. Choose a feather or synthetic material for added comfort.

I hear a crunching noise when I turn my neck. Is this bad? Should I have it checked?

Popping sounds can sometimes be heard when a muscle or tendon slides over a bony bump. The sound you hear may also be the gliding of joints as you turn your neck. Articular cartilage forms a smooth covering over the surface of healthy joints. If your joint has been injured or becomes inflamed, the surface may thicken, creating a rubbing sound as you move. A courser grinding or crunching may indicate more advanced changes in the surfaces of one or more joints. Such changes can be caused by osteoarthritis (OA). OA can happen from normal wear and tear, especially when there has been a change in the alignment of your joint. Joint alignment can be changed following an injury, when your muscles are tense or in spasm, or from poor spine postures that have been used over the years. A therapy program to help with your posture and muscle balance can improve movement in your neck and may help stop the noise.

Is ‘correct’ posture really that important to the health of my spine to prevent back pain or neck pain?

Using healthy spine posture is like a protective shield against back pain and neck pain. When your joints and muscles are positioned in their safe/ neutral postures, your body works like an elegant machine preventing any pain and injury. It works safely and even more productively. Prevention of pain and injury has a lot to do with keeping a balanced position in your spine.

Are abdominal ‘crunch’ exercises the best way to keep from having low back pain?

Not necessarily. Abdominal crunches do help strengthen the upper abdominal muscles. But many people with chronic back pain already have fairly strong upper abdominals. Chronic back pain has been linked to a loss of muscle quality and nerve function in the lower abdominals. These problems in the lower abdominals mean that other muscles, including the upper abdominals, must take over and do more of the lower abdominals’ job.

Strengthening the upper abdominals with exercises like abdominal crunches may help low back pain feel a little better. But strengthening the lower abdominals is more important in preventing and treating low back pain. Working the lower abdominals can improve your core strength, holding your spine steady as you lift, push, and pull. Increased core strength can also help ease your pain and get you back to your daily activities.

What exercises should I continue doing to keep my low back toned and healthy?

One of the common denominators in in chronic and recurring back pain include weak abdominal and trunk muscles, unhealthy posture, and overall deconditioning due to lack of exercise. Spinal exercises should be chosen to offset each of the problem areas that contribute to back pain. Putting safe posture in action is important to protect your back from small injuries that add up when the spine is strained in awkward or stationary postures. A well-rounded program for maintaining a healthy spine should include some form of aerobic exercises. Examples may include walking, cross-country skiing, or swimming. It is important that you choose an aerobic activity you enjoy, so you’ll stick with it. Always, remember to check with your spine specialist before beginning an exercise program, as our bodies are uniquely structured and these programs need to be individualised.
My spine condition related to back or neck pain has kept me out of work for some time. When can I get back to work, and how will I know I can do my work safely?
Spine specialists use their knowledge of human spine movement, spine ergonomics and spine injury prevention to make sure patients are safe when returning to work. After understanding the type and nature of your job, your spine specialist might suggest small changes in the way your workstation is designed or how you do your job which can make a big difference in your comfort and safety at work. Based on your level of spine related back or neck pain and your expected activity level at work your spine specialist will suggest the safe time frame for you to get back to work.

Will a support belt or brace keep my low back safe when I lift at work?

Unless you have had a significant spine injury, you probably do not need to use a support belt when lifting at work. Support belts have not been shown to effectively reduce back injuries among workers who lift. Actually, workers who use these devices often gain a false sense of security and may hurt themselves by lifting too much. Long-term use of a lumbar support belt has been shown to actually weaken abdominal and back muscles. This is because the brace becomes the source of support instead of your trunk muscles. A brace may be prescribed if you have had a recent or severe spine injury. However, you will likely be instructed to use it on a short-term basis only and to continue with an abdominal strengthening program.

I’ve had back pain off and on for years. Why does it keep coming back?

It is estimated that 80% of people will have a significant episode of back pain. This is not a simple backache, but pain that limits your ability to participate in leisure, recreation, or work activities. After you have had a pain episode like this, there is a 90% chance that the pain will happen again. This is called recurring back pain. It can happen when you are starting a new or seasonal activity, when you lift incorrectly, or when you use awkward postures. If a weak disc has started to bulge, these types of activities can put extra pressure on the weakened disc, expanding the bulge. The bulge can bring on the pain by putting pressure on the joints, nerves, or ligaments of your low back. With time or treatment, the bulge may get smaller and the pain may go away.

Back pain that comes and goes can also happen when the muscles or ligaments are not able to control the movement of a spinal vertebra, leading to spinal instability. Ligaments connect bone to bone, helping to limit the amount of movement of a joint. If a ligament has been stretched, it loses its ability to hold the joint stable. Your abdominal and low-back muscles provide support for your lumbar spine. If your abdominal muscles are weak from postural changes or from not being exercised it can cause recurring pain.
Are there other medical professionals who may be able to help me deal with my chronic spine pain?
Conservative spine care is most successful when a team of skilled professionals works together to help you gain control of your symptoms, improve your back function, and help you return to doing the things you enjoy. Other medical professionals who may help with your conservative treatment include: Dietician, Physical or occupational therapist, Psychologist, Psychiatrist, Counselor or an Ergonomic specialist

When will the pain in my spine go away?

Identifying and getting treatment for the condition that is causing your pain is an important first step toward controlling spine pain. The treatment and reassurance from your spine specialist can help get you on the road to recovery. Sometimes these are all that are needed to help your pain go away completely. In fact, many people who experience mild back pain for the first time become pain-free within six to eight weeks without treatment. Yet spine pain is not predictable most of the time. Your Spine specialist will have a better idea of your recovery time when your medical exam is completed. Most of the times the goal of treatment will be to help you control your pain and get back your best possible function, even if your pain does not go away completely.

What should I expect on the first visit to my Spine specialist?

Your Spine specialist will begin by getting your complete health history related to back pain and neck pain, followed by a physical examination. The history and physical examination are needed before your condition can be accurately diagnosed or treated.
To help get your physical history, your Spine specialist may ask you some questions about your pain and symptoms. Examples of the questions that you may be asked include:

When did your pain first begin? Are you aware of work postures or other factors that may be causing your pain? Was there an injury that may have caused your pain? Where do you feel the pain? What is the intensity? Does the pain radiate to other parts of your body? What makes the pain feel better or worse? Have you had problems with your bladder or bowels? Do you have a family history of similar problems?

During your first visit to the Spine specialist, he or she may also order some tests to help with your diagnosis.

What can I do while I am at home to relieve my back pain?

There are a number of things you can do at home to relieve your back pain. Your Spine specialist may recommend using heat or ice, relaxation, breathing, and positioning exercises to help control your pain and relieve stress based on assessment of your condition. Simple rest can many times help relieve back pain since having pain with an activity or movement is a sign of irritation.
Should I just lie in bed and avoid exercise if I am having back pain?
Prolonged bed rest is not healthy and can cause your muscles to weaken and your joints to get stiff. On the other hand any exercises you do should be done only under the direction of your Spine specialist. Talk to your Spine specialist if you continue to have pain after 48 hours of rest.

What hobbies and recreational activities should I avoid?

For people with back or neck pain, the answer to this question is “It depends.” It depends on the stress of the activity you have in mind, and the type of back or neck problem you have. Be aware of your limitations and safety. Avoid activities that strain your spine or increase your pain. It is best decided by your spine specialist after thorough assessment of your condition.

How will I know whether surgery is needed?

The good news is that the majority of back problems do not require surgery. Once the most likely cause of your problem has been determined (once your diagnosis is made), you and your Spine specialist can decide on a plan for taking care of your back now and into the future. A variety of treatment options exist for different types of back pain. In most cases, conservative therapies such as mild pain medications and rest are effective in relieving the immediate pain. The overall goal of treatment is to make you comfortable as soon as possible, design a program to reduce further pain and injury, and get you back to normal activity as soon as possible.
The first decision that must be made is whether your problem is very serious, or less serious. Some problems need immediate attention—possibly even surgery. For example, if you have significant muscle weakness or have nerve pressure that is affecting your bowels or bladder, you may require immediate surgery. If you have pain that cannot be tolerated or you are unable to gain reasonable function for daily activity, surgery may be suggested.

What can I do to keep from making my pain worse?

Learn to move without straining your back. When getting in or out of bed, use the “log roll” technique. Roll to your side and sit up while keeping your back steady and secure. Instead of twisting your upper body when you roll to one side, try to roll your whole body as a unit, like rolling a log. When you sit or stand, try to keep your back straight and bend forward at the hips. Also, keep your back straight or use a grabber to avoid bending over at the waist to put on your socks and shoes, or to pick up items from the floor. If you must bend, try to keep your back straight and secure as you bend forward at the hip joint—not your back. Do not test your back by trying to see how much you can lift or carry. If you must pick up or carry lighter items, squat down by bending your knees. Do not lean forward by bending at your low back. When you lift, keep the item in close to your body, even if it is light. Holding the weight out in front of you puts extra strain on your low back. Check with your Spine specialist if you have any questions about the safety of lifting or carrying.

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