Making adjustments Simon Crompton Making small changes to your lifestyle can reduce your risk of back pain.

In this article

At home

Out and about

At work

Back pain can be caused by many factors. Run through your daily routine and examine the amount of strain you place on your spine.

Stress can also create muscle tension, causing a loss in flexibility that can lead to back pain. To reduce stress, try exercise, yoga, meditation, getting more sleep or listening to music.

If you smoke, stop. It puts you at increased risk for back problems since your blood has trouble delivering oxygen to working tissues, making your back weaker.

The best way to sit down is to do it without bending your back. Stand in front of the chair with one foot behind the other, almost under the chair. Bend your knees, and at the same time place your hands on the arms or seat of the chair. Lower yourself gently into the seat. A chair with arms makes this much easier.

The following can also help back health in the home:

• Make sure work surfaces are a comfortable height so you don't have to bend your back
• Use a ladder or stable chair when painting or cleaning - don't stretch too far
• Squat or kneel when cleaning the bath or reaching low shelves
• Use an upright vacuum cleaner and keep it close to your body
• Ensure easy access to each side of the bed so you don't have to stretch when making it, and kneel or squat to tuck in sheets and blankets.
• Take regular breaks from time-consuming tasks

If you have children, make sure you:

• Bend your knees to pick up a baby - don't twist
• Kneel down to talk to toddlers rather than picking them up
• Adjust the height of the cot so you don't need to bend, or choose one with drop sides
• When unloading a pram's shopping tray, always bend from the knees

When getting into bed, sit on the edge, lower your body on to one elbow and shoulder and draw up your knees and then feet. Reverse the procedure to get out.

The wrong sleeping arrangements can put additional strain on your back. If you're experiencing back problems, you might want to try the following:

• Replace a sagging mattress
• Lie on your back with a pillow under your knees or on your side with a pillow between your bent knees
• Don't have too many pillows - they support your neck, not strain it

When buying a bed, try any you are considering for as long as you can. Your bed should allow ease of movement but mould to the contours of your body. Don't assume a bed marked 'orthopaedic' is what you need - the word can sometimes be used as a marketing tool.

To test if a bed is giving you the correct level of support, lie on your back and slide your hand, palm down, between the small of your back and the mattress. If you can:

• Work your hand through with some resistance, the bed support is probably about right
• Slide your hand easily through a large gap, the bed is probably too hard (or saggy)
• Hardly force your hand through at all, the bed is probably too soft

If you're in pain, the easiest way to turn in bed is to bend your knees, bringing your heels up towards your buttocks. Let your knees fall to one side and as the weight of your legs takes you over, bring through your hip and shoulder - don't twist.

When you're shopping:

• Don't shop until you drop - take regular rests or make several short trips
• Don't overload your trolley and use a high 'tray' trolley rather than a large deep one
• Distribute your shopping evenly between both hands or hold a bag in front of you
• Wear comfortable shoes

In the car:

• Adjust your seat properly so your arms have a slight bent at the elbow when your hands are on the steering wheel
• Support your lower back with a small cushion or rolled up towel
• Take regular breaks on long journeys and get out of the car for a stroll and a stretch

Help yourself

Print out and fill in a back pain plan to help you keep track of your back problems. It could help you pinpoint triggers and enable you to take better care.

Employers have a responsibility to ensure their employees don't get back problems as a result of working practices. They can face prosecution if they fail to identify and assess risks to staff and take preventative measures to overcome those that are found.

Employees also have a responsibility to look after their own backs but they should be properly trained in back care by their employer. The Government is keen workers get as much information and advice about back care as possible.

• Take regular quick breaks to do simple stretching exercises - for at least one minute every hour
• Sit up straight in a chair that supports your lower back
• When using a keyboard, adjust your seat height so your forearms are horizontal and your elbows at right angles and both feet are flat on the ground
• Mix your tasks so you're not making the same movements for hours

This article was last medically reviewed by Dr Rob Hicks in September 2007.
First published in March 1999.