So back pain is common and it’s quite likely that almost all of us will experience it at some point. Not the most cheerful note to start the conversation but a reality all the same! Most of the times it will be just the temporary muscle imbalance from a poorly judged weight or from the extent of excessive bending or stretching that goes into doing that activity and on other occasions it can be a recurring injury or a chronic problem. So what are the things that we can do to help ourselves when we do land with these problems? And even better, what can we do to reduce our chances of running into these problems in the first place? It’s time to get back to the basics: 1. The fundamental need of a healthy back is a good posture. The direct result of a good posture is less strain on your back for the simple action of holding you upright. A good standing posture is where your head is up and chin in, shoulders are back but dropped ( initially you have to consciously do this by relaxing the shoulder and neck muscles), chest out and tummy tucked in. It seems like a lot of motions and a lot of things to remember for the simple act of standing! But if we don’t get this step right then the next ones will tend to yield lesser gains. When sitting we have to remember to sit back, preferably with some support at the small of the back, commonly known as lumbar support, with both feet resting on the ground. This is very important for those doing sitting desk jobs most of the times. If you’ve felt that nag in the lower back at the end of the day then monitor your posture actively for a fortnight and see the difference. Lifting weights with your legs and not your back is another part of maintaining correct posture – when bending to lift stuff, remember to bend the knees and feel the tension in the quads ( thigh muscles) and not the back. 2. Maintaining a healthy weight is crucial for a healthy back. Carrying excessive weight is like walking around with a backpack at all times. It’s going to tire you out quite easily, particularly if that weight is around the midriff. 3. Core muscle strengthening is very beneficial for the back. I get asked quite frequently about which exercises are the best for this and I’m a big advocate of exercises that increase your body awareness such as yoga, Pilates, tai chi, amongst numerous others. These exercises involve stretching, help muscle strengthening, improve balance, help improve posture and are calming for the mind. Swimming is great as well. But this doesn’t mean that other forms of exercises can’t help back. I’ll revisit this section as a separate topic to talk about at a later date as there are lots of simple routines that can be done even at home or work that can help strengthen the core muscles. 4. Relaxation – it’s all about maintaining the balance. So once you’ve done the hard yard of maintaining good posture and having done the exercises, do remember to relax. Massage is a wonderful way of doing it and is certainly quite helpful in relieving the tension from the muscles but just not adequate or enough on its own. 5. Good diet – adequate calcium is important for the bone health. A cup of milk has about 300 mg of calcium and our daily recommended need is roughly about 1000mg. If you have low fat milk then the calcium content tends to be higher as the fat in the milk doesn’t contain calcium. A cup of yogurt has about 450 mg of calcium. There are plenty of non dairy foods that are rich in calcium such as broccoli, spinach, figs, fortified orange juice, tofu, fish etc. Some fortified cereals can have up to 1000 mg of calcium in 1 cup. An average multivitamin has about 600 mg of calcium. So it’s quite easy to get your daily recommended dose of calcium from diet only. And just as its important to have adequate calcium for optimal bone health, it’s equally important to avoid too much of it as it can be harmful for the heart muscle and can lead to kidney stones when taken in excess. 6. Adequate vitamin D – best source is sunlight but it shouldn’t come at the expense of risking skin cancer! The best times are before 10 am & after 4 pm on exposed or bare skin which soaks up direct sunlight for about 15-20 minutes. For those of us that stay covered up most of the times, have sun sensitivities or have jobs at desks from dawn to dusk, the best alternative is a good supplement – 600 IU to 1000IU, depending on what is the baseline status of vitamin D levels in the body. 7. Some good studies have been done recently which have shown benefit from taking high strength fish oil. It’s effect has been shown to be similar to that of a mild anti inflammatory agent which is quite impressive. Hope you’ll see and agree that these simple looking measures go a long way in avoiding and managing back pain. In the next section I’ll talk bit more in detail about some core exercises, physical therapy and other alternative methods of treatment such as acupuncture.