I got in trouble with my back around 3 years back. I had persistent lower back pain, and then radiating back pain through my nerves to my limbs. It got so bad that I spent a week just in bed rest, and then, after a whole whirlwind of treatment options that included Ayurveda, physiotherapy, and medication, I recovered enough to return to work.

Since then, I’ve tried to examine all the factors around me that contribute to a better back, and this post is a distilling of my learning around mitigations. Note: this is just my personal experience, and none of this should be considered medical advice.

Body Stiffness

I think this was the root cause of my back pain, and what got diagnosed as mechanical back pain. In other words, I should have gotten off my ass more, and gotten more exercise. It’s general muscle stiffness that contributed the most to my sore back muscles. As you grow older, your body’s natural flexibility reduces, and you have to give it booster shots via regular stretching exercises or yoga to make sure you remain bendable. In particular for me, my leg muscles would become rigor mortis stiff at the end of the day, and that led to my back becoming strained as well.

The only thing that really help to avoid stiffness is regular exercise. During the initial stages of my recovery, I used to do regular a daily routine similar to the one in this video:

I continued those for upwards of 6 months until my stiffness and pain went away. Nowadays, I do maintenance exercises, which is mostly a combination of basic yoga Suryanamaskars & leg stretches.

One more thing: have enough water. The importance of water to improving your general muscle stiffness cannot be understated. A healthy adult should have about 4 liters of water a day. That’s four refills of your 1 liter bottle a day.

TLDR: The only real way to fix body stiffness is to incorporate some regular stretching and flexibility exercise into your day.

Weight Gain & Diet

The basic premise behind this category is simple: the more weight you have, the more your back will have to support. And especially if the weight you gain is in the form of fat around your tummy and your thighs, your back muscles will complain more.

Make sure you are within your ideal weight range. A decent thumb rule to find your upper limit is to subtract your body weight in cm by 100 to find your weight in kg. I’m 184cm tall, so my upper limit is somewhere around 84kg.

As you grow older, your metabolism is not as active as it was before, and what you used to inhale in your college days is no longer sustainable as a regular diet. The only way to keep your weight under control is to eat less. I’ve found that Intermittent fasting is the best way to do that. I’ve been doing a 16-8 fast for about 2 years now, and after around a month of adjustment, it became the norm for me. I’ve also experimented with keto in the past, and while I decided a strict keto diet is not for me, I have consciously reduced my carb intake. The other no-no (which I’m still working on) is to have less of everything that your parents will say is bad for you: sweets, fast food, desserts, oily food, and what seems like everything tasty.

TLDR: Eat less, keep your weight under control, and your back will complain less.

Posture

There’s a whole bunch of things I’ve clubbed under posture, but this is everything that’s got to do with how you sit, work, and even sleep. Posture is also easy to understand: make sure your body is not in positions that it was not designed to be for long periods of time, and your back will thank you. The troubling fact is, most of the work that a desk bound human does today are things that are absolutely 100% bad for the back. Human beings evolved as hunter gatherers, and while we’ve moved on to build a society where most of us do knowledge work, our backs are still catching up. So to be good to your back, behave more like the hunter gatherers of yore.

While Working

Do not sit for long periods of time. That’s the best advice for anybody who has got a bad back. Take frequent breaks. I try to take a ten minute break every hour or so. It’s also nice to be aware of an ergonomic work posture:

It’s also great if you get a good chair. Try to get one with adequate adjustments, and preferably with an arm rest. I currently use the Sayl, but there are several more affordable options around. Please try to think of the chair expense as an investment in a back though, since one of the causes of back discomfort may be a bad chair.

While Sleeping

You spend a third of your life sleeping, so it’s great if you do that well. Get a good mattress with adequate back support. Please-oh-please don’t spring for a spongy mattress that curves in. The height of fashion is a memory foam mattress and while I’ve never slept in one I’ve heard good things about them. Just like chairs, mattresses are an investment.

Another good trick to exercise your back is to invest in low-floor furniture: beds, dining tables, et. al. You get far more exercise just bending up and down through the day.

Lack of Strength

In particular, muscular strength, and well developed muscles that support your back. It’s particularly difficult to improve this while you have back pain because any sort of strenuous exercise might aggravate that pain, but it’s imperative that you work on recovering and improving strength once your pain goes away.

There are several full-body activities that naturally improve your strength. I’ve heard swimming is one, and sports like football or basketball are another although I’ve never tried any of this for any length of time. These activities are probably the best ones to attempt early on during your recovery, especially if you love one or more of these things.

The easiest and safest exercise anybody can do would be to go to a gym and selectively work on your strength. I know gym machines get a bad rep for being inflexible, but when you start after an injury, some structure is great for you. Besides, it’s easier for a coach to guide you along. Yeah, definitely do get a coach if you go to a gym after back pain.

Once you have some basic strength, proceed to free weights because the benefits in terms of overall structure and balance is definitely up there. I’ve currently settled on a Kettlebell routine to build my strength. Over the past year, I’ve steadily grown my kettlebell weight to 12kg, and my aim is to up it to around 16kg in the next couple of years. One thing that I’ve found is that it’s not the weight you lift that you should brag about if you care about your back, it’s your form. Here a couple of great videos about swings and cleans:

Good Mental Health

A lot of pain is psychosomatic. Your mind influences your body quite a bit: think droopy shoulders & sleepless nights or just continued persistent tiredness. What starts as a niggling pain in your shoulders or lower back will be aggravated if you don’t find time to take care of yourself. It gets worse if you spend a lot of your energy thinking about what’s troubling you. If you can’t function enough to keep an exercise routine or have healthy food, then your back troubles will only get worse.

There is no magic wand to wave here I’m afraid. I’ve personally gone through a very difficult period and in hindsight, my mental state definitely contributed to the breakdown of my back. The only way out is to take time out to recover. Time heals a lot of wounds, and alongside that, structured help in the form of therapy & counselling help a lot too. Feel free to hit me up if you need good therapist recommendations, I’ll be happy to refer you to good folks.

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So that’s it folks! I know this was long, but the road to recovery after being diagnosed with back pain is long. It takes persistent effort to get out of your rut, and structural change in your life if you want long-term health. I hope everybody who suffers from back pain recovers because it’s one of the worst kinds of illnesses when you are relatively young: all the pleasures of life you take for granted (like biking or basketball for me), or even just moving about are taken away from you suddenly. But it is possible to recover, and live a better life.

I’m still on the road to recovery, but my back flareup has been a major positive life event: I’m now more conscious of my age, and how to live a healthier life.