
Ask HN: How do you guys prevent back problems? - dh9kim
Hey guys,<p>Like everyone here, I probably spend way too much time at a desk and have been dealing with back problems lately. I&#x27;m trying to see what I need to do going forward to prevent my back problem from getting any worse.<p>I recently bought a standing desk with a mat so I think it&#x27;s a good start. What else should I look into?
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ZeroGravitas
The evidence based advice from Dr Stuart McGill is right up HN reader's
street.

An actual academic who takes a rigorous, logical approach to identifying and
remedying back problems while also addressing very down to earth issues like
how best to sneeze, tie your shoelaces or or lift light objects from the floor
in the best way possible for your back.

He's got some books, I've got the one called "Back Mechanic" which I highly
recommend and you can find him mentioned in various blogs and YouTube
channels.

He also does work with high end athletes, powerlifters etc. which may be of
interest to some, but I found too much of that kind of thing while researching
and it was his more down to earth advice that I found very useful. In
particular his "McGill big 3" excercises for strengthening core back muscles.

His website is a little cheesy but don't let that put you off, lots of great
info in his books.

[https://www.backfitpro.com/backpain/](https://www.backfitpro.com/backpain/)

Also, walking (though McGill has some more specific hints on walking posture).

~~~
fabiomaia
Which of his books cover those very down to earth issues? That sounds super
interesting

~~~
ZeroGravitas
"Back Mechanic" is his book most aimed most at "normal" people (i.e. neither
athletes nor medical professionals)

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Glawen
The trick is to harden your back muscles, so that they hold your spine firmly
in place.

I had a spinal disc herniation 3 years ago, followed by back pain for a year
after. Since a year, i have no more back problems, what helped is dead simple
abdominal exercise every morning. I do every day 2-3mins of plank exercise
[https://en.m.wikipedia.org/wiki/Plank_(exercise)](https://en.m.wikipedia.org/wiki/Plank_\(exercise\)),
it doesnt take long and can be done everywhere. When the pain comed back, i do
the exercise 2 or 3 times a day.

I also go once a month to do Kinesiotherapy (i'm in France, its quite popular
and reimbursed) but i've stopped since i'm healed.

~~~
tugberkk
It is about your abdominal muscles, not back. Abdominal muscles and glutes
hold your spine in check.

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jugjug
My movement teacher Ido Portal shares these two main principles:

\- Every day is a spine day.

\- The best way to get rid of pain is to flush it away with tons of new
information" (In other words, you have to move the part that hurts a lot)

Preventing back problems is thus straightforward: move your spine a lot, every
day. Here are some suggestions, that I started working with and have had very
good results with:

* Do minimum 10 minutes of spine waves every day to increase vertebrae mobility - [https://www.youtube.com/watch?v=_tlMntE1WzQ](https://www.youtube.com/watch?v=_tlMntE1WzQ)

* Change positions when working. Learn to squat in a relaxed position, so you can for example type emails while squatting - [http://placeofpersistence.com/30-30-squat-challenge-by-ido-p...](http://placeofpersistence.com/30-30-squat-challenge-by-ido-p..).

* Learn to hang passively. Apart from stronger shoulders, inter-vertebrae pressure get released. - [http://placeofpersistence.com/30-day-hanging-challenge-by-id...](http://placeofpersistence.com/30-day-hanging-challenge-by-id..).

* Learn a proper handstand. This had tremendous advantages to my wrists, elbows, shoulders, spine, core. - [http://gmb.io/handstand](http://gmb.io/handstand)

Such combination of movements introduces plethora of new positions to your
spine: rotations, extensions, static holds.

I liked the book "Move Your DNA" which explains why constant movement is so
important and how inactivity affects our bodies.

EDIT: Typos & editing

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nextos
I got rid of my laptop, they are an ergonomic disaster. I realize this is not
a realistic option for everyone. Using an external screen and a split
keyboard, like a Kinesis Freestyle, makes an incredible difference. I also
recommend a thumb trackball like a Logitech or an Elecom.

Lastly try a relatively firm chair that allows different positions, like a Håg
Capisco. And a firm bed with a soft but thin topper.

The latter option might be the key. If you have a bed that is too soft, you
will sink in and your spine will be twisted.

In general, look for firm supportive options that allow different positions.
For example a split keyboard allows many natural angles, putting your
trackball between both panels, etc.

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DoreenMichele
Among other things, you need strong abdominals to support your back. For some
people, this is non obvious. It's common to think you only need to strengthen
your back muscles.

Anecdotally, for me, low back pain is immune system distress. I think it's
because the pelvic bones are the largest well of bone marrow in the body. My
low back pain is often helped by nutritional support for the bone marrow, such
as calcium, B vitamins and the right fats.

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javaIsGreat
If i dont get light cardio exercise in a few days time my back tightens up, my
knees hurt, and i dont look forward to sitting for hours at a time.

Commuting by bicycle 3 miles to work helps a lot. Basically prevents my back
and knee pain.

Walking a mile bus station to work helps as well but not as effective as
biking.

Getting up for water, coffee, and bathroom as frequently as possible to keep
the blood flowing in my body helps as well even though people around you give
you looks for moving around so much (and not working lol).

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mastrsushi
Make sure to get out of your chair and walk a little every hour or so. And
don't slouch in your chair, make sure you have a chair with good lumber
support, or at least something to help elevate. More importantly, look into
exercises that strengthen your posture, yoga, pilates, core strength workouts.
We really weren't made to be sitting at a desk 8-10 hours a day. Not trying to
sound hippy dippy, but it's the truth.

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kUdtiHaEX
Exercise. If you have a weak back, first go to see a physician. He can
recommend some light exercises to strengthen muscles on your back.

I always suggest swimming, it involves all muscles in your body and is a good
way to build up your body. Especially if you're not a gym type.

But all in all - exercise, going for a walk, try to reduce amount of time in a
chair and/or replace some other "leisure" activities for a good old exercise.

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Starknaked
I've had serious back injuries in the past and sitting at a desk would soon
lead to poor posture and discomfort.

The three best things I found for my back are.

1\. Be mindful of how you're sitting and keep that natural curve in your spine
with your shoulders back and chest out. You don't have to be aware of it all
the time just make a habit of checking in with your posture when you sit down
or when you're changing tasks.

2\. If you go to a gym then hit the rowing machine. Good technique requires
good posture and its great for strengthing those muscles.

3\. Get a ball like a tennis ball and put it between the back of the chair and
around the base of your spine/hips. This gives you space to relax your
shoulders back and maintain a natural curve in your back. Just as long as you
feel comfortable.

I found that after a while maintaining a good posture gets easy and more
comfortable than slouching.

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DanBC
Here's the NHS recommended exercise for non-specific lower back pain.
[https://www.nhs.uk/live-well/exercise/lower-back-pain-
exerci...](https://www.nhs.uk/live-well/exercise/lower-back-pain-exercises/)

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godot
I personally don't buy into the standing desk trend; I often feel that my back
gets sore more if I stand for any extended periods of time.

I'm entering my late 30s this year and I've never really had any back
pain/problems. I don't know what my secrets are, but I have a gut feeling it
might be because I never sit still. Even when I'm coding, I just naturally
tend to move my body every couple of minutes. You could say I have a problem
staying still since I was a child, but it may be what helped me to never have
any muscle stiffness issue.

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raindropm
Like everyone said, strengthen your back muscle, glute and whatever muscle
that weakened by sitting for too long — is the way to go.

What works for me personally is Foundation Training by Dr. Eric Goodman. You
can search Youtube and try their basic 12 minutes exercise. I've tried quite a
different way to combat my back pain, but this one gets me a good result.

A standing desk is good, but you eventually, inevitably, have to sit and work.
So, make your back stronger is more of a long term solution. Good luck! :)

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atrocious
Pilates class at my local gym. Friendly, low stress and only once or twice a
week for 45 minutes. Sorted out my core strength, messed up shoulders and
back.

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speedplane
I've had on and off back pain for years. Ibuprofen works in the short-term,
but after a while you start feeling like you're addicted to the stuff. The
only thing that really works for me is running. It doesn't have to be much.
One or two 30 minute runs a week totally vanquished any back pain I had after
the first few weeks.

Golfing, on the other hand, is the worst. The twisting motion inherent in golf
does a real number on your back.

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dontbenebby
I try to avoid videochats. Instead I do audio only and walk (either outside,
or just around the office). People sometimes balk, but when they see I give
the call my full attention instead of turning on video, muting my mic and
"multitasking" they usually warm up.

Also exercise, specifically squats do wonders. Consider a weightlifting
regimen. (I found Starting Strength useful)

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rayrrr
Daily yoga, tai chi, qigong, or another such gentle body movement activity is
the way to go for able folks of all body types and situations.

------
dh9kim
The key takeaway I am getting from the comments - EXERCISE! I've been off the
gym for about a month. Duh!

~~~
grantbachman
Yes! Many people think they shouldn't exercise their back because it already
hurts and they don't want to upset it any further. In reality, a lot of back
pain comes from having a weak back. Squats help tremendously with this.

I highly recommend watching Mark Rippetoe's videos on getting stronger, and
learning how to squat, bench, deadlift, and press in a safe way.

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sjg007
Yoga helps. Planking, press ups, posture over correct, back extensions, and a
variety of back specific stretches. You should see a PT if possible. There are
some chairs too that help posture. The one where you sit on your knees and the
bouncy ball typically help with core strength.

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mud_dauber
Yoga, planks, pushups, back extensions, squats, dead lifts, and (the real
kicker) TRX straps.

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flarg
IME that's enough. I spent my early working life in a job where I had to stand
and walk all day and my back muscles retain that strength even to this day. I
still stand at work, now out of choice, and have never had back pain.

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Spooky23
Stretch and lose 30 lbs.

I ended up getting a spinal fusion in my 20s. Thank god and my PT team 15
years later and i have been great since.

Back pain sucks and when it gets worse and as you get older, treatments just
get riskier and more difficult.

------
0x54MUR41
Related discussion:
[https://news.ycombinator.com/item?id=19805674](https://news.ycombinator.com/item?id=19805674)
(2 days ago since this comment posted)

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truth_seeker
If you can do surya namaskar, it will help in mnay ways

or just do Bhujangasana

[https://en.wikipedia.org/wiki/Bhujangasana](https://en.wikipedia.org/wiki/Bhujangasana)

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dmitripopov
Good chair and regular breaks (with a pomodoro timer) to walk or do some
exercises. Standing for a long time actually takes toll on your knees and
other joints so you need breaks and exercises too.

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synapse0
Had recurring back pain every 2/3 months since I was 18, for anywhere from 5
to 15 days.

At 43yo started lowbar back squats and deadlifts, and in the last 2 years back
pain is totally gone.

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hotdox
I use one of this
[https://en.wikipedia.org/wiki/Kneeling_chair](https://en.wikipedia.org/wiki/Kneeling_chair)

------
tugberkk
I would like to recommend something different: Healing Back Pain: The Mind-
Body Connection

This book shows that almost 90% of back pain is psychosomatic.

Here is Amazon link, feel free to read customer reviews:
[https://www.amazon.com/Healing-Back-Pain-Mind-Body-
Connectio...](https://www.amazon.com/Healing-Back-Pain-Mind-Body-
Connection/dp/0446392308/ref=zg_bs_4660_3/139-7835443-8031541?_encoding=UTF8&psc=1&refRID=EQ0TK17EZ7ZZY9F3S08W)

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hammock
Lift heavy. A stronger back and core will protect against injury and also
naturally improve your posture.

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rurban
Train your muscles. I started with some EMS training for a few months, and do
now regular sports 4x a week.

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atmosx
Yoga, standing office, ergonomic chair, healthy diet, lose weight, exercise at
least 4 times a week.

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jmpman
Chiropractor to get everything “good”, and then started squats at the gym.

~~~
dh9kim
Def. need to visit a Chiropractor!

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afarrell
On most days, I do 20 squats while holding a 20kg weight.

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hebetude
Squats stronglifts.com

Focus more on form than putting up more weight

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ScottFree
Deadlifts.

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k0t0n0
deadlift worked well for me

~~~
jakobloekke
But absolutely not recommended unless you already have a strong back!

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ScottFree
That's ridiculous. How else do you get a strong back to begin with?

~~~
swah
[https://www.cheatsheet.com/health-fitness/weight-lifting-
mov...](https://www.cheatsheet.com/health-fitness/weight-lifting-moves-you-
can-substitute-for-deadlifts.html/)

