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Ask HN: How do you guys prevent back problems?
57 points by dh9kim on May 4, 2019 | hide | past | favorite | 44 comments
Hey guys,

Like everyone here, I probably spend way too much time at a desk and have been dealing with back problems lately. I'm trying to see what I need to do going forward to prevent my back problem from getting any worse.

I recently bought a standing desk with a mat so I think it's a good start. What else should I look into?

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.


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

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

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

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), 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.

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

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

* 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....

* Learn to hang passively. Apart from stronger shoulders, inter-vertebrae pressure get released. - 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

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

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.

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.

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).

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.

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.

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.

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

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.

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! :)

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.

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.

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)

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.

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

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.

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.

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

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.

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.

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

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

or just do Bhujangasana


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.

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.

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...

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

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

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

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

Def. need to visit a Chiropractor!

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

Squats stronglifts.com

Focus more on form than putting up more weight


deadlift worked well for me

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

Deadlifts will make your back strong. You can start with almost zero weight and slowly work your way up. At any age. I really mean any age, even 85 or 90yo

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

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