Prevention of Degenerative Lesions in the Lumbar-Sacral Region

The prevention of degenerative damage to the lumbar-sacral region should start from early childhood. There are two types of prevention: the prevention of the onset of pathological processes and the prevention of their recurrence. Preventive measures aimed at preventing the disease are, in essence, general measures focused on maintaining and strengthening health. These measures encompass almost all aspects of human life and boil down to eliminating unfavorable factors that disrupt the normal functioning of the human body.

Prevention of complications in the dysplastic process in the lumbar-sacral area, like most diseases, involves both individual and social measures. An important role in the development of lumbar osteochondrosis is played by predisposing factors, the most significant of which are unfavorable heredity, constitutional features (the presence of dysplastic traits), and a burdened pre-morbid background. Identifying hereditary predisposition and dysplastic traits (mainly abnormalities in the development of the lumbar-sacral spine) should be a key component of preventive measures.

Modern sports are characterized by increasingly higher loads, particularly on the musculoskeletal system, whose injuries and diseases are the primary factors limiting the growth of athletic skills and performance. Therefore, great attention is paid to scientifically justified selection of children and adolescents for sports activities.

However, it should be noted that professional selection for sports is a complex issue, “in which there can be neither excessive categorical judgments based on one or two signs, nor excessive leniency.” Therefore, it would hardly be justified to exclude young men and women from sports activities if their families have a history of vertebrogenic diseases of the lumbar-sacral region of the peripheral nervous system. It is also not advisable to subject all of them to radiographic examination of the spine in the absence of appropriate clinical indications.

If, however, there are pronounced dysplastic disorders combined with periodic discomfort in the lower back after physical activity, participation in sports clubs should be considered contraindicated. A thorough medical examination, systematic therapeutic exercises aimed at strengthening the back muscles, abdominal muscles, and pelvic girdle are required. Naturally, sports contribute to the harmonious development of an individual and the hardening of the body. However, it is important to distinguish between sports for health and training athletes of high qualification and skill.

In recent years, there has been much written about the risk factors for the development of various diseases, including vertebrogenic lesions of the lumbar-sacral region of the peripheral nervous system, recommending regular dispensary observation. According to our data, the first clinical manifestations of dysplastic processes often coincide with the most intense growth phase (often up to 8–10 cm per year). This leads to musculoskeletal inadequacy. Therefore, special attention should be paid to the formation of the adolescent during this period. A rational physical activity regime, strengthening of the musculoskeletal system, proper posture formation, normalization of existing vegetative and neuroendocrine dysfunctions, sanitation of focal infection sites, and the elimination of allergic factors are of primary importance.

Let’s briefly discuss the prevention of recurrences in individuals with reflex and root syndrome of lumbar osteochondrosis. Recommendations on this issue for adults can be successfully applied to children and adolescents. Naturally, in such cases, it is important to avoid heavy lifting, physical exhaustion, prolonged static postures, sudden and sharp movements, as well as overcooling. We recommend that such patients learn proper lifting techniques, primarily engaging the leg muscles instead of the lower back. Additionally, two courses of anti-relapse treatment should be taken per year (in spring and autumn), including massage, vitamin B group injections, bio stimulants, Rumalon, electrophoresis with lidase, and ultraviolet irradiation. Recurrence prevention also includes achieving effective remission as a result of correct treatment for the previous exacerbation. This involves timely hospitalization, use of an optimal therapeutic regimen, improved qualification of physicians, and preventing premature discharge from care.

One of the most important factors in prevention is scientifically justified professional orientation. Despite technological upgrades, automation, and mechanization of labor-intensive processes, reducing the share of heavy physical labor, professional hazards and occupational diseases still persist. Among the production factors negatively affecting the lumbar-sacral region of the spine, the following stand out:

1. Physical strain on the bones, joints, ligaments, and muscles of the lower back due to lifting and moving heavy loads or static loads on the spine, performing frequent stereotyped movements when bending and twisting the torso, and prolonged staying in uncomfortable forced postures.
2. Exposure to high temperatures and radiant energy, as well as sharp temperature fluctuations at the workplace.
3. Vibration in combination with physical strain.

The development of lumbar osteochondrosis and its clinical manifestations are also facilitated by adverse climatic conditions—high humidity, exposure to radiant and convective heat. What matters most is not the presence of these factors but their duration. Naturally, children and adolescents with diseases of the lumbar-sacral region of the peripheral nervous system should not be recommended to pursue professions associated with the aforementioned occupational hazards.

If adolescents have two or more risk factors, great caution should be exercised when selecting professions associated with significant static-dynamic loads, prolonged periods of being in uncomfortable postures, and work in unfavorable microclimatic conditions.

It should also be noted that the criteria for professional selection are generally indicative and cannot account for all the nuances that may arise in the production process. For instance, an improper and irrational workplace layout can increase the load on the spine even in the absence of the aforementioned occupational hazards.

Prevention of Degenerative-Dystrophic Processes in the Spine

How to Sit Correctly?

Avoid overly soft furniture, it’s not for you. To prevent excessive pressure on the spine, the torso should be supported by the sit bones, which is only possible on firm seats. Furniture on which you have to sit for long periods must meet the following requirements:

1. The height of the chair or armchair should correspond to the length of the shin, ensuring that your feet are firmly planted on the floor. For shorter individuals, it is recommended to use a footrest.
2. The maximum depth of the seat should be about 2/3 of the length of your thighs.
3. There should be enough space under the table for your legs, so they don’t need to be excessively bent.

If you have to sit for extended periods, try to change your position and stretch every 15-20 minutes. Make sure your back is pressed against the backrest of the chair. Sit upright, without tilting your head or bending your torso, to avoid straining your muscles. If your work requires you to read for long hours, consider setting up a reading stand (lectern) on your desk to hold the book at an appropriate height and angle, so you don’t have to lean your upper body forward.

When driving a car, try to sit without tension. It’s important that your back has good support. Place a thin roll under your lower back between the seat and the backrest to maintain the natural lumbar curve. Keep your head upright. After a few hours of driving, get out of the car and perform simple stretching exercises: turns, bends, squats—8-10 reps each.

Don’t sit or lie in the same position for too long in front of the TV. Periodically change your position, get up, and move around. After 1-1.5 hours of sitting, lean back in your chair, relax your muscles, and take a few deep breaths.

How to Stand Correctly?

Knowing how to stand correctly is just as important as knowing how to walk. Your posture directly affects muscle tension and spinal alignment, which in turn impacts your overall health. Correct standing involves minimizing tension in your spine, muscles, and joints. As you know, excessive load on the spine can lead to problems.

When a person stands for a long time, the spine experiences significant loads, especially the lumbar region.

✓ Change your posture every 10-15 minutes, shifting your weight from one leg to the other. This will reduce the load on the spine. It’s better to alternate the load on your legs as often as possible, rather than waiting until your legs fall asleep, because prolonged tension on one side of the body leads to curvature, bone displacement, muscle strain, poor posture, and all the consequences that follow. This can even lead to a hernia or osteochondrosis.

✓ If possible, walk in place or move around. From time to time, arch your back, stretch your arms upwards, and take a deep breath. This can relieve fatigue in the muscles of the shoulders, neck, back, and head.

✓ When standing for long periods, avoid pushing your chest forward or pulling your shoulders back, as this creates a lot of tension. The most natural posture for the spine is one where the chin is slightly lowered and the buttocks are slightly pulled in.

✓ If you are washing dishes or ironing, alternate placing one foot on a small stool or box. Those suffering from osteochondrosis should iron while sitting or adjust the ironing board so you don’t have to bend down too much.

✓ When cleaning the house or using a vacuum cleaner, avoid bending down too much. It’s better to extend the hose with additional pipes. When cleaning under the bed or table, kneel on one knee.

✓ To lift an object from the floor, squat or bend your knees, supporting yourself with a chair or table. This way, you won’t overload the lumbar region of the spine.

And finally, while you now know how to stand correctly, remember that standing for long periods is an unnatural position for the human body. Therefore, try to avoid situations where you have to stand for extended periods.

How to Lift and Move Heavy Objects Correctly?

One of the main causes of exacerbation of osteochondrosis and the formation of intervertebral disc hernias, especially in the lumbar and sacral regions, is lifting and carrying heavy objects. Sharp, sudden pain in the lower back occurs when lifting heavy objects quickly, jerking them, and then moving the heavy item to the side while turning the body.

Do not carry heavy loads in one hand, especially over long distances, as this overloads the spine. Divide the weight and carry it in both hands. It’s unacceptable to hold a heavy load while sharply bending and straightening (leaning back).

In general, for people with osteochondrosis, lifting and carrying weights over 15 kg is not recommended. We advise purchasing a trolley or a bag with wheels. For carrying heavy loads over long distances, a backpack with wide straps is very convenient. The weight of the full backpack is distributed along the spine, and your hands remain free.

But if you have to lift something heavy, follow these rules:

1. Wear a weightlifting belt or any wide belt, if available.
2. Squat down, ensuring your back is straight and your neck is aligned.
3. Grip the object with both hands and lift it without bending your back.

How to Lie Correctly?

It’s better not to sleep on a soft bed, but also not on a hard surface. The bed should be semi-firmed to ensure that when lying on your back, the body maintains its natural curves (cervical lordosis, thoracic kyphosis, and lumbar lordosis). To achieve this, place a board across the entire width of the bed or sofa, and top it with a 5-8 cm thick foam pad. Cover it with a woolen blanket and place a sheet on top. If you experience radiating pain down your leg, you can place a small pillow under your knee to reduce the stretch on the sciatic nerve and relieve leg pain.

Many patients prefer to sleep on their stomach when their back hurts. To prevent excessive lumbar curvature, which causes more pain, place a small pillow under your lower abdomen. Those who prefer to sleep on their side can lie with one leg over the other and place their arm under their head.

It can be difficult for patients with acute osteochondrosis to get out of bed in the morning. Here’s what to do:

1. First, do a few simple exercises with your arms and legs.
2. If you sleep on your back, roll over onto your stomach.
3. Lower one leg to the floor.
4. Using your leg and hands for support, transfer your body weight to your knee and slowly rise, avoiding sudden movements.

A final tip: If you enjoy the sauna, it’s better to opt for dry heat, but avoid it during flare-ups of osteochondrosis.

Carrying Heavy Bags Can Cause Back Problems

Women, in particular, often carry heavy, overloaded bags, which negatively affects their posture and gait. Try to distribute the weight evenly between both hands when carrying a load. It is forbidden to constantly carry a bag in one hand or on the same shoulder. Improper bag carrying, even with a lighter one, can disrupt muscle tone in the back and neck, worsen posture issues, accelerate the development of osteochondrosis and scoliosis, and lead to back or shoulder pain.

The weight of the bag should not exceed 10% of your body weight. If it’s heavier, and you carry it consistently on one shoulder, it can cause pain in your back and shoulder. Heavy bags can also trigger headaches.

People often think they’re experiencing migraines, but the real culprit is a heavy bag. Excessive pressure on the trapezius muscle, which runs from the neck to the skull, can cause intense headaches.

To avoid this, alternate sides when carrying your bag every 3-4 months. Most people carry their bags on one side for 20-30 years, justifying it by convenience. Make a habit of switching sides to avoid headaches.

Tip: It’s better to carry a backpack or frequently change the position of your bag.