What’s the leading cause of disability worldwide? If you guessed lower back pain, you’re right

And while you can’t prevent every cause of lower back pain, you can take steps to reduce your risk of disabling back pain
Neurosurgeon and neurological spine surgeon Dr. Ryan Hofler of Novant Health Brain & Spine Surgery – Huntersville shares the everyday habits that help protect your back, along with the common mistakes that can increase your risk of back pain and injury
Expert spine, back and neck care when you need it
What does your spine do, and why is it so important?
Your back is the primary structural pillar holding your body up. It’s flexible enough to let you move, and it’s also the tunnel your nerves and spinal cord run through — I like to say that it’s the housing for the wiring that controls your arms and legs
Why is back pain common?
It’s the nature of being creatures that walk on two legs instead of four. We have a vertical spine instead of a horizontal spine, we carry lot of weight on that spine, and it contends with stress every day. As a weight-bearing structure, it’s prone to injury even if we do everything right
It is possible to prevent back pain?
Sometimes back issues trace back to how our bones formed in the womb — a congenital (a condition that’s present at birth) or developmental problem. Sometimes we have issues because of an accident beyond our control
But there are strategies we can use to keep our back healthy, and building those habits now makes it easier to treat and heal from back issues if they do come up
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To reduce your risk of back problems: Do these things
1. Bend your knees instead of your back — every time
You’ve probably heard you should bend your knees, not your back, when lifting something heavy. But I tell patients to bend at the knee for smaller tasks too — taking dishes out of the dishwasher, picking up something that fell on the ground, tying your shoes. Always use your knees
Here’s why: Bending with your back puts excess strain on your joints, discs and back, which increases your risk of injury. If you lift with your hips and knees, you’re much less likely to damage your back because your back stays in a more mechanically optimal position
2. Walk as often as you can
Our bodies weren’t built to sit for 12 hours a day — we’re built to get up, stand, move, walk and run
Walking is one of the easiest and best things you can do for your back. Being vertical forces your body to use your abdominal, back and leg muscles. It’s not strenuous, but it maintains the tone of those muscles and keeps them working
Aim to walk every day, multiple times a day, as much as you can
3. Build and maintain a healthy core
The skeleton surrounding your spine doesn’t hold itself up on its own — the muscles and ligaments around it hold it together and keep it vertical
If those muscles weaken, they’re not able to brace your spine as effectively as they need to and your spine can weaken, leading to increased degeneration and increased pain
Strengthen those muscles with back and core exercises targeting your abdominals, obliques, pelvic floor muscles and lower back. Don’t worry about lifting heavy — just get them moving, work through a good range of motion, and build strength and stability. A strong core properly supports your back
4. Strength train — and prioritize good form over lifting heavy
When it comes to exercise, doing it right is more important than how many miles you’re running, how many seconds you’re completing your 100 yards in, how many pounds you’re lifting, or how many laps you’re doing. Technique is the most important thing
If you’re new to exercise, or new to a certain type of exercise, work with a certified personal trainer or fitness professional to make sure your technique is right
Any exercise can put you at risk for injury if it’s done unsafely, so it’s hard for me to say, “don’t do this specific exercise or type of exercise.” But I can say that some lifts carry a higher risk for injuries
Deadlifts, for example, are a great exercise when done correctly — but they’re also a commonmore important than the amount of weight on the bar — and if you’re not using good technique, you’re putting yourself at risk
Also, everyone talks about wanting big biceps or strong thighs — but if you don’t have a healthy core, you aren’t actually strong. Big lifts are more exciting than crunches, but core work should be the foundation of your strength training
5. Work on flexibility
Flexibility often gets neglected, but it’s important for joints to move through their full range of motion to stay healthy. Make time for regular stretching and mobility work. Yoga is a great option for this — it combines stretching with holding poses against gravity and your own bodyweight
6. Think through the ergonomics of your daily tasks
Many of us hear “ergonomics” and think it only applies to our computer monitor. But think more broadly about how you move and hold your body throughout your whole day — both while stationary and while moving. Are there ways you could improve your movements, position and posture?
You have to be active in your ergonomics. I could have a very ergonomic office chair, but if I slouch while sitting in it, I can find myself in a position that’s not great for my back or neck. You have to actively work to maintain good posture
And even if you have the most ergonomic chair in the world, sitting in itfor 18 hours a day isn’t great. Get up, move, stretch and change your position at least once every hour
7. Maintain a healthy weight
There isn’t a certain body mass index at which back problems become inevitable, but your spine doesn’t get bigger just because your body gets bigger. Carrying more weight than needed creates stress and strain on your back, and can lead to a higher likelihood of developing spine and back issues
If you’re already dealing with back pain, healthy weight loss can often improve symptoms, mobility, and strength
The importance of a healthy weight goes both directions: Someone who’s underweight often doesn’t likely have the muscle tone needed to support a healthy back
Talk with your doctor and find out what weight range is healthy for you. Then work to stay there
To reduce your risk of back problems: Don’t do these things
1. Don’t look down at your phone for long periods of time
Your neck is built to look down, but not for hours a day. If you spend a lot of time on your phone, vary the position you use to look at your phone, and build in time looking straight ahead. When you can, swap that screen for a bigger one: For example, watching a show on a properly placed TV can make for better ergonomics than looking down and watching a show on your phone
2. Don’t give up on movement because you’re getting older
As we get older, our bodies start to break down a little and injuries tend to take longer to heal. It can be tempting to stop exercising — but staying active matters more than ever
Maybe you’re not doing burpees and deadlifts and squats in the squat rack — but you should still perform exercises to keep your muscles strong. To the extent that you’re able, work on your core, focus on ergonomics and posture, walk regularly and stretch to maintain flexibility. You’ve still got life to live, and maintaining a healthier spine helps you keep up with it
3. Don’t put off managing chronic conditions — especially arthritis
Two decades ago, patients with arthritis could have very serious, hard-to-treat problems. Thanks to the quality of modern medications and treatments, we don’t often see patients with such severe spinal deformity and instability these days
If you have arthritis, or suspect you do, it’s important to make sure you work with your health care team to identify and manage it. This will minimize the time you spend in pain, and maximize your flexibility, mobility and overall health. It doesn’t mean you’re guaranteed to avoid complications, but we certainly see them a lot less these days
The same goes for any chronic condition with potential to affect your spine — prioritize managing itbefore things get worse
4. Don’t use tobacco products
Smoking, vaping, chewing or using nicotine patches and gums leads to increased degeneration in the spine
And if you need spine surgery, tobacco use makes recovery much harder — so much so that many insurance companies won’t approve non-emergent spine surgeries for patients who smoke because smoking is such a risk factor for complications
If you smoke, make a plan to quit. And if you don’t smoke, don’t start
The takeaway
We can’t control everything that might happen to our backs, but we can control our daily habits. Being proactive now can help you avoid many back problems — and will help you recover faster if you do end up with back problems


