Transcription:
How to Have a Back-Healthy Lifestyle

Maggie McKay: If you have ever bent down to pick something up or been playing tennis or golf and your back goes out, you know it's no fun. Living with back pain can affect so many aspects of your everyday life We take for granted until we have a pinch in our back. so today we'll find out how to have a back healthy lifestyle. Joining us to tell us all about it is Dr. Claudia Dal Moin, assistant professor, director of Musculo Skeletal ultrasound education at University of Maryland School of Medicine and Sports Medicine expert with a passion for lifestyle medicine at University of Maryland Medical Center.

Welcome to The Live Greater Podcast Series, Information for a Healthier You from the University of Maryland Medical System. I'm so interested to hear about how to take care of our backs, doctor, because I know, at least for me, I don't really think about my back until there's a problem or pain. It can be debilitating. So just to start off, what are some of the most common causes of back pain not related to an injury?

Claudia Dal Molin: Probably the most common condition that I see is actually arthritis. And believe it or not, that can start at a really early age. Some of the earliest cases that I've seen of degenerative disease or arthritis in the spine, I've seen as early as people's late teens and early twenties. And by and large, what determines how early you can get that or how bad it can be is usually genetic or family history.

But obesity can also play a large role by putting pressure on those joints. another common cause of back pain is actually deconditioning. So our sedentary lifestyles not so great for the back. As our muscles get weak, this can cause an imbalance in the system which translates to less support for the spine. And then lastly, something called somatic dysfunction.

So as a do, we are trained in identifying when parts of the body, including the spine, can be out of alignment. And our term for that is somatic dysfunction. And the sacrum, which is the tailbone at the very bottom of the spine, is one of the most notorious causes of that. So those are probably the top three causes of back pain that I see every day.

Maggie McKay: And how can someone's lifestyle affect their back positively or negatively?

Claudia Dal Molin: Certainly being active and not just being fit, but active in a well rounded way. So what I mean by that is including a mix of movement in your exercise. So for instance, not just only being a runner, but maybe throwing in swimming, throwing in dancing, and also including strength exercises and weightlifting into a routine can all help develop a more well rounded body. That can help to offload the back and support the back so that it's not doing quite as much as the work and the converse is true too.

Sedentary can definitely contribute to having back pain . That usually happens because in a sitting position, our hip flexors get tight, our hamstrings get tight. Our glutes and our core get weak, and it puts a lot of extra pressure on the back.

Maggie McKay: Is that one of the reasons we've read articles over and over about when you have a nine to five job sitting down, you should get up every hour and walk around a little bit?

Claudia Dal Molin: Absolutely.

Maggie McKay: What are your recommendations for a back healthy lifestyle?

Claudia Dal Molin: Well, there are some things to consider. So for instance, for people who have autoimmune disease, assessing dietary factors can actually matter. situation, an allergy test might help point a person in the right direction to see if there is an intolerance or an allergy to food, and that might help direct them to try a double elimination of that food item. Usually gluten and dairy are the most common culprits in that patient population. An allergy test isn't the most reliable thing in the world, but it can help point people in a direction to try removing some items and then reintroducing them to see if it makes a difference.

For everyone, though exercise definitely matters. So like I said before, it's important to change it up. Incorporate strength training as a part of your exercise regimen, and then beyond that, a quality mattress can go a really long way.

Maggie McKay: I wouldn't have even thought of that. Of course that makes sense. so if someone wants to make changes in their lifestyle to help with back pain, what are the first steps they should take?

Claudia Dal Molin: The first step I always recommend is a quality physical therapist. It can sometimes be hard to find a physical therapist that is skilled or that you feel like you can trust, so I tend to look for a couple of different things if you're not familiar with a specific person with a good reputation. I always look for extra certifications, something where they've continued their education and a lot of common and very useful ones for the back in particular include dry needling, taking courses and functional movement, and osteopathic manipulation certification.

Those specifically can fit back problems pretty well outside of. Having a focus in sports or even formal education in sports can be really helpful. It's not required, but it can help cope or deal with the problem in a more thorough way. And then the last thing I always tell my patients is avoid wallflower physical therapy. So physical therapy works just like the gym. It should be challenging, it should be engaging, and you've gotta do it consistently and frequently enough to make a difference because we're trying to develop your muscles and get stronger.

So going to physical therapy, if you're handed a set of exercises and those exercises are really easy and you're just kind of moving body parts around without much more effort than that, that's a clue that it needs to be harder. And you want a physical therapist to be engaging and work with you to find that balance. So you also want a physical therapist who is going to pay attention to how you move.

Maggie McKay: Going back to dry needle, is that acupuncture?

Claudia Dal Molin: Dry needling is a technique that uses acupuncture needles, but not in a way that most acupuncture practitioners use them. It actually is a technique that was developed by a physician, an MD physician. And she discovered that painful spots or tight spots in a muscle could be released by sticking a needle in them. And as that technique evolved, people discovered that it doesn't have to be a big needle, and it doesn't have to include an injection of anything. The needle just helps to relax the area and sort of reset the tone.

Maggie McKay: Wow. What kind of healthcare provider should someone look to when they need help to create a healthier life?

Claudia Dal Molin: This could be a lot of different providers, but certainly some sports medicine doctors like myself, and I'm talking about primary care, sports medicine doctors. We are the ones that don't specialize in surgery, as opposed to our orthopedic surgeon, colleagues. A lifestyle medicine doctor can also help create healthier lifestyle for their patients. I've also seen some functional medicine doctors do that work as well as some primary care doctors when they have a personal interest.

Maggie McKay: And at what point should they see a provider about their back pain?

Claudia Dal Molin: So for injuries, I say if it's not better after a week, it's smarter to seek out care. Believe it or not, back injuries are the one area of the body that can get injured, and it's more common that if you don't do anything about it, if you just take that wait and see approach, that the pain can actually get worse or just not get better. So don't be afraid to ask for help earlier than later. In terms of more chronic back pain, I think if something is rearing its ugly head for more than a month, it's probably time to at least start by saying hello to your primary care doctor. A lot of times the primary care doctor can take common initial steps to start dealing with it, which is usually anti-inflammatories, maybe an x-ray and some physical therapy.

Maggie McKay: If someone were to need back surgery, how would a healthy lifestyle help with the procedure and the recovery?

Claudia Dal Molin: Well, a lifestyle covers a lot of different things, so I'll take things piece by piece. As far as nutrition goes, when you have quality nutrition, you have the building blocks to help with wound healing. So nutrition can be an important part of a healthy lifestyle that can actually help with recovery. For exercise, surgeries always tend to run smoother and recovery be smoother the stronger you are before surgery. Sleep is another lifestyle factor that can be really important for recovery and for healing.

And then lastly, having a healthy weight. Is also been shown to decrease the risk of complications around surgery. So especially if someone is less than a BMI of 40, that's been shown to substantially decrease their risk of surgical complications, whether that's infections around the surgery or even having complications with hardware that might be a part of surgery.

Maggie McKay: Any key takeaways?

Claudia Dal Molin: Self care is really important and combined with a healthy lifestyle, it's just a normal part of life. Think about doing these things, taking care of yourself, exercising, trying to quality things. As just a normal, healthy part of life, just like brushing your teeth or washing your hair, things tend to go better when it's not neglected.

Maggie McKay: Thank you so much for this useful information. I think we can carry this with us throughout our lives, if we remember it and integrate it. It's been a pleasure having you, Doctor

Claudia Dal Molin: Thanks for having me.

Maggie McKay: Find more shows just like this one at umms.org/podcast. Thank you for listening to Live Greater, a Health and Wellness podcast, brought to you by the University of Maryland Medical System. We look forward to you joining us again. And if you found this podcast helpful, please share it on your socials and check out our entire podcast library for topics of interest to you.