10 Golden Rules from the Patients' "Healthy Back Seminar"

Once patients have received successful treatment, either conservative or operative, and resume normal everyday life activities, they usually want to know what to do in order to avoid a relapse. The answer is: learning the Golden Rules of the "Healthy Back Seminar"! This encompasses postural and behavioural training, which goes hand in hand with instructions on ergonomically recommendable ways of sitting, standing, lying, lifting and carrying. A persistently slumped posture (kyphosis-type), lifting heavy objects with a twisted upper body, and strains on lordosis-prone spines, entail a significantly higher number of back pain complaints and - more than anything else - dislodged intervertebral disc tissue, than those postures and movements taught in our Golden Rules, or, Commandments, on how to keep a healthy back. The recommendations are summarized as follows:

Your Healthy Back - the Ten Commandments

  • Thou shalt move
  • Thou shalt keep your back straight
  • Thou shalt use your knees when bending down
  • Thou shalt not lift heavy objects
  • Thou shalt distribute weights and keep them close to your body
  • Thou shalt keep your back straight, support the upper body and make sure to change this position frequently, when you sit down
  • Thou shalt not stand with straight stiffenend legs - bend your knees ever so slightly!
  • Thou shalt bend your knees and pull your legs towards your body, when you lie down
  • Thou shalt seek physical exercise, preferably swimming, running or cycling
  • Thou shalt exercise your spinal muscles every day

Regular compresseion and decompression of the intervertebral discs encourages the diffusion processes within the intervertebral disc tissue, which has no blood vessels. This way, the intervertebral disc tissue receives more nutrients, whilst the tendency to develop fissures and signs of wear and tear decreases. Physical exercise also ensures that the central mobile intervertebral disc tissue, the so-called "nucleus pulposus", is kept in its central position. Persistent asymmetric strains, such as bending from the hips or sidewards, lead the core to develop a higher tendency towards this undesirable type of shift. It is particularly axial strains when bending down, lifting and carrying of heavy objects, that can lead to an asymmetric line-up of the intervertebral section and thereby cause the intervertebral disc tissue to become dislodged to the convex side, with associated intervertebral disc prolapse. Rules 2 to 6 are specially designed to prevent this. The rules 7 to 8 are designed to prevent hyperlordosis, i.e., developing a "hollow back" whilst standing or lying down. Hyperlordosis actually does not particularly damage the intervertebral discs, however, it can affect the vertebral joints.

For an efficient rehabilitation and prophylaxis of back pains and associated painful complaints affecting the legs, so-called "straightforward" types of sport such as swimming, running/jogging and cycling, as well as a daily regime to exercise the muscles that stabilize the spinal column, are essential. For people with a negative predisposition and those who suffer from conditions caused by intervertebral disc complaints, including such that have received therapeutic treatment before, a good physical condition and stamina, and regular application of the rules detailed above help to make it possible to play sports, even such as the so-called sports that strain the spinal column, such as tennis, golf and other ball sports.