Most of us would not walk around all day on a sprained ankle. However, we frequently walk around all day on a "sprained" back. If you experience back pain, one of the first things you can do to treat it is to take the weight off of your spine. Frequently we forget that the low back or lumbar spine is a weight bearing joint. Whenever we are standing, walking, or sitting we are bearing weight through our lumbar spine. In order to unload or take the weight off of our lumbar spine, we need to lie down. 

There are three positions that physical therapists recommend for periodic unloading of the spine to help control back pain. The first is lying on your stomach, either flat on your stomach or propped up on your elbows putting a gentle curve in your lumbar spine. The second position is lying on your back with your knees bent. The third and final position is lying on your side with a pillow between your legs. Not all positions will work for everyone. Depending on the cause of your back pain, one position may be more helpful than another. For instance, clients with degenerative or arthritic conditions of the spine usually feel better lying on their backs with their knees bent in order to bias the spine in a slight amount of flexion. On the other hand, clients with disc problems frequently get relief from lying on their stomach in order to promote a bit of spinal extension. An evaluation by a physical therapist can help you determine which position is best for you.

Unloading the spine by having clients relax in one of the above positions has proven to be a very effective tool in managing back pain. People with low back pain should try to unload their spine every two hours. The "unloading" need not be a long time. A person with low back pain can experience a decrease in symptoms by lying down for only 2 to 3 minutes at a time. After that short period of time, they can return to a vertical position (sitting or standing) and resume their daily activities. The more consistent clients can be with unloading of their spine every two hours, the quicker their back pain will resolve.

By Mark Smith, PT