Watch your weight
Research has shown that being overweight is associated with back pain so, while maintaining a healthy weight is advisable for a whole host of reasons, it’s even more important if you are troubled by back pain. According to MBST Medical UK physiotherapist Ann Clare, “Maintaining a healthy weight is critical in reducing strain on both the lower and upper back. Conditions such as osteoporosis, which directly impact spinal health, underscore the importance of weight management. By prioritising a balanced diet and consistent exercise, you can effectively support your spinal health and mitigate issues related to bone density.”
Wear supportive footwear
We have all experienced the discomfort of wearing high heels or ill-fitting shoes, a discomfort that extends far beyond the feet to the entire body. Clare says that the right shoes are crucial for back health. “Choosing footwear with adequate support is vital for preventing imbalances and back pain, particularly for those who spend extended periods standing,” she says. “Proper shoes play a crucial role in maintaining spinal alignment and preventing the development of pain, including in the upper back.”
In the past few years, however, the footwear market has seen increasing examples of “unstable footwear” – which mimics the shape of the foot when it’s bare. This deliberately challenges the muscles in a way that conventional footwear does not. Some research indicates that such shoes may decrease postural sway, which is associated with poor balance and weight distribution, but more research is needed into the efficacy of such shoes in reducing back pain.
According to Clare, selecting the right supportive shoes for activities such as running or walking requires a focus on features that ensure both comfort and proper foot mechanics.
“Look for shoes with adequate cushioning, especially in the midsole area,” she advises. “This helps absorb the impact when your foot strikes the ground, reducing stress on your joints.” She also notes that different foot types demand different support – flat feet, for example, need shoes with structured arch support to prevent overpronation (rolling inwards of the foot), while “high arches do not absorb shock effectively and need shoes with a softer midsole and more flexibility to help with cushioning”.
She also says that gait analysis at a specialised running shop or physiotherapist may be beneficial, as this “helps in choosing shoes that complement your walking or running style, reducing the risk of injury”.
According to Clare, “The shoe should fit snugly around the heel to prevent slipping, which can lead to blisters or instability, while the ‘toe box’ should have enough room to wiggle your toes. Shoes that are too tight can lead to issues like bunions or hammertoes.” Width should also be “comfortable and not squeeze the sides of your feet”.
“Replace running and walking shoes every 300-500 miles,” she advises. “Over time, the cushioning and support structures break down, increasing the risk of injury. While you don’t need to spend excessively, investing in a quality pair of shoes can save you from discomfort and potential injuries.”
Watch how you sleep
We don’t need to be princess-and-the-pea-style sensitive to our sleep environment to feel the effects of a sagging mattress or awkward position. Experts agree that a supportive mattress of firm-to-medium hardness is key to reducing back pain but, even so, says Cronin, that doesn’t mean there is one “correct” position in which to sleep.
“Find the sleeping position that is most comfortable for you and adapt this position to support your back,” he advises. “If you sleep on your side, try placing a pillow between or underneath your legs for extra support. This can help align your spine, pelvis and hips, and take pressure off your back. If you sleep on your back, place a pillow under your knees to help relax your back muscles and maintain your lower back’s natural curve.” Furthermore, he says, “if you need additional support, try a small rolled towel placed under your waist. Support your neck with a pillow that keeps your neck in alignment with your chest and back – and avoid sleeping on your stomach as this can place additional pressure on your lower spine.”
Try to minimise stress
“Stress plays a significant role in the development of lower back pain,” says Ben Ousey, an osteopath and clinic director.
“When we’re stressed, our body enters fight-or-flight mode, resulting in the release of stress hormones such as cortisol. One of the net effects of this state is an increased tension in the muscles, which can then either cause or exacerbate back pain. Manual therapy, exercise and time spent in nature are all good ways to alleviate the symptoms of stress, but mindfulness practice is particularly effective in this regard. Mindfulness involves the cultivation of present-moment awareness through simple exercises that also help engage our relaxation response.”
When to turn to medication
According to Matthew Piff, if you’re suffering with an acute bout of back pain, paracetamol can be very helpful in the short term, and moving can help to ease discomfort. “If you need something stronger, you can seek advice from your GP or pharmacist on whether anti-inflammatories would be suitable for you to take on a short-term basis,” he advises.
What treatment is available?
If your back pain is persistent and does not resolve by itself, seek further help. “Your GP may prescribe an opioid, such as codeine, for moderate pain, or something stronger like morphine if the pain is unbearable,” says Cronin. Additionally, “Osteopaths can diagnose the causes of lower back pain and the National Institute for Health and Care Excellence (Nice) guidelines recommend osteopathy and other manual therapies, like massage and physiotherapy, for the treatment of lower back pain,” says Ousey. Ice, heat and ultrasound may also be recommended.
Sarah Carter is a health and wellness expert residing in the UK. With a background in healthcare, she offers evidence-based advice on fitness, nutrition, and mental well-being, promoting healthier living for readers.
