Ask HN: What do you do to avoid back pain?

26 points by evex ↗ HN
I get upper back pain when I sit for ~1-2h writing some code,

Even when I take breaks and walk or do back exercises, I still get pain when I get back on the chair.

It's taking a toll on my productivity, I waste all day trying to find a comfortable position to sit in.

How do you prevent back pain from stealing away your focus?

40 comments

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When you sit in the front of the computer your hands on the keyboard, your pectoral muscles are being shortened, your shoulder turn inward and posture becomes hunched. --> upper back pain.

If you want just one exercise to do just now it's 'supine gross-leg spinal twist' https://www.youtube.com/watch?v=L41eyPmXhIQ It's a core exercise for upper back pain and helps neck, pecs and spine.

You gradually stretch until you get knee to the ground and the hand is on the ground also and you can look at the hand.

You should really get short program 10-15 mins you do daily, but that one exercise is the best single exercise for upper back pain IMHO.

Wow, I just done this and my whole upper back started cracking!

How does this fix my pain long-term?

> your pectoral muscles are being shortened

Does this move stretch the pectoral muscles? or shorten the back muscles that are stretched?

> Wow, I just done this and my whole upper back started cracking

You have had bad posture for a long time.

> How does this fix my pain long-term?

Doing it daily may or may not fix the problem. It surely has fixed my upper back problems. I do it and just few other back stretches. I also go running frequently.

The way they do it in the video is not perfect in my opinion. I could not find the way I do it anywhere. So here is instruction:

Take the same posture but instead of letting knee stay up and hand on the floor, push knee to the floor and let the hand hang palm upward above the floor (it really stretches your pec). Gradually you should be flexible enough to have both knee and hand on the floor.

>or shorten the back muscles that are stretched?

Short time stretching can't shorten muscles. Muscles shorten when they are never stretched.

Do the following test: Stand straight look forward. Have a pencil in your fist. When you are standing relaxed, look at where the pencil points. If it points inward, your shoulders are turned inward. Pencil should point directly forward.

> Pencil should point directly forward.

Pencil does point directly forward(yay!)

> Short time stretching can't shorten muscles.

So basically what this stretch does is, elongate/stretch the pecs and extend/mobilize the thoracic spine? (I think thats more than enough!)

I had upper and lower back pain (and RSI in my forearms) for years with tons of physical therapy, meds, and acupuncture to fix, but nothing stuck. Eventually what fixed it all was eating healthy, lifting, and now CrossFit. I know this is an unsatisfying answer and I don’t know what you’re doing atm, but for me having a generally healthier and fitter body pretty much fixed all my chronic pain issues.
> I don’t know what you’re doing atm

I'm doing weighted exercises for the posterior muscle chain(back, glutes, and hips), I'm skipping working out the anterior muscles(chest, shoulders, biceps) until I get rid of this back pain issue.

> lifting, and now CrossFit

I've seen a lot of people fixed their backs by lifting, I'm giving it a try today,

I know nothing about lifting other than bench presses and dead lifts,

I'm thinking about starting with deadlifts at first until I have a good posture, and then start doing both deadlifts and benchpresses.

Do you think its a good route that I'm taking?

https://www.youtube.com/watch?v=k1luKAS_Xcg

I found this Ted talk helped me with some lower back and leg issues. I don't do exactly what she demonstrates in the video, but I find focusing on the 'tail out' posture helps a lot. Also regular breaks and going for walks.

Hm, this tail out thing is very controversial, I've heard physiotherapists say you should tuck your pelvis.

actually there is this postural issue called APT(short for anterior pelvic tilt), it looks the same as "tail out", and people are getting a lot of lower back pain out of it.

not sure if APT is exaggerated 'tails out' or it is the actual 'tails out'.

Have you asked any physiotherapist about this 'tails out' approach?

No, this is purely anecdotal. I found that it helped when sat up straight and adjusted my hips. But, pushing out too far does put a different pressure on your lower back, and I agree, is just as bad. I think it's about getting the right alignment for the best support for your whole back.
If you get upper back pain that quickly, I'd be most suspect of your workstation ergonomics. Are you crunching over a laptop?

There are a thousand drawings out there, but basically, you shouldn't have to hunch forward to work on a computer. Your back and upper arms should be roughly vertical, your forearms and thighs should be roughly horizontal, and your monitor should be at about eye height.

Since you're already having problems, treat yourself to the things you need (monitor, keyboard, desk, chair, whatever) that help you get closer to that alignment.

And then work on strengthening and habit-training. I'd vouch for Pilates and the Alexander Technique, but you'll get a hundred equally valid recommendations. The what is probably less important than the that -- so pick what excites you enough to stick with.

> so pick what excites you enough to stick with.

Great advice!

I've picked a couple of exercises before, but they were too hard that I stopped doing them.

I set my workspace according to what you and the guys here are saying, and I'm already feeling way better.

tho a bit sore in the back.

Are you using a laptop without an external keyboard? If so, you have to hunch over at an awkward angle to see the screen. No amount of stretching or exercise will make that comfortable in the long term.

Get an external keyboard and mouse/trackpad. Make sure your desk is low enough and your chair high enough that your hands rest comfortably on the keyboard with your shoulders down, elbows at a right angle at your side, and wrists straight. Raise your monitor until its center (for a laptop monitor) or a point 2/3 of the way up the screen (for a large monitor) is level with your eyes when sitting fully upright and looking straight ahead.

Doing this right now, I feel like my back is getting sore!

is this normal?!

I have no idea if you're doing it right without being able to see.

With proper posture, your back will be nearly vertical, and your vertebrae stack directly on top of one another with almost no support from your muscles. You should be able to sit up in your chair and let your chair support your back (your butt should be at the back of your seat instead of slouched to the front).

This is a decent illustration: https://www.vectorstock.com/royalty-free-vector/correct-spin...

Standing desk helped me. I still have the option to sit, but rarely use it. Going on four or more years now.
i do the exercises from the 30-day Posture Makeover app. I was in a really bad car accident years ago. My car was totaled when a truck delivering heavy equipment to a construction site, hydorplaned and rear-ended me. I have had all kinds of jacked-up nerve damage and pain from it over the years, but this seems to help.

Also standing up and walking around, even for 30 seconds every once in a while helps a LOT.

oh and one more comment -- i sw that other people posted about RSI. Im convinced that the number one reason I dont have incapacitating carpal tunnel is the I frequently switch the hand I use my external mouse with.Try it out, if you dont already. I also use a wireless keyboard and wireless mouse. Crunching forward all the time to huddle over a laptop takes a real toll as years go by.
Walking, an hour or two a day, is almost always a good way to keep your back in shape.
Stand up desk, walking around, and not sitting in the same position too long unless the posture is perfect.
Its probably just your desktop ergonomics

Ideally, your monitor's central point to your eyes should be parallel to the ground. You can slouch in your chair slightly so long as your back is straight. Elbows should be supported by the desk or armpad. Feet should touch the ground fully, if not get a foot restpad

If you want to reduce backpain from prolonged sitting / standing, I usually do deadhangs. Basically a pullup, without pulling up. Also foamrollers on floor/ massageball against wall reduces need to do any massage therapy

I use a tennis ball against the wall, very effective.
Try the "foundation method". For example https://www.youtube.com/watch?v=4BOTvaRaDjI I started doing those exercises a few months ago and I feel much better. Also, my posture has improved significantly, I even got a compliment from a fitness professional who saw me sitting in front of my laptop in a cafe :)
Using a standing desk part of the day and weight training worked for me.
I sit up straight when I can. It is easy to end up sitting wrong when I focus on the terminal too much. I get up and walk around. I take garlic extract which makes me have to use the restroom hourly and keeps my BP lower.

I walk around the parking lot / complex a couple of times a day and drink water while doing so.

If my back gets inflamed, I use a topical anti-inflammatory creme (penetrex), but do so carefully, as it dumps all the buildup in the muscles into the blood stream which puts a heavy load on the kidneys and spikes blood pressure. It contains no warning about this.

If things get really bad, I pay a local massage place to walk on me and spend 2 hours working on my back. That also requires drinking a lot of water and / or sugar free cranberry juice to keep toxins flushed.

I am contemplating a standing desk, but not sure that I would use it as often as I should.

I had mild chronic back pain for years. I was browsing a similar thread like this one on hacker news. Someone replied saying that they took up lifting and it resolved the back issues.

I took the advice to heart and paid up for 2 months of personal training before I could change my mind. My best investment so far. It got rid of my back pain completely.

Also, it improved my posture and body language automatically and also gave me quite a few unexpected benefits.

deadlift
I was going to also recommend this. Nothing works as well at improving my posture
Walk. Move.

I have a treadmill desk. Walking covers a multitude of sitting sins. :)

I find standing desks alone trade one mobility problem (sitting) for another (standing in one place). Moving is a much better solution.

yep this - any time I have a meeting that doesnt involve impressing a client or being in front of a PC, I do it via walking around outside.
When not in work: weights, or swimming, or rowing - something that strengthens the muscles that you don't hate and will do.

When in work: make sure your desk is set up sensibly and your chair is decent, but if your back still hurts, stand up and work like that.

You need to make the back pain go away if you intend to continue your career in programming.

The good news that it's entirely possible to fix. The bad news is that it takes time and money. I couldn't even type for more than 15 minutes before losing my breath from intense jolts of back pain, and then I would be in pain for the rest of the day. Now I code for 8 hours a day again, pain-free.

The answer is probably going to be some combination of ergonomic equipment, posture adjustments, and physical exercises.

Frustratingly, I've found that conventional medicine gravitates more towards wonder cures like muscle relaxants, dry needling, posture straps (which are basically glorified rubber bands), etc. I found the best advice came from other programmers, ergonomic specialists, and physical trainers and involve significantly changing the way your body interacts with the equipment.

If you want to have a career going forward, you need to devote some serious time and energy into this right now. Literally, stop everything and fix it. It's probably affecting your work more than you realize, or want to admit. Be completely transparent with your employer, too. They will help you out financially if you have note from a doctor.

Got a better chair years ago and it consistently works. When I'm traveling etc the first thing I miss is having a comfortable chair.
How's your setup? Do you sit hunched over at a laptop? Do you use a monitor but look down at it?

But in general: proper posture, foam rolling, mobility exercises.

Things that help against back pain:

- physio therapy

- Ibuprofen

Things that prevent back pain:

- any type of exercise (running, biking, rock climbing, anything that you enjoy)

- good chair

- desk at correct height

- ergonomic mouse/keyboard/screen

Things that are pointless:

- exercises that you do once and then don't bother anymore