By Penelope A. Domogo, MD

Let’s have more discussion on what to do if you have low back pain and how to prevent it. Let’s have a brief review first.
Low back pain is pain in the lumbar area. The lumbar area, which is the weight-bearing part of our body, is from the “siket” (waist) down to the upper hip area. It is usually a mechanical problem like displacement of the disc between the “dulig” (vertebrae). Or there is wear and tear of this disc thus it disappears so there’s no cushion in between the dulig and the nerves are pressed. It’s double trouble. You see, when there’s no cushion, siempre the bones will scrape each other. And also when nerves are pressed or irritated, there is pain. Take heart, however, because the severity of the pain is not necessarily proportionate to the severity of the damage. Sudden excruciating pain maybe due to just a sprain or strain in the muscles or ligaments or tendons. A slipped disc may not cause so much discomfort until you carry something heavy. Usually, low back pain does not mean anything serious. However, we should bear in mind that pain is a survival mechanism to alert you to take remedial measures to avert more damage to the body.
So what do we do to ease the pain and also prevent it from recurring or occurring?
Good posture is healthy and will help a lot in preventing low back pain. It is also good for proper breathing and general functioning on the body and mind. Igorot women of the past had the benefit of the bakget or wakhes or traditional woven belt (more like a girdle) to ensure proper posture. It doesn’t just make you sit and stand straight, however. It also controls food intake- try wearing one and you will see what I mean. Women in Masferre’s fotos are slim with belts tightly wound around their waists. So this traditional belt helps, in many ways, to keep our women healthy. Overweight, as we have discussed last week, can cause low back pain. We encourage women to wear “bakget” just after childbirth, just like what our grandmas did.
How we carry and lift weights will also affect our back. “Agto” (carrying load on the head) is a better way of carrying heavy load than carrying it with a shoulder bag for at least three reasons. One, “agto” will force you to keep a good posture or else your load will roll away. Second, “agto” keeps the load evenly distributed and thus prevent damage in your weight-bearing area. I found out that I can carry heavier load easier if I carry it on my head. Third, weights understandably keep the backbone strong- “masedsed”. In short, “agto” will prevent lower back pain. In lifting heavier weights, always lift with both hands right in front of you, not from the side, and bend your knees. Some have experienced severe back pain because they lifted wrongly, straining the muscles and ligaments.
Another cause of low back pain is lack of physical activity. Our spine is a series of small bones connected to each other by ligaments and tendons and muscles. For that matter, our whole body is a series of bones and joints and muscles. This kind of body structure is meant for movement. We are meant to move. In contrast, plants have no joints because they are meant to be stationary. So just like a door- if you don’t open it for some time, it can get creaky and the hinges get rusty. For our bodies, sitting for a long time will shorten the muscles and tendons and such will stress the back and decrease flexibility. Such will lead to decrease in function so that, as the years go by, you will be doing less and less motion. Unless you take measures to arrest the problem. We are not meant to sit all day in front of the computer or sit for many hours over bottles of gin or beer or slouch all afternoon in front of the TV.
It is also unwise for us who are sedentary on weekdays to have intense physical activity just on weekends. Such can cause sprains and strains. Physical activity has to be built up and done more often to keep our body toned and fit. Physical activity does not necessarily mean we have to go to the gym or play basketball. Walking daily will do wonders to our body and mind- the longer the walk, the better. Start training your kids to walk long distances. The kids we see walking to and from school like those from Alab Elementary School going home to Dantay are lucky. They are not “kawawa”- sometimes we feel “Ayy, kawawa naman sila, they have to walk far to reach school.” Well, they are not. They are able to develop their bones and muscles, get mental and social stimulation from the various sights and sounds of nature, get the all-important sunshine, get wet in the rain, appreciate the birds and the bees, and have more bonding with their schoolmates. And they would have developed a strong back.
There are many more things we can do- farm work, gardening, fetching water, cleaning the house, laundry, etc. We just have to will ourselves to get up and do them.
Here in Asia, we have a lot of traditional wellness and healing methods like yoga, tai chi and shibashi. Yoga is a great thing to do for a healthy back and whole body. The various poses stretches and moves the various joints in your body, especially those that are not usually used in common daily activities. In the cobra pose, for example, it stretches the neck which we don’t usually do. Normally, I stretch my neck only when I want to see an airplane flying overhead or to look at the clouds. At the same time yoga will energize you. Yoga is not just about poses. It is a lifestyle and a discipline. Being a vegetarian would allow you a wider range of yoga poses. The Chinese Tai Chi or Japanese shibashi are also great activities to engage in. I am happy to see some people doing tai chi in Bontoc and Burnham Park. These Asian traditions are not only physical- they are also metaphysical or mental and spiritual exercises. You need to concentrate, focus and meditate to be able to do these. Those with major back problems, though, need to have professional advice before embarking on these activities.
We cannot underestimate the role of diet in low back pain. After all, it’s what we put in our mouths that are the building blocks of our body, whether it is our back or our front – for growth, for repair. If we eat the right building blocks, then our bodies will be built strong and beautiful. If we eat the right building blocks, then any damaged part will be repaired well. Let’s compare it with a cement road. If we mix the right proportions of good cement and good sand and other ingredients, then we get a good cemented road that will last forever. If our ingredients are of poor quality, then we get a cemented road that will be damaged in a few months of rain. Well, as to our food, the good news is that we have the power to choose what to eat and what our kids will eat. It is only us, grown-ups, who will put food in our mouths and the mouths of our young children.