Scott Hanselman

The Computer Back - Pain and the Programmer

July 19, '04 Comments [31] Posted in Programming
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I'm on my butt today.  More specifically, on my back.  This weekend my lower back seized up - just one muscle it seems, as the back turns into butt.  It's amazing how a little stabilizer muscle can go nuts suddenly and mess up your whole system. 

I call it "Programmer Back" as there are a handful of other folks that sit in front of a machine all day that have had this problem. 

It seems the symptoms are nearly universal:

  • Everything is fine, often for months.
  • A seizing happens and you drop to your knees.
  • Often you can't stand without help, or if you do, you're bent over like an old person.
  • If you don't move, you're OK, but bending over, or rolling out of the bed become impossible.
  • It lasts for as little as 3 days or a much as a week and a half.

Some say ice, some say heat, some say massage.  Still others advocate chiropractic.

Have you had Programmers Back?  How do you deal with it?

About Scott

Scott Hanselman is a former professor, former Chief Architect in finance, now speaker, consultant, father, diabetic, and Microsoft employee. I am a failed stand-up comic, a cornrower, and a book author.

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Monday, July 19, 2004 9:14:27 PM UTC
You have to stretch every chance you get. Granted, you can get some odd looks from co-workers, but my doctor told me to stand up every 30 minutes. He said to not wait for it to hurt; by then you've waited too long. I've considered an Outlook reminder, but that sounds too annoying. Once you get deep into problem-solving, hours go by before you know it. I've even tried working standing up but setting my laptop on a box, but even don't do that as often as I should.

Gee, I don't know if any of this is helpful...
Lance
Monday, July 19, 2004 9:17:10 PM UTC
It IS helpful...thanks for the input!!
Scott Hanselman
Monday, July 19, 2004 9:24:23 PM UTC
Chiropractic works wonders with me. Of course, I'm married to a chiropractor, so I might be a little biased. Barring that, lying on your front and having a weight (~15 pounds) placed on your back on the spasm helps. You'll need a helper to place it. Leave it on until it feels heavy - that means the spasm has exhausted itself and released. Rest. Drink lots of water after.
toml
Monday, July 19, 2004 9:35:37 PM UTC
Stretching and moving is key, as a previous poster stated. Humans were not created to sit in a chair for long periods of time. On the topic of reminders, I have found, for me, the perfect reminder system: 1 gallon of water.

Frequently and regularly drinking large amounts of water causes the body to need to eliminate the water. This urge is one of the few things that can get me out of my chair when I am deep in problem solving mode. When I first get to the office, I fill up a 1 gallon water bottle and drink 20 gulps from it. Then in about an hour, I *MUST* get up and move around. Before I leave my cubicle, I drink 20 gulps of water. Again, in about an hour I must leave my cubicle. This cycle continues until the gallon is gone. Also, I work on the third floor, and travel down the stairs to use the facilities on the first floor.

I have successfully avoided severe back pain with this method of frequently moving throughout the day. I hope you heal soon and find a good method to help remind you to move and stretch.
Monday, July 19, 2004 9:43:47 PM UTC
I agree with Matt. Drinking lots of water is not only healthy (my doctor said back pain is sometimes caused by a shortage of water in your spinal discs), but it forces you to get up and walk around, both of which help the lower back.

If you work out, unweighted hyperextensions with high reps are great for building tone without size. If you really want to work out the lower back, "good mornings" are the way to go.
Monday, July 19, 2004 9:59:07 PM UTC
Let me throw one more idea into the mix - while I love my Aeron chair, my wife bought me an exercise ball to sit on.

You can't slouch on an exercise ball, you'll end up on the floor. You also constantly work on the muscles in your back - in fact, the first time I sat on it, I only lasted an hour before I was exhausted.

Now I sit on the ball one day a week (usually Wednesday), and I don't have any problems at all. The back gets worked regularily, so its stronger, and I still get work done. Plus when I do sit on my Aeron, I sit properly.
Monday, July 19, 2004 10:11:07 PM UTC
An exercise ball. Huh. Would not have thought of that. It sounds like a great idea.
Monday, July 19, 2004 10:41:54 PM UTC
You friends have offered you some good advice; you might as well invest in a better chair. Rory’s problems of late were also most likely also caused by bad posture at the keyboard. I stretch everyday before running and drink lots of water. Maybe we should have a workshop at the next PDC on Programmers ergonomics.
Monday, July 19, 2004 11:16:12 PM UTC
I’ve had this for years. It actually is due to slight damage to my L3-L4 vertebrae as well as a mis-alignment of my hips due to the bunions on my very ugly feet (I’m not kidding).

The only think that I have found that keeps it at bay is a strong core. Particularly abs and glutes. Get a physical therapist and learn how to do all the exercises required.

Since I started “being in shape” when I get spasms (rarely) they are gone after 8 hours max. Before they lasted (as you indicated) 3-14 days.

Oh, when it does happen, ice and ibuprofen help.

-cek
Charlie Kindel
Monday, July 19, 2004 11:16:37 PM UTC
+1 for exercise.

The chiropractor helps for the immediate issue of being able to walk. But it seems the problem only happens if I lay off the gym for a few months. As long as I keep my muscles toned, I think it’s all OK.
Chris Wuestefeld
Monday, July 19, 2004 11:16:56 PM UTC
Yep. With much apprehension, but with little option left as I could no longer walk, I finally tried a Chiropractor. I got a recommendation from a trusted friend and gave it a shot. I was back up to speed in hours. The doc recommended ice to calm the spasms and that, together with the adjustments, worked like a champ. He showed me from the x-rays how the bottom vertebra was misaligned and explained how he would adjust it. The relief was immediate, but took a bit of time before it would hold that way. Although the pain is mostly muscular, he explained that the muscles are compensating for the misaligned vertebra and trying to relieve resultant disc pressure and inflammation. If you end up trying this, I would definitely try to get a recommendation and try to find a chiropractor that uses the Gonstead method. Although many think chiropractors are witch doctors (and many are), my experience has been very positive.
Steve Johnson
Monday, July 19, 2004 11:21:11 PM UTC
+2 for exercise.

And a weekly visit with the massage therapist.
Mike Frith
Tuesday, July 20, 2004 2:27:19 AM UTC
all the recommendations above make good sense. it is worth pointing out that golfers have many problems with their backs. and from their vast historical experience if you want to have a good back you have to make sure you have strong abs because they support the back. i know many professional golfers who do hundreds of crunches a day in order to prevent back problems. perhaps this is good advice for coders.

C Ellis
Tuesday, July 20, 2004 8:46:47 AM UTC
I've had the same problem and last winter it was killing me for about two weeks. It's no fun. I found that a small bit of yoga, something like twice a day for 5 minutes, helps tremendously. Yoga Journal has this page - http://www.yogajournal.com/poses/index.cfm - where you can search for comfortable poses and read about making the best stretches out of them. Choose 'Lower Back' for anatomical focus, and you should be on your way.
Tuesday, July 20, 2004 10:53:45 AM UTC
Chocolate and Ice Cream do wonders.
Tuesday, July 20, 2004 12:52:05 PM UTC
whiskey.

It'll cure what ails ya.
Tuesday, July 20, 2004 1:02:48 PM UTC
I've had a lot of back problems over the last 10 years. I've found a couple things that work great for those intense spasms that won't go away. Put a tennis ball on the floor, lay on top of it so it puts pressure in the spot that hurts. Similar to the release techniques a PT uses but without having to go to the office. For really severe ones that won't go away trigger point injections work wonders for me. They inject a strong anti-inflamatory directly into the spasming muscle causing it to relax. You have a little pain at the injection site for 24 hours or so but after that you're like new.

Of course staying in shape, drinking tons of water and sittng in a good chair will do wonders to keep it from happening in the first place.
Greg
Tuesday, July 20, 2004 1:20:02 PM UTC
First I'll admit that mine might not only be due to "programmer's back", but also to a degenerative disc. At any rate...

Chiropractor is wonderful. Mine basically just stretches out the disc and uses electro-therapy. At home, stretch a few times a day. I also take glucosomine for prevenative measures (I've noticed a direct correlation when I run out and take 1-2 weeks to refil my stash to when I hurt my back)... one note: it's good for all your joints, but takes a few weeks to get into the system. When it's really hurt, stretch, and get the Thermacare heat packs. I threw myself out of alignment pretty bad the day I was leaving for a 4 day work trip. Stopped by the drug store to get Alleve and the heat packs, popped an Alleve (but NEVER on am empty stomach) and put the back pack on before my flight. By the time I got to my connection (45m flight), I had all my range of motion back, just a little aching pain. Three days later it was gone.
Tuesday, July 20, 2004 2:15:03 PM UTC
Everyday I am conscious about 3 things during workdays.

- Drinking water and eating an apple. Fluid & Fiber.
- Stretching or just moving around. The human body needs to move. In the summertime I take a brisk walk at the nearby YMCA's track. Winter time when it rains a lot in Portland, I walk up and down the building's stairs.
- I wear a special glove with a bottom padding. Preventative measure against carpel tunnel.

A bad habit I see very often in the workplace is where people have their lunch at their desk. I mean.. you work all day long sitting infront of a computer. At least give yourself a break and change your setting by eating somewhere else, breath different, hopefully, fresher air and give your eyes a rest from monitor radiation (and glare).

Abdu
Abdu
Tuesday, July 20, 2004 2:52:35 PM UTC
sleep on the floor on your back without a pillow.
Prakash S
Tuesday, July 20, 2004 3:38:18 PM UTC
I'm battling a bit of this right now, although I'm not laid up by it this time it still hurts like a banche. I usually just take about 4 tylenol and suck it up. I suppose thats the wrong way to do it but hey someone needs to point it out :)

Hope all goes well with the back!

Pat
Tuesday, July 20, 2004 4:11:18 PM UTC
This is a topic I definitely know about. You must stretch at least once a day, especially your back. You must also exercise regularly with weights to some degree. Stretching applied *consistently* over time will prevent another occurence. It's important to be consistent.

The best book on stretching is this one:

http://www.amazon.com/exec/obidos/ASIN/0936070226/qid=1090339508/sr=2-1/ref=sr_2_1/002-7912924-1083244

it's a classic.

Steve
Tuesday, July 20, 2004 4:13:53 PM UTC
Oh yea, in the meantime apply a heating pad to your back. They only cost about $15 bucks. You can get them at any drug store.
Steve
Tuesday, July 20, 2004 5:03:44 PM UTC
Sorry to hear that this has afflicted you too. Both Mary and I have variations of it; we're both computer folks. Many of my coworkers have this also. My upper spine was pointed at as the culprit, with Mary it was lower spine.

Ice always works better than heating pad for me, except that morning hot showers also help.

Resting/moving every hour or so is essential. I lie on a rolled up towel (down the spine) and do some of the Robin McKenzie exercises. Got his book. Aerobics also good.

Be careful about your posture on planes and long car trips. Planes are the worst offender, and you do a lot of long-haul conferences. Also watch for odd positions at work, like always reaching over towards a certain keyboard.

If you need motivation, go to a tradional doctor who will discuss disk surgery, cortisone shots, etc. This will scare you into remembering to do the rest of it. ;-) Give it at least 6 weeks to get better. Relief past a certain point isn't immediate but iterative/cumulative.

Good luck!
Bob
Tuesday, July 20, 2004 5:11:31 PM UTC
Stretching/yoga makes a big difference for me, as do ab and hip excercises. There are several "Yoga for back care" DVDs that have lots of good, low stress back stretches. I've tried the excercise ball thing too. During the worst "programmer's back" episode I've had, I couldn't sit in a chair for more than 10 minutes at a time, but I was able to sit on the ball for much longer.

+1 on the water too. It's good for you all around, and it makes you get up.
Tuesday, July 20, 2004 6:19:45 PM UTC
I feel your pain! Earlier this year, I was out for nearly a week due to severe lower back pain. If it really is as bad as you say, do yourself a favor and go to a doctor immediately! Mine was so bad that I could not even stand fully erect...it even hurt while just laying in bed. I had to walk into the doctor's office bent over like an old person. If I was bent over, I didn't feel it much...but either trying to stand straight or do almost anything else was incredibly bad. They gave me something for the pain, and also something for muscle spasms (you can't even drive while on these things). Those, along with a heat pad, multiple showers a day, and at least moving around some when I could was what helped me. It probably took three to four weeks before I felt 100% again. These days, I get out of my cube every hour or so, and also try a few stretches at work when I can, along with working out a few times a week. Good luck, man!
Mike
Tuesday, July 20, 2004 10:06:30 PM UTC
yoga.ball++;
Wednesday, July 21, 2004 2:42:03 AM UTC
I agree with others. Stretching, core exercise, running(once you're healthy), lots of water, massage/chiropractic, and for me a Tempur-Pedic pillow to sleep on. I used to go see Dr. Clark on Macadam Ave. in Portland, right down the street from Step-Technology, when I lived there. I was plowing through the CSET program at the time and had all kinds of back trouble. He was the Olympic track team chiropractor for the 2000 games in Sydney. He can hook you up with all kinds of nifty treatments.
Jamin
Wednesday, July 21, 2004 5:40:26 AM UTC
I just ordered the Stretching book from Amazon as well as the Stretching in the Office Book. They both look great. Went to the Chiro and had my hip adjusted. I'm sitting on the 34cm Exercise ball, and while it's a little low for my taste, it works well.

What wonderful advice from a great community - Thanks everyone! This is a great example of why Blogging is superior and more personal than Newsgroups. I hope this content gets Googled and used by others in future.
Scott Hanselman
Wednesday, July 21, 2004 2:25:59 PM UTC
In case of debilitating spasm I always maintain a stock of anti-inflamatories, plus some of the older anti-depressants such as Valium. For the rest of your life remember to get out of bed carefuly, especially after a chilly/draughty night. I'm sure all the fitness stuff helps longer term too, but I do quite a lot of that and I'm still a fat bastard whose back goes 'pop' from time to time. My problem started after a visit to an osteopath.
Monday, August 09, 2004 1:28:11 AM UTC
My current job necessitates not "programmer's back," but something far less glamorous: "remedial call center girl's back." I usually end up running downstairs for a little caffeinated beverage drink from Moonstruck or whatnot, just to break the monotony and discomfort. Not that I'd advocate that kind of tactic in the slightest - I was told by a physical therapist that drinking espresso increases muscle tone. Not a good idea if you're prone to muscle-related back problems like I am.
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Disclaimer: The opinions expressed herein are my own personal opinions and do not represent my employer's view in any way.