Back pain is one of the most common afflictions in the developed world. The majority of Americans will experience it at some point, especially as they grow older, and an incredible one-third of them will suffer the chronic variety, for which treatments will not work.
But what is basically a given experience in the U.S. and other industrialized countries is a rarity among many indigenous cultures, namely those that have continued to live a traditional way of life. NPR follows Esther Gokhale, an acupuncturist and chronic back pain sufferer who travelled the world to study societies that seemed to lack this problem. Though I do not put much stock in the practice of acupuncture, her observations are worth noting:
If you look at an American’s spine from the side, or profile, it’s shaped like the letter S. It curves at the top and then back again at the bottom.
But Gokhale didn’t see those two big curves in people who don’t have back pain. “That S shape is actually not natural,” she says. “It’s a J-shaped spine that you want.”
In fact, if you look at drawings from Leonardo da Vinci — or a Gray’s Anatomy book from 1901 — the spine isn’t shaped like a sharp, curvy S. It’s much flatter, all the way down the back. Then at the bottom, it curves to stick the buttocks out. So the spine looks more like the letter J.
“The J-shaped spine is what you see in Greek statues. It’s what you see in young children. It’s good design,” Gokhale says.
In case you are wondering what a J-shaped spine looks like, here is a sample:
While the hypothesis seems to make sense, there is yet to be any scientifically rigorous study or documentation of indigenous peoples’ spines and whether their shape has anything to do with back pain. Hopefully this idea will spur such well-needed research, especially as back pain becomes more common.
But there’s a whole bunch of reasons why Americans’ postures — and the shape of their spines — may be different than those of indigenous populations, he says. For starters, Americans tend to be much heavier.
“If you have a lot of fat built up in the belly, that could pull your weight forward,” Mummaneni says. “That could curve the spine. And people who are thinner probably have less curvature” — and thus a spine shaped more like J than than an S.
Americans are also much less active than people in traditional cultures, Mummaneni says. “I think the sedentary lifestyle promotes a lack of muscle tone and a lack of postural stability because the muscles get weak.”
Everyone knows that weak abdominal muscles can cause back pain. In fact, Mummaneni says, stronger muscles might be the secret to Gokhale’s success.
In other words, it’s not that the J-shaped spine is the ideal one — or the healthiest. It’s what goes into making the J-shaped spine that matters: “You have to use muscle strength to get your spine to look like a J shape,” he says.
In essence, a J-shaped spine and the subsequent lack of back pain is a symptom of greater physical activity and well-developed core muscles, so the lack of both is what accounts for greater back pain in developed societies like the U.S.
In any case, back pain — not to mention other common but seemingly inexplicable pain like that of the knees — is a consequence of being bipedal. It has a natural basis that can nonetheless be mitigated through greater physical activity and less caloric intake, both of which were once the norm for humanity for millennia.
As someone who once suffered from chronic back pain, due mostly to growing up obese and sedentary, I can attest to the efficacy of building up muscle and being more active. The following tips from Gokhale are well worth considering for those of us who work desk jobs:
1. Do a shoulder roll: Americans tend to scrunch their shoulders forward, so our arms are in front of our bodies. That’s not how people in indigenous cultures carry their arms, Gokhale says. To fix that, gently pull your shoulders up, push them back and then let them drop — like a shoulder roll. Now your arms should dangle by your side, with your thumbs pointing out. “This is the way all your ancestors parked their shoulders,” she says. “This is the natural architecture for our species.”
2. Lengthen your spine: Adding extra length to your spine is easy, Gokhale says. Being careful not to arch your back, take a deep breath in and grow tall. Then maintain that height as you exhale. Repeat: Breathe in, grow even taller and maintain that new height as you exhale. “It takes some effort, but it really strengthens your abdominal muscles,” Gokhale says.
3. Squeeze, squeeze your glute muscles when you walk: In many indigenous cultures, people squeeze their gluteus medius muscles every time they take a step. That’s one reason they have such shapely buttocks muscles that support their lower backs. Gokhale says you can start developing the same type of derrière by tightening the buttocks muscles when you take each step. “The gluteus medius is the one you’re after here. It’s the one high up on your bum,” Gokhale says. “It’s the muscle that keeps you perky, at any age.”
4. Don’t put your chin up: Instead, add length to your neck by taking a lightweight object, like a bean bag or folded washcloth, and balance it on the top of your crown. Try to push your head against the object. “This will lengthen the back of your neck and allow your chin to angle down — not in an exaggerated way, but in a relaxed manner,” Gokhale says.
5. Don’t sit up straight! “That’s just arching your back and getting you into all sorts of trouble,” Gokhale says. Instead do a shoulder roll to open up the chest and take a deep breath to stretch and lengthen the spine.