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Laura Seitz, Deseret News
Physical therapist Esther Smith, left, demonstrates optimal standing alignment on Kara Tucker at the Intermountain Medical Center in Murray on Thursday, Jan. 10, 2013.
With the right therapy, anyone can get better. And the amount of time one has suffered doesn't dictate how quickly you can get better. —Physical therapist Esther Smith

MURRAY — Back pain can be brought on by arthritis or other chronic conditions, but occasionally, it results from trauma, such as a car accident or other unexpected action.

About 80 percent of the time, however, it comes on for no apparent reason, said physical therapist Esther Smith, who works at the Intermountain Orthopedic and Spine Therapy Clinic at Intermountain Medical Center in Murray. Incorrectly lifting something or daily postural stresses can also spur on neck pain or low back pain, specifically for individuals with desk jobs.

"A lot of times, people start to get better if they're instructed to sit with better posture and avoid the activities that make them worse," Smith said, adding that her job is mainly to educate people about why the pain occurs, resolve it and help prevent it from happening again in the future.

Smith and Dr. Justin Hohl, an orthopedic surgeon with Intermountain's The Orthopedic Specialty Hospital, will participate in the Deseret News/Intermountain Healthcare Health Hotline on Saturday to answer questions on neck, back and leg pain. From 10 a.m. to noon, anyone interested is welcome to call 800-925-8177 or post a question on the Deseret News Facebook page, and the health professionals will provide confidential advice.

Slouched posture, she said, puts the spine in a position out of its natural and neutral alignment, causing pain after so long.

"The spine is resilient in its neutral position," Smith said. A neutral position while sitting lines up the hips, shoulders and ears. While standing, she said, the ankles also need to be in alignment with the rest of the body.

Pain and injury can also occur during improper lifting. A swift or traumatic movement may be too much for the joints and muscles in the back to handle, damaging the soft tissue that surrounds bones and nerves along the spine.

"It doesn't matter how long it has been around," Smith said. "With the right therapy, anyone can get better. And the amount of time one has suffered doesn't dictate how quickly you can get better."

Workplace behaviors are often the culprit of back pain, Smith said. Ergonomics are addressed in therapy. She teaches patients various exercises or stretches to strengthen back tissues and relieve pain.

"I also encourage people not to sit more than 30 minutes at a time," she said. "And the worst thing is to sit in bad posture over a long period of time." A standing workstation, where feasible, is recommended.

Smith works with a variety of patients, including women expecting a child or dealing with postpartum pains that result from the added demands of caring for a child. "A lot of it goes back to understanding how you body has become stressed and moving accordingly," she said.

Core strength is also important, as the core area stabilizes and protects the spine. Because of this, movements to enhance abdominal strength are part of any physical therapy program.

With neck and back pain as common as it is, Smith said, physical therapy should be the first line of defense where individuals can turn for help. In Utah, most insurance companies do not require a referral for physical therapy services, but some, including Medicare, still do.

In episodes of severe back pain, extreme muscle weakness or loss of bladder function, Smith said a patient may require emergency care. Nerve issues typically require surgery for proper relief.

Effective treatment for back pain, she said, is becoming a huge topic as the country moves toward less costly care, "because so many people have it."

E-mail: wleonard@desnews.com

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