When I speak to groups on the topic of low back pain prevention, my message is always the same. Balance the forces you place on your spine, and you will likely decrease your chances of developing low back pain.

While numerous factors can cause low back pain, if I had to pinpoint the one thing that could make the most significant difference for the greatest number of people, it would be the way they position and move their spines on a daily basis.

For most people, the majority of their waking hours consist of activities involving spinal flexion, such as sitting and bending. For example, they wake up, eat breakfast while sitting, sit in a car or public transportation on their way to work, work at a desk job, sit on the ride home, eat dinner while sitting and then relax by watching TV or reading on a couch or recliner before bed. In addition, activities such as laundry, dishes, gardening, sweeping, vacuuming and caring for young children all involve spinal flexion.

On the contrary, very little time is spent in the other direction, termed spinal extension.

Over time, this mismatch of mechanical stresses can get many people into trouble. Too much time is spent in spinal flexion and not enough time in extension. Therefore, as a way to decrease your chances of developing low back pain, it’s essential to even out the forces acting on your spine.

The importance of balancing spinal forces was demonstrated in a study that randomized military recruits into two groups. The first group was instructed to perform 15 repetitions of spinal extension twice per day and adopt an upright posture when sitting. Extension was done in the form of a prone press-up, similar to the cobra pose in yoga.

The second group served as a control, and those recruits were simply told to carry out their usual daily activities.

The findings between the two groups were significant.

Over the course of one year, low back pain was reported in just 33% of the extension group, compared with 51% of the control group. In addition, only 9% of the extension group sought medical care for low back pain, compared with 25% of the control group.

My advice: Bend backward several times throughout the day (which can be done in standing or lying) and sit with better posture. Optimal sitting posture is defined as 10% relaxation from extreme upright sitting and can be attained through the use of a small pillow called a lumbar roll.

Those tips will help counteract excessive spinal flexion forces and give people the best chance of preventing low back pain.

Now, that advice is based on looking at the problem of low back pain from a 30,000-foot view.

Therefore, it doesn’t apply to every individual. Spinal extension isn’t the answer for everyone, and if it aggravates your lower back, it might not be for you. That being said, the standard medical advice for people to avoid spinal extension has not diminished the incidence of low back pain one bit.

Incorporating it into daily life, however, likely will.

Dr. Jordan Duncan is from Kitsap County and writes a monthly online health column for Kitsap News Group. He is the owner of Silverdale Sport & Spine.