How to treat and avoid bar back

No, not you, you lovely people who support bar teams; you, with your lightning-fast keg changes and total glass-rack dominance, are gods and goddesses among us.

Bar back, however, the affectionate name given by many to that horrible stiffness in your lower back, the achy crunch all of us who spend our workweek on our feet—be it behind the bar, in the kitchen, or on the floor—try to loosen by leaning back, hands at the bases of our spines, mouths bent into tight grimaces: That is something that needs to be addressed.

And it’s something that, according to a local specialist, can totally be worked out, but can also force you out of the industry if left untreated.

Dr. Pradeep Dinakar, a neurologist and pain management treatment specialist at Boston Children’s Hospital who also sees and treats adult patients (several of whom are members of the industry) at Brigham and Women’s, says that the spine is the most common thing he sees injured in folks working in restaurants.

“Long hours of standing, plus bending over, picking up heavy things. It’s a tough job,” Dinakar says. “The spine, the hips, the sacroiliac joints [what connects the triangular sacrum at the base of your spine to the pelvis] are all affected.”

According to Dinakar, lifting something wrong can also cause disc bulges which may in turn send pain to your legs, and repetitive motion, particularly all that shaking, chopping, or tray carrying, will lead to myofascial pain, a chronic disorder caused by overused muscles, that results in deep aching muscle pain, uncomfortable knots, and sometimes even difficulty sleeping.

Sound familiar? Yeah, I know, right? So what’s to be done?

“You can never train enough for those awkward movements [like reaching across the bar for stray napkins and empty glasses, or navigating a crowd with a tray full of drinks], but if you can get to the gym and work out, be physically active on your days off, that will help,” Dinakar says.

Core strength, it turns out, is good for a lot more than six-pack abs or your yoga practice—well-toned core muscles also support your spine.

“Get back to the gym if you haven’t been working out,” Dinakar says. “With all the bending and lifting, without a strong core something is going to give way.”

Which is great, going forward, but what to do about what already hurts?

“First we look to make lifestyle changes, to avoid what’s causing the pain,” which, Dinakar notes, isn’t always possible for many in the industry. Next steps are anti-inflammatories, physical therapy, or steroid injections.

Self-care is also always an option. Massage, acupuncture, hot tub soaks—all of these can help alleviate pain in the short term.

What about a trip to the chiropractor? That’s a back doctor, right?

Yes and no. Pain specialists like Dinakar, and the world of neurology in general, don’t make referrals to chiropractors because, in their practice, there is no medical evidence for chiropractic adjustments.

“If it feels good, fine,” Dinakar says. “But everything, even what I do, has risks.” And direct manipulation of the spine, in Dinakar’s professional opinion, carries a few more risks than physical therapy.

Ultimately, the industry is a demanding workplace. The aches and pains are real, and they’re not going away from a lack of treatment.

“It’s like any profession,” Dinakar says. “We keep pushing until we can do it no longer, and then we find something else. What we don’t realize is that we need to have a spine for the rest of our life.”

Finally, even if your employer doesn’t offer health insurance, we live in Massachusetts, where care has been mandatory and relatively affordable for years. Get your monthly premium’s worth and talk to your doctor about those spasms in your shoulders and the way your lower back feels like it’s weighing on your knees. For vertical mobility’s sake, also hit the gym. If nothing else, check out a place like Inman Oasis, which is offering a discount on soaks and massages for industry folks through the end of February.

Treat yourself. Your career depends on it.

Copyright 2016 Haley Hamilton.

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