Stay Hydrated to Reduce Back Pain

Staying hydrated is so important. We know, everyone says it, and we understand if you tune out right now, because staying hydrated is something that everyone tells you to do. Your doctor tells you to do it, your dentist probably tells you to do it, your trainer tells you to do it, everybody tells you to do it. We all try to do it, we just maybe sometimes fall short. But why is it so important? Why do we continue to harp on the hydration issue?

How do back pain and hydration go together?

You may have heard somewhere along the line that we are made up of a lot of water. By mass, we mean that the human body is over 50% water. As chiropractors, what we’re talking about is your back, and specifically your discs. Your discs are made up of 75% to 90% water. Inside each disc is something called the nucleus pulposus, it’s filled up with water and it actually makes your disc act like a water balloon.

Here’s the thing about your body. Your brain and your digestion are using a lot of water. When you’re a little bit dehydrated, your body’s going to steal water from places where it stores water to make sure that other things have water. Nobody realizes that water is so critical to how your body functions.

Your built-in shock absorber

To keep our backs healthy, we need to make sure that we have so much water in our bodies that our body’s not stealing water from the discs in our backs, because the nucleus pulposus is a shock absorber. This shock absorber is making sure that every time you take a step, every time you jump, every time you’re walking around or going from sitting to standing, this shock-absorbing is preventing injury to your spine. We want to make sure that we have plenty of water in our discs so that it still acts as a great shock absorber.

Water and your muscles

Water also impacts our muscles. The muscles actually store up to 90% of the water for your body so your body has this extra store but also so the muscles can move. Without water, your muscles would get stuck in a calcium blocked-up state, and then they don’t move. And a lot of times when patients come in, they’re like, “I think I have this issue where my muscles are cramping and it’s got to be because I don’t eat enough bananas or I don’t get enough magnesium or potassium.” And that’s usually my second guess. My first guess is almost always that you’re a little bit dehydrated, especially here in Florida, and then your muscles are giving up all their water to these other digestive processes and these other important things that your body needs to do.

Your body is hoping that you’re going to replenish those water stores into the muscles so that you can go on doing what you have to do. Your body chooses where it is going to push the water based on your environment. Is it going to push the water to your digestive system and your brain because those are critical and those can never stop working? Or is it going to make sure that those still are working and you have plenty of water in the discs of your spine and the muscles of your spine so you don’t end up getting back pain? When you are dehydrated, when your body uses up all this water and it starts to steal water, it’s almost like losing the insoles from your shoes.

Have you ever taken the insoles out of your shoes? And then you’re walking around in the shoes that don’t have insoles and it feels so terrible, right? It feels like your foot is smacking the concrete every time you’re walking. And the same thing is happening in your spine when all that water has gone from those discs.

How to stay hydrated

You may be asking: “Wait, Dr. Merrill, how do I stay hydrated? What does that take? What are we talking about here?” We’ve all heard, by this point, that you’re supposed to drink eight eight-ounce glasses of water every day. It turns out that’s not a bad place to start but it’s not really the whole picture and I want to dispel some of those myths right now.

The typical starting point that I have for patients these days is half your body weight in ounces. About 190 pounds means 95 ounces of water per day but we’re going to get some caveats to that. So that sounds daunting because if you think about it, a gallon of water is 128 ounces, what we’re talking about is 95 ounces is almost a gallon of water every day. That sounds really hard to drink all that water. How are we going to accomplish that?

So, we’ve got to talk about what counts as water and what doesn’t count as water. The three things that I typically go back to when talking about water equivalents are obviously water, unsweetened tea, and then black coffee without creamer or sugar. Every time I say this, I get pushback. “No Dr. Merrill, coffee’s a diuretic, it doesn’t count one-for-one.” It DOES count one-for-one. Research shows that coffee is just as good as water when it comes to staying hydrated.

Now, keep in mind, I do not recommend that you drink half your body weight in coffee every day. That’s a really, really bad idea, that’s going to give you some problems. It’s the same thing with unsweetened tea, even though it doesn’t have sugar in it. If you drink too much tea or coffee, you’re going to end up with some kidney problems. So if I drink my one unsweetened iced tea and my two coffees, I’m almost halfway done with how much water I need for the day.

One other thing to remember is that most whole fresh fruits and vegetables can also count one-for-one as water. Things like leafy spinach, apples, oranges, and other fruits have a ton of water in them. They count one-for-one as water so if you’re doing a good job eating all of your fresh produce throughout the week, that also should count into how much water you’re getting as well.

Here’s what doesn’t count: milk, juice, and soda do not count. Fruit juice actually does hydrate you pretty well except that it has fructose in it which is going to tax your liver a little bit and uses a bunch of water, so it doesn’t really count one-for-one. Also, alcohol, red wine, beer, liquor do not count as water. In fact, they set you back. So for every alcoholic beverage you drink, you need to drink an extra glass of water to make up for the dehydration effects.

Go beyond the minimums

Half your body weight in ounces is the starting line of what we need, the absolute bare-bones minimum to make sure that your brain is working, your muscles aren’t cramping, and your spinal discs aren’t degenerating, that you’re not falling apart. Now if you’re in Florida and it’s 90 degrees outside, you need more water. If you’re outside and you’re sweating, you need to increase that amount of water. And after you have lost a ton of water, you probably need to add some Gatorade. I would not get a whole lot of your water from Gatorade because it has a ton of calories. But if you’re going to be adding Gatorade in, that’s fine if you’ve been sweating a lot or exercising a lot, but it should not count one-for-one as water. It’s not the same. It will hydrate you, but it will end up being too many calories, too much salt. It’s not the best replacement one-for-one as water. Stick to water if you’re going to be outside a lot.

Tips and tricks to stay hydrated

First, make sure that you’re counting all of those different drinks that you’re getting. Don’t go overboard with it. If you’re already drinking two or three cups of coffee a day, I wouldn’t change that. Count that in and figure out how much is left over to get your number of ounces that you need to stay hydrated. My favorite technique is to use a very big glass. If you start with a little eight-ounce paper cup, it’s going to take you forever to drink 95 ounces. You’re going to forget about it and then you’re never going to get your water goals. If you start with a larger container, like 32 ounces, that’s going to be great because all you need is three of those. Start your day off with one of those, fill it up two more times, and you’re good. The bigger the container, the better. And making sure that it’s front and center with you all day is also imperative. I hope these tips for calculating your water needs and daily intake will help you keep hydrated and healthy!

About Dr. Merrill

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Dr. Andrew Merrill is a passionate active clinician and owner of Nightlight Chiropractic Orlando where him and his team treat hundreds of patients each month. With a strong background in exercise science from Stetson University, clinical skills from Palmer College of Chiropractic, and continued postdoctoral training in spinal disc injuries and clinical nutrition, Dr. Merrill is very well versed in the healthcare landscape. With topics ranging from "what to do for common ailments" to "why the medical system is failing you" Dr. Merrill and this blog in particular aim to keep readers up to date on what the research shows and how you can put it into practice NOW to keep yourself healthy for a lifetime.