A cane is an effective assistive device used to improve stability, redistribute body weight, and reduce the load on the lower extremities, which is beneficial for chronic or acute back pain. When used correctly, a cane widens a person’s base of support and helps minimize the physical forces that contribute to spinal and pelvic stress during walking. However, an improperly fitted or positioned cane can worsen posture and increase strain on the back and shoulders, making correct instruction necessary for safety and effectiveness.
Selecting and Adjusting Your Cane
Choosing the right cane begins with understanding the types available. A standard single-point cane is suitable for individuals needing minimal assistance for balance or mild pain relief. For those requiring more significant weight support or stability, an offset cane or a quad cane may be better choices. An offset cane centers the user’s weight directly over the shaft, offering greater weight-bearing capacity and wrist comfort than a simple crook-handle cane.
The most important step is adjusting the cane to the correct height. When standing upright with arms relaxed, the top of the cane handle must align precisely with the crease in your wrist. When grasping the handle, your elbow should have a slight bend, typically between 15 and 20 degrees. A cane that is too tall causes neck and shoulder tension, while one that is too short forces you to stoop forward, straining the lower back.
Determining Proper Cane Placement
The general rule for using a cane to relieve back or lower extremity pain is to hold the device on the side opposite the painful or weaker leg. This contralateral placement is a fundamental biomechanical principle for effective pain management. Holding the cane opposite the painful side allows it to act as an artificial abductor muscle when you step onto the painful leg.
When the painful leg bears weight, the cane pushes downward, creating a force that opposes the natural gravitational pull. This effectively shifts a portion of your body weight away from the painful hip and lower back region. Research has shown that using a cane contralaterally can reduce the compressive forces on the hip joint by up to 60%. This reduction in force minimizes the muscle activity required to stabilize the pelvis and spine, translating directly into reduced back pain during movement.
Mastering the Standard Walking Technique
The proper sequence for walking on level ground with a cane is known as the three-point gait pattern. This pattern coordinates the movement of the cane, the affected leg, and the unaffected leg to maintain continuous support and a natural rhythm.
To begin, move the cane forward simultaneously with the painful or weaker leg. The cane should land slightly ahead of the painful foot and about four to six inches to the side for a stable base. Next, bear some of your weight down onto the cane handle and the weaker leg at the same time. This action uses the cane to absorb impact and load from the painful side.
The final step is to bring your stronger, unaffected leg forward, stepping past the cane and the weaker leg to complete the stride. Throughout this sequence, maintain an upright posture and keep your gaze directed forward, not down at your feet, to encourage proper spinal alignment and balance.
Handling Specific Situations
While the standard walking technique is for level surfaces, specific maneuvers require modified techniques for stability and safety.
Navigating Stairs
When navigating stairs, a helpful mnemonic is “Up with the good, down with the bad.” To ascend, step up first with your stronger leg, then bring the cane and the weaker leg up to meet it on the same step. When descending stairs, place the cane down onto the lower step first, followed by the weaker leg, and finally, step down with your stronger leg.
Sitting and Standing Transitions
When transitioning from sitting to standing, you should not use the cane as a primary lever for pushing off, as it is not designed to support that kind of shearing force. Instead, slide forward to the edge of the chair and use the armrests or the seat to push yourself up with both hands. Once standing and stable, then place your hand on the cane handle.
For sitting down, back up until the backs of your legs touch the chair. Slide the cane to one side, and use both hands on the chair arms or seat to lower yourself down slowly, maintaining control.