Low Back Pain

June 21, 2012

Lumbago, or low back pain, affects around 80% of people sometime in their life. Wikipedia states that it is the second-most common neurological ailment, and first in the job place, with headaches alone beating it out. Most often, the pain stems from benign, or non-specific, musculoskeletal problems such as sprains or strains. Classification of low back pain includes acute (less than 4 weeks), subacute (4-12 weeks), and chronic (12+ weeks).

 

There are many reasons people suffer from low back pain. Inactivity and a sedentary lifestyle are two main causes. Sitting long hours at a desk, hunched over work, hunched over in the car to and from work, and hunched over while sitting at home in furniture that promote poor posture are some of the most common, repetitive habits that induce and/or exacerbate low back pain. As we age, the fibrocartilege discs between the vertebrae thin and diminish in size. Prolonged sitting further compresses these spaces as gravity exerts its force upon the body; as one goes throughout the day, one shrinks.

 

Other forms of injury include, but are not limited to, lifting heavy objects without properly developed muscles/core and/or lifting posture, exerting too much force on the lumbar region of the spine (or anywhere else for that matter) which cause herniation of the intervertebral discs, and the development of chronic disease such as osteoporosis, arthritis, degenerative discs, the shifting of the vertebrae more than they ought from spondylolisthesis, fracture of vertebra, and even tumors. My husband injured his low back several years back from sprinting in frigid temperatures. I know many people who suffer from chronic pain due to a sedentary lifestyle coupled with overweight and obesity.

 

One of the main ways to combat low back pain is exercise. As in the case of those who are overweight or obese, simply shedding that weight makes worlds of difference. Numerous studies have shown that excessive weight is, at the very least, a contributing factor to a multitude of diseases, the most obvious of which are heart disease, stroke, and diabetes; chronic low back pain is another. Those who make the commitment to lose 20 pounds over a period of six months have told me that they feel worlds better all-around. One of their most commonly cited complaints, low back pain, lessens or disappears completely. For more “sure-fire” tips, see here.

 

This, I believe, is because they begin to develop their core muscles, the most integral part of one’s body. Joseph Pilates said that the core is responsible for holding you erect, protecting your pelvis and lower back, shielding your internal organs, connecting your legs to the rest of you, and stabilizing you for any and all movement you are about to do. The transverse abdominus, the deepest muscle of the core, contracts in preparation for movement microseconds before the movement actually occurs.

 

With this said, there is hope of alleviating or curing low back pain. For those who suffer from temporary, or acute, cases, careful exercise focusing on strengthening the core (the abdominal muscles–transverse, obliques, and rectus abdominis; back muscles, including those of the upper back; gluts; hip flexors and upper quads) and proper posture can eliminate the pain. For those suffering from chronic injury or disease, exercise can still assist in moderating the pain. Strengthening the core helps support and hold up your weight.

 

I have found when talking to students that posture plays a huge role in low back pain. Rounding of the shoulders not only caves in the chest, making it more difficult to breathe and worsening self-esteem, but it places extra stress on the middle and lower back, which tighten and contort to help hold you up. Improper posture also softens the belly, making it harder to stabilize and contract the core. By rolling those shoulders down the back and away from the ears, you lift the chest, activate the whole core, which draws you up out of the waist and better supports the spinal column, and feel better about yourself.

 

There is another part to combating low back pain. In the latest edition (July 2012) of the American Council on Exercise’s Certified News, Dr. Nicholas A. DiNubile, M.D., states that the key to treating this epidemic is not only exercise, but the “baggage” the patient brings into the doctor’s office along with them. He goes on to talk about how orthopedic surgeons are changing the ways they handle patients and their treatment.

 

We’ve seen the same studies every other doctor has that unequivocally connect stress with immune dysfunction and disease, but we haven’t connected all the dots on how to help patients who are stressed out. Mind and body are seen as two completely different and completely separate realms. We, as surgeons, all to often just deal with the physical; we don’t get the patients to the right person, or incorporate a team approach, or, perhaps most important of all, call on them to help themselves emotionally. The result is suboptimal healing and/or recovery and recurrent frame-related (or other) ailments.

 

That’s beginning to change in a big way. Psychoneuroimmunology (PNI) is a medical discipline, still in its formative stages, that was established to clarify the complex hormonal and biochemical triggers that alter the immune response and other physiological systems. Either these triggers allow your mind and central nervous system to give you a boost, or they set off a downward spiral.

 

The mind affects how you feel and how you heal.

 

Low-back pain, or any kind of physical pain for that matter, can either be exacerbated or alleviated by our mental and emotional responses to it.

 

He goes on to cite some methods that are beneficial to stop the impact of stress on the body, including implementing a relaxation breath (deep breathing), identifying stress “buttons,” and positive thinking, perhaps through guided imagery. (See article for more information.)

 

Dr. DiNubile’s article strikes a cord with me. Regardless of what you are facing, the most important thing one can do to help minimize stress and its related factors is to connect one’s mind and body. To become aware. Awareness is the first step toward healing, for when we can figure out what is going on inside of us, we can verbalize our needs.

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3 Responses to “Low Back Pain”

  1. habisha said

    I got a beginner’s Tai Chi cd by Gaia. Thoughts?

    • Meredith Rose Ashe said

      Definitely give it a go. Pace yourself, of course. Don’t try too much on the first go. Bend your knees over toes only as far as you can, etc. Be aware of how you feel as you progress through the video. And smile while you do it! Relax too. Movement is movement 🙂

      • habisha said

        Yes, smiling helps when things feel weird and you look like an elephant trying to balance on a circus ball for the first time. Eventually it will become dancing. Smiling also helps you relax which makes the movements easier.

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