Low Back Education
The statistics of reported low back pain is staggering. Did you know that 80% of Americans suffer from debilitating low back pain at some point in their life? My mission is to help those 80% of Americans who fall in this category, recover from back pain, and to help reduce that staggering percentage by helping you prevent low back pain…keep you out of the 80% statistic. What about you? Do you want to suffer from debilitating low back pain or do you want to prevent that from happening?
From my experience and knowledge, a common problem among all patients with lower back pain is bad low back posture during common activities, such as putting on your shoes, bending over, picking up your kids, exercises, and sitting. Poor posture and movement patterns puts odd stresses on your spine which put you at risk for back pain.
The low back (lumbar spine) is meant to have a little curve to it that need a different word here towards the front (your stomach). This natural curve displaces the forces of weight evenly. When that curve become too far out of neutral (too much curve or too little) more force and stress is being put on the disc, muscles, ligaments and joints that support the lumbar spine. The result is low back pain.
Low Back pain is an umbrella term that many conditions fall under. In this article we will touch on some of the key points you should know to help you lower your risk of low back pain. Some of these key points are: 1) what are the condition and symptoms 2) what are the leading causes 3) what can you do to prevent it.
Low Back Conditions:
Lumbar Strain and Sprains
Like a strained hamstring or a sprained ankle, these sprains and strains can occur to the low back as well. In the low back, both have similar pain and symptom patterns. They have pain with movement and most often you can nail down a time when the pain started. Sometimes during heavy lifting, exercise, car accidents, sporting activities or a slip and fall on the ice. When these injuries occur, most people will adapt a dysfunctional movement pattern to avoid the painful points. With a sprained ankle, people will start to limp to reduce the pressure and pain placed on the hurt ankle. For a short time this is expected. It is when this dysfunctional movement becomes a lasting habit that problems arise later down the line.
Poor physical condition with weak core muscles will put you at a higher risk of this injury occurring. If you have a desk job and are sitting down for most of the day with poor posture, you are also at a higher risk of a sprain/strain of the lower back.
Ways to prevent/treat it: Doing some core and glute strengthening, low back stabilizing corrective exercises. Stretching hips and upper back for more mobility in those areas will help as well. Understanding the joint-by-joint concept will add to your knowledge. You can learn more by going to this article. Joint-by-joint article. Some corrective exercises will be shared at the end of the article. These can be done in the comfort of your own home.
Lumbar Stenosis
This condition is more common among the older population. This is a narrowing of the spinal column or the lateral recess of the spine. That is a lot of big words there but let’s break it down. Your spine primarily does two things, 1) provides structural stability for your body to stand up straight and 2) protects your spinal cord (nerves) that go up to your brain. Stenosis is when the space for your spinal cord and nerves to move freely is getting smaller and smaller which then applies pressure to the cord and nerves. Nerves have a characteristic about them that you should know about. They are claustrophobic, if they don’t have their space, they will let you know about it through pain and discomfort. So when stenosis is closing the space down you will have constant pain and discomfort in your back and sometimes your legs.
Stenosis is more likely in the older population because it can be caused by bony spelling of bony? overgrowth from arthritis which infringes on the joints or the spine itself. It could also be from a bulging disc. Osteoarthritis is aging of the spine like gray hair is to your head. It is a natural aging process, most of it doesn’t cause stenosis and sometimes it does. This statement is contradictory.
What can you do about it: at a young age, continue to move. Bed rest can really aggravate back pain and recovery. Start to implement some low back corrective exercises to stabilize your back. If you have stenosis and need additional help, seek guidance from a trained professional.
Lumbar Disc
Lumbar discs are flexible, fibrous material that lay between each bone (vertebrae) of your spine. They work as shock absorbent for the spine and add flexibility to the spine. A common analogy to spinal discs are jelly donuts. Yummy! The outside of the disc is a thick fibrous material, the inside is a “gel” like substance called the nucleus pulposus.
You may have heard of different types of disc injuries, such as, disc bulge or disc herniation (aka:ruptured disc). The latter would be the more severe disc injury of the two. A disc herniation is when the gel substance in the disc has broken its way through the fibrous outer shell (like a jelly donut) and is now outside the disc. The pain would be from the broken fibrous shell and/or the pressure of the herniation on the neighboring nerve.
If you are experiencing a disc injury you may be having some or all of these symptoms. Low back pain, leg pain (sciatica), leg numbness/tingling, more pain with sitting and bending forwards. Often times the leg pain will be worse than the back pain.
What puts you at risk of a disc herniation?
- Middle age: 30-50 years of age are at higher risk
- Obesity – being overweight puts more stress on the lumbar disc
- Sedentary lifestyle – lack of exercise and poor core body strength
- Smoking – Smoking in general is bad, but with the disc is speeds up the degeneration process.
Again poor posture of the low back will put you at risk of this injury. Rounding your lower back puts a significant increased amount of pressure on your lumbar disc and over a long period of time (months to years) this will cause injury to the disc. Heavy lifting with poor lumbar support and a rounded back will cause a disc injury faster and more severe.
It has been known that three activities puts added stress on the disc. 1) Increased weight bearing (sitting for long periods of time, dead-lifting w/ added weight, squatting w/ added weight) 2) Flexion-bending forward (rounded back) and 3) rotation-twisting. Any combination of these activities increase your risk of disc injury dramatically.
Wait, do you mean I can’t do dead-lifting any more? No, what this means is understanding what your back is doing throughout the day. If you have sat all day with poor-rounded back posture then want to go do a max dead-lift, you have compromised your back before the dead-lift putting you at risk for disc injury. Dead-lifting is not a bad exercises, in fact I would encourage it when done properly. I would say you can dead-lift or squat at the gym, but only if you have taken care of your spine before hand, and you compromise your spine by adding either Flexion(2) or Rotation(3) to your spine with the added weight. Have a buddy watch you as you lift.
What can you do to prevent it? Know what your spine is doing throughout the day. Do some spine stabilize corrective exercises before a workout for warm up and later in the day. Mobilize those hips of yours, joint-by-joint approach. Do any lifting or up and down motion with the “hip-hinge” motion. Link here
If you have experienced some low back or leg pain from a disc injury, seek guidance from a trained professional to help guide you through the recovery of this injury.
The most concerning question people have is “Will I need surgery to fix the disc herniation?” Most likely, No. Most disc injuries resolve best with conservative care and in a patient but timely manner. The only time I would recommend getting a surgical consultation for a disc injury is: 1) Conservative care (chiropractic/physical therapy) has failed over a month’s time 2) There is progressive nerve damage (weakness in the leg) 3) Or you find it more difficult to use the restroom (bowel and bladder function).
Lumbar Facet (joint) Syndromes
Along the back of your spine there are four little joints to each bone. Two on each side (right & left), one joint works with the bone above and the other works with the bone below. These joints are called facets and they work the same as all other joints in your body (ie. ankle, knee,…) just at a smaller scale. These joints can cause pain to the general area when too much stress is being placed on them or they have been injured like a sprained ankle.
The main physical causes that put you at risk for a facet pain are:
- Overweight
- Whiplash/auto accident
- Slip and Fall
- Arthritis
- Sitting for long periods of time leading to lower cross syndrome. Lower cross syndrome is a combination of muscle imbalances that we will speak of later.
With proper education you can prevent yourself from this condition. The most common characteristic of this condition is, poor physical condition with weakness of the small stabilizing muscles of your spine. Those that sit all day at a desk job are at high risk.
What can you do to prevent this from occurring? Take micro breaks if you have a desk job. Every 20-30 minutes you need to either change your position (sitting/standing) or get up and move around. Understand the proper stretches/exercises for lower cross syndrome (below). Improve your fitness/activity levels.
Lower Cross Syndrome (aka: Donald duck butt)
Remember the natural curve we talked about earlier? When we sit to long throughout the day that curve starts to become exaggerated and that applies more stress on the joints. When sitting to long, that can create some muscle imbalances that lead to lower cross syndrome.
The muscles imbalances are:
Tight muscles
Hip flexors (psoas)
Lower back muscles
Weak/inactive muscles
Core wall (abdominals)
Gluteal muscles
This is created because of the constant sitting position. In my opinion this is the crux of a lot of lower back complaints. (There is also an upper cross syndrome with similar characteristics, but that causes most of upper back and neck discomfort). If you were to take a guess at what you want to do to combat this syndrome what would your guess be? You’re right, stretch the tight muscles and strengthen(wake up) the weak/inactive muscles. Here is some guidance to what stretches/exercises you can do to work this out.
That is the basis of what you need to know about some of the top low back conditions that cause low back pain. The next post will be a list of exercises you can do to help with your lower back pain. Do them and you will see improvement with your low back discomfort and preventing low back pain.