by Bryce Hastings
Effective Lower Back Pain Treatment
What exactly is going on when you suffer from lower back pain? And what can you do about it? Follow these three rules to stay pain free.
Imagine these two scenarios of a patient visiting his doctor.
Patient 1: “Doctor my thumb hurts.”
Doctor: “When does it hurt?”
Patient 1: “When I grab it with my other hand and pull it back as far as I can and hold it like that for a few hours.”
Doctor: “Ummm, don’t do that.” (Idiot!)
Next scenario …
Patient 2: “Doctor, I’ve got lower back pain.”
Doctor: “When does it hurt?”
Patient 2: (slouching) “When I sit like this at my desk for a few hours.”
Doctor: “Okay, I’ll prescribe you some anti-inflammatories. And I’d also like you to see a chiropractor and let’s organise some x-rays and an MRI if things don’t improve.”
Can you see the similarities?
I can appreciate that many cases of lower back pain are a lot more complicated than the thumb pain described here. However, in a lot of cases, finding out how to stop hurting yourself is one of the most effective forms of treatment.
Our spines collapse under very little pressure – they need an active support network to hold them up – this is provided by our muscles. Now, you can get very technical about which muscles do what, but for the sake of simplicity, we’ll describe these as our core muscles.
When we slouch we disengage our core muscles. In turn, this causes our muscles to switch off – meaning two things can happen:
The muscles get weaker and are less able to support us when we need them to.
If we stay in a slouched position for long periods our muscles stretch. Prolonged stretching can prevent muscles from firing when you need them to.
Neither of these things are good for us – which brings us to rule number one.
Rule number one: Don’t slouch – it turns your spinal muscles into jello.
If you have to sit for long periods (which I would avoid if possible) you should have a slight inward curve in your lower back.
When we sit in a rounded posture for long periods we put stress on our discs. Now, we’ve all heard of a “slipped disc”, but the reality is that they don’t really slip – they ooze. Let me explain.
Our discs are little gel-filled pads that sit between our vertebrae. The gel is usually contained in the centre, with rings of connective tissue that keep it in place. Prolonged rounding of the lower back stretches and breaks down the connective tissue rings at the back of your spine. This means the gel part of the disc can leak backwards, creating a bulge at the back of the disc. We’ve all felt that stiffness when we first stand up from a period of prolonged sitting (particularly if we sat with a rounded back – see rule one) or have been gardening. The problem is that this stiffness becomes pain if it’s not kept in check.
Eventually your back becomes sensitive when slouching, or even just bending forward to put your shoes on. If we ignore this and keep slouching, the disc can continue oozing to a point where it puts pressure on nerves that run through the back of your spine. This can really hurt, and sometimes needs surgery.
However, if we recognise this in the early stages we can rectify it – you just need to follow rule one, and rule two.
Rule number two: If your back hurts bending – you should try extending.
We often do this instinctively. If you’ve been bent over in the garden for prolonged periods – when you come to stand up it’s likely you’ll instinctively bend backwards. This helps balance out the pressure in your discs and may help recentralise the gel, preventing it from moving to the back of your spine.
A lot of people with early stages of lower back pain benefit from extension exercises.
Simply lie on your stomach and gently push up through your arms to lift your chest while keeping your hips down. Hold for just a couple of seconds and go back down again – repeat 10 times and do this whenever you feel that discomfort from bending forward or slouched sitting.
With this simple move you could prevent the need to see a surgeon as a result of your excessive disc oozing.
The last rule comes from the need to condition those muscles that support our spines.
Rule number three: If your back feels unstable – stabilise it.
This sounds terribly tedious but it doesn’t need to be. Obviously core-focused exercises such as hovers and planks, and certain types of abdominal exercises, are all geared toward keeping these muscles in great shape. Squats and deadlifts (even with just bodyweight) are also great stability exercises. Doing these on a regular basis helps keep these muscles toned, and you get to burn calories and tone other muscles at the same time. Just remember to keep that slight inward curve in your lower back as you do them.
Studies have even shown that running helps to condition our spinal muscles.
The golden rule: Get active.
When our species made the decision to be bipedal our spines were always going to be at risk of injury. I’ve personally witnessed people with such severe lower back pain they’ve had to revert back to moving on all fours for short periods – usually as a means of getting to the toilet. You can make sure you’re not one of them by taking care of your spine – all you need to do is follow the simple tips above.
Bryce Hastings is a leading New Zealand physiotherapist and fitness expert. As Les Mills Head of Research he leads research into the most effective approaches to exercise and plays a pivotal role in structuring all LES MILLS™ workouts. Bryce’s passion for effective exercise is born from spending 30 years in physiotherapy, where he saw “people getting their lives wrong” every day and felt like he was acting as an ambulance at the bottom of the cliff. By working in fitness he gets to be the fence at the top.