It’s a glorious morning and you’ve slept well except for the occasional lower back twinge. Well, it’s been there for a few days now, still…
The sun is shining and you’ve a lot planned. A wonderful warm shower has eased that mild ache and you sit on the edge of the bed both to ponder the world, what it means to have just hit your 30s and to pull on your socks ready for another day of work. But as you reach down gently to pull on your right sock, lower back pain grabs you in its vice, as the happiness you felt moments ago leeches from your body and your lower back locks solid…
It is at this point, I often saw patients for the first time. Pain etched on their face, lower back in spasm, many wondering what just happened as they ‘hadn’t done anything’ to warrant the experience.
Or had they?
See, back pain is a warning sign that things aren’t right. And for most people, changes have been bubbling under the surface for a long while. Poor posture, a sedentary life, inflammatory food and lifestyle habits, extensive sitting, unhealthy sleep habits, excess stress, weakened spine supporting muscles, poor blood flow, an altered sense of our body in space (called proprioception, and it’s so important we’ll discuss it in greater detail shortly).
Before we get into the why and where and look at how you can combat your low back pain, let’s talk about some important facts.
How common is lower back pain?
If you’ve experienced lower back pain at any point in your life, you are in the overwhelming majority. In fact, it’s estimated up to 84% of people will. In a study by Matthew Thiese and his research team, published in BMC Musculoskeletal Disorders, people were asked whether they had lower back pain on the day of the interview, or within the past month. The result? People were suffering, with a ‘yes’ in 20.8% and 44.0% respectively.
That’s a lot of lower back pain!
While back pain may be acute (of short duration), sub-acute (between six weeks to three months) or chronic (lasting more than three months) and the causes may vary, there are treatment approaches and stretches that can offer profound help.
Note: If your back pain is severe, occurs after a serious injury (car accident, fall, sporting injury), or you have leg pain, loss of bladder or bowel control, accompanying fever, or the pain remains present after several weeks, see your qualified health professional.
What can you do to alleviate your lower back pain?
There are a number of approaches that have been clinically and scientifically shown to reduce — even eliminate — back pain. Let’s look at the most prolific pain type: mechanical back pain.
Our spine is an incredible piece of mechanical mastery crafted from 24 spinal bones called vertebrae (usually! Some people grow an extra bone or miss one out altogether), the pelvis (created from two ilia, the sacrum and the coccyx), with the skull sitting comfortably on top.
Movement of these spinal bones enables us, too, to move. As we do, the remarkable tissues that hold each vertebra to the next, stretch and compress, flex and compensate. This stretch causes local nerves within the joint to fire, this input rising to the brain. This complex computer that sits in our skull then acts like the control center it is: Move to the right while standing, the muscles on the left tighten to prevent you tumbling over. Raise your leg, and the muscles in your back compensate to support your body in doing so fluently. This body-brain communication is called proprioception and allows us to know exactly where we are in space without having to look.
What happens when the information provided to your brain is altered due to poor local, or segmental, spinal motion? What if the right side of a vertebral joint is effectively ‘stuck’ while the other side moves freely?
Several important issues arise.
Firstly, the joint tells the brain, ‘Help me out here! Slow down the increased motion happening over there. I need balance!’ The body does this by tightening the appropriate muscles… and so you may experience spasm, cramping and pain.
Secondly, as noted by Dr Roger Sperry — 1981 Nobel Prize winner for brain research — “Ninety percent of the stimulation and nutrition to the brain is generated by the movement of the spine.” When spinal motion is limited, so too, is brain function. This is likely a significant reason many back pain sufferers also complain of gut issues, poor concentration, tiredness, for example, and this Chiropractors see commonly in clinic.
And speaking of clinic, let’s take a look at Chiropractic and how it can help your recovery from lower back pain.
Chiropractors are spinal experts, holding at minimum a five year University degree and mandatory government registration.
A Chiropractor may use a variety of techniques to restore segmental motion via a spinal adjustment. An adjustment is the application of a short, sharp, (usually) painless thrust aimed specifically at the restricted spinal joint (known traditionally as a subluxation). The adjustment has been shown to both improve spinal motion and reduce local muscle spasm.
Let’s take a look at an excerpt from my book, The Back Pain Relief Book…
A study by Haas et al. showed three to four adjustments per week for three weeks gave the best pain relief for chronic lower back pain (lower back pain that has been present more than three months). This study looked only at pain relief in the short term, however, and not the benefit or schedule of restorative care and maintenance care. So, we need to look to another study.
Senna also supported spinal adjustments in relieving lower back pain. This study showed that an initial care plan of 12 adjustments in the first month gave superior pain relief. The study found the pain might return without on-going care. However, by receiving fortnightly care for the following nine months (i.e., for the duration of the study), the back pain was significantly decreased on a long-term basis, and that on-going maintenance care was most beneficial. Function was also improved with on-going care, disability was decreased, and the number of episodes and the intensity of back pain were reduced. And remember, a correctly moving spine means improved brain function and this positively influences each and every cell in your body and each and every aspect of your health.
What else can improve your lower back pain?
Ah, stretches that ease lower back pain
There are two major muscles that tighten in lower back pain and cause pain in both the lower back and other areas: the psoas and the piriformis.
The psoas muscle runs from your lower back (lumbar) spine, through your pelvic and to the inside of your upper thigh bone (femur). The psoas helps you move, bring your knee to your chest and support your body. As we sit so often, this muscle can become chronically contracted and contribute to back pain. Clinically, it can refer pain to the front of the thigh and the lower back on the affected side.
How to stretch your psoas
There are several ways to stretch this muscle; let your pain levels determine which option is best for you.
1) Stand in a comfortable lunge position, with the leg on the affected side behind and the opposite arm placed on a wall for support. Hold your pelvis straight and level. Gently lower yourself forward and down until you feel a stretch in the leg behind, through your upper thigh. Hold for 20 – 30 seconds.
2) Lay on your back, with your bottom at the edge of a bench or bed. Pull the unaffected side knee toward your chest. Let the other side extend off the bench/bed, with gravity acting to gently lengthening the affected hip. If you have a support person, they can stand near you, place one hand on the raised knee, and the other on the lower thigh to increase a gentle stretch. Hold.
The piriformis muscle runs from the front of the sacrum and to the bony protuberance and the outside your hip (called the greater trochanter.) The piriformis helps to turn your leg outward and to bring it sideways when your knee is flexed. It can cause buttock pain, and pain to also run down the back of the leg. Depending on the person, the sciatic nerve can run over, through or under the piriformis muscle, and so piriformis pain can be mistaken for sciatica.
There are also several ways to stretch this muscle. I’ve witnessed the most convoluted pretzel approaches to stretching this muscle, from legs tied under laying bodies, to treading the needle type supine moves. In truth, the simple version below is perfectly suitable for people with lower back pain. This is the stretch I recommend.
How to stretch your piriformis
Sit with one leg crossed over the other, the raised ankle close to your opposite knee. This forms a figure four shape. Straighten your spine and gently bent forward. You will feel a pull in your buttock, and once you do, hold this for 20 – 30 seconds.
Remember, stretches should feel like, well, stretches. When you have lower back pain, an overly enthusiastic push won’t help and may exacerbate the pain.
Strengthening your core is key
In our busy, often sedentary lives our abdominal (or core) muscles can loss their oomph, weakening and allowing our tummy to protrude. As this happens, excess pressure is placed on our lumbar spine, which can trigger lower back pain. As our psoas tightens, a weakened core also no longer offers a counterbalance.
Ah, but I hate sit ups I hear you scream! GREAT! I don’t recommend traditional setups at all as the muscle they are really good at strengthening is, in actual fact, your psoas.
Planking, crunching, bridging, airplaning and tabletops are superior choices. Check out this picture for more information.
Remember, with all strengthening and stretching regimes, start where you are at. There are no prizes for beginning above your level, except additional pain.
Supplements to soothe
I have found, both personally and clinically, supplements like magnesium and fish oil can be a blessing for lower back pain.
Magnesium is commonly known as the great relaxer and does just that. Choose a powder-to-liquid or liquid form for better absorption. Foods rich in this mineral also include the humble banana (that’s why this is the fruit of choice in many sporting events), dark leafy greens, avocados, nuts and seeds.
There is much you can do to both hasten your recovery from lower back pain and reduce the recurrence of this common, potentially disabling complaint. Receive the right care, supplement where helpful, implement sensible approaches and lifestyle changes, and look after yourself and your health.