Back Pain Intro
Back pain has been clearly identified as a modern healthcare disaster, the number of people who suffer from back pain in their lifetime estimated at around 80%. Back pain can affect people of all ages, from adolescents to the elderly.
Western medicine has made hugely impressive gains when it comes to the successful management of conditions like cancer and heart disease. In terms of back pain however, the statistics indicate in no uncertain terms that we have actually taken steps backward in recent decades.
Part of the problem we have with back pain is that it is in a sense ‘invisible’. Visible conditions like tooth decay are easy for anyone to grasp because you can actually see and feel the changes that occur physically. Conditions like back pain on the other hand are fundamentally ‘unseen’ which leads to a great deal of debate over what causes it and what we should do to treat it.
Some Quick Back Pain Facts
Back pain is the leading cause of disability worldwide. Disability is defined as a condition that not only causes pain but limits your ability to either work or lead a normal active lifestyle.
Back pain is a major cause of missed work days and loss of productivity, some estimates of the annual cost of back pain to UK society through loss of productivity are in excess of 10 billions GBP.
Back pain is the worlds 3rd most common reason to visit the doctor’s office; after skin disorders and osteoarthritis/joint disorders.
By far, the majority of back pain cases are biomechanical, this means essentially that they are not caused by medical conditions, like inflammatory arthritis, infection, fracture or cancer.
Most back pain episodes are self limiting and they settle down by themselves, although reoccurrence is virtually as common as the reoccurrence of an asthma attack.
The ‘natural history’ of back pain indicates that in most cases it is not an injury but an episodic, chronic or reoccurring complaint that relates to more subtle aspects of a persons physical and emotional wellbeing.
Back pain is on the up! Statistics confirm that disability caused by low back pain has increased by 54% between 1990 and 2015.
Reasons Custom Orthotics May Help Your Back Pain
Reason 1 – Concrete
Your human ancestors all lived, loved, ran, walked and stood with their bare feet in the mud. Natural surfaces have no paths, no roads and no pavements, instead they are overwhelmingly soft, compliant and contoured. Natural surfaces are basically uneven, varied and mostly highly shock absorbing. Modern surfaces on the other hand are extremely hard and extremely flat.
The flatness of ‘urban terrain’ in itself is an issue because we never need to balance and we rarely encounter ground obstacles of even contours. Imagine the normal amount of work involved in moving a mile through a forested area or rolling grasslands compared to walking along a street.
A lifetime on hard flat ground makes our core, hip, leg and foot muscles weak and sloppy. If you were to spend enough time with tribal humans who still live in bare feet and sleep under the stars, you would witness a lower back, hip and leg strength way beyond your own, even in those many years your senior. This lower body strength deficit between our domesticated state and those who live outdoors is partly related to muscle wasting triggered by hard & homogenous ‘urban terrain’.
All this weakness in combination with hard jarring vibrations that travel through the bones when we heel strike are potentially a major source of strain for the lower back!!
Custom orthotics ‘hug’ the arch much like soft natural surfaces do when we bear weight upon them. Custom orthotics also offer some shock absorption for the arc and for the heel. In addition it is believed that by triggering nerve activity in the arch custom orthotics may increase muscle activity in the hips and core. These are ways of reducing the repetitive strain and weakness inflicted on our delicate spines and potentially assisting with back pain.
Reason 2 – Lifespan
Building on our first reason, not only do we spend our days stomping around on unnaturally hard and unnaturally flat surfaces, we do so for a long time.
One upon a time custom orthotics and back pain were the least of our worries as a species and we didn’t live anything like as long as we do now. The lifespan of hunting & gathering humans is estimated to have been somewhere between 21 and 37 years. So your spine and your joints need to last arguable for more than twice as long as nature had allowed for.
Those of us who aren’t part of ‘team couch potato’ take upwards of 3 millions steps per year and many of us alive now can expect to exceed 80 years of age. Let’s call that 250 million steps onto hard surfaces like concrete in a lifetime. Is it too much to hypothesise that this amounts to 10X the wear and tear potential on our lower back and its joints when compared to living on grassland for 25 years in bear feet !
To fully comprehend what all this bashing and crashing of the heels onto hard surfaces over long periods of time means in terms of back pain there are a few key points to consider.
Back pain, whether it requires assistance from custom orthotics or not is virtually always a ‘non-medical’ issue which means it relates to movement and mechanical issues as opposed to disease processes.
Stubborn pain is always a message from the body about some form of stress or strain that it is struggling with. The delicate tissues of the lower back come under a great deal of compressive and vibrational stress when we move around on hard surfaces.
What can be confusing about back pain is that while is often caused by the trouble our bodies have with walking and running on concrete, we don’t feel that damage until we have been sitting or lying for some time and everything stiffens up. Many people mistakenly think the damage to their lower back happens at night because they feel it in the morning; when actually their back pain and back stiffness was caused during activity the previous day.
Reason 3 – Lumbar ‘Facet’ Joints
As we said before, when the heel strikes hard surfaces powerful shock waves travel up the leg bones. Imagine jumping off a high wall onto sand compared with jumping down from the same wall onto paving.. 2 very different topics !
Jumping down onto sand is way more comfortable because natural surfaces absorb shock whereas industrially manufactured urban surfaces reflect that shock back into the bodies tissues. This energy has to go somewhere, and that somewhere is up the leg and into the spine and pelvis… where your back pain lives.
There is a key fact about the anatomy of the lumbar spine that might just make it extremely susceptible to hard ground. That fact is how small and delicate the ‘lumbar facet joints’ are.
The lumbar facet joints are delicate little weight bearing joints, no bigger than a finger joint. Lumbar facet joints are so delicate that they don’t appear to make a huge amount of sense being where they are, until you understand that the human design is adapted from a 4 legged walking structure. The basic design of these little joints is a remnant from a time when we didn’t bear the upper body weight though our lower spine because we didn’t walk upright. Now however, they must contend with a scary amount of stacked vertical loading.
The fact that they are already delicate in design has predisposed these joints to struggling with the invention of hard surfaces.I can personally vouch for the fact that many of those lower back pain cases where the joints are sore seem a whole lot happier once they have custom insoles for a short time.
Back pain is a complex issues that had given healers and healthcare providers the run around for millenia. No matter how relevant the issues covered here are to you, custom orthotics will not be a magic bullet. If you have chronic lower back pain I will personally guarantee you that you have multiple issues that have caused it.
Perhaps the best testimonial for custom orthotics is how often they do feel pretty damn close to a magic bullet. Countless individuals before you have watched their healthcare bills drop off the chart and their quality of life go up virtually overnight, once their foot position is corrected while walking and running.