‘Our’ lower back pain is completely out of control. It is more than fair to say that as a collective we have made a complete and utter mess of back pain in the same way we have made a big mess of many other parts of life.. like obesity.
Not only do we suffer with the niggly frustrating form of back pain in great numbers we also may have ‘invented’ chronic disabling back pain, there is evidence to suggest that has only existed since WW2 and only in developed countries. On top of all this we have ‘thrown kerosene’ on the fire by addicting millions of people to pain killers. People who are often unable to contribute meaningfully to society because they have been failed by a system that doesn’t know how to manage them.
And yet it has been my experience over the years that back pain is a very manageable condition. It takes a great deal of flexibility and a certain amount of tenacity to relieve large numbers of stubborn lower back pain cases but it has been my observation that it can be done. Here are 3 major rehabilitation tools to consider for those seeking longer term outcomes for their lower back pain.
1# Learn to isolate Your Core
It’s pretty much common knowledge these days that we have a group of muscles that form our ‘core’ and that when they are strong and functioning well they help to prevent lower back pain.
If we can maintain good strength in the deeper layers of trunk muscles we do indeed benefit our spine in a big way. The most basic reason for this is that without muscle support your lower spine really is just a bunch of bones, it doesn’t really have the ability to move itself or protect itself from injuries and repetitive strain. The contraction of the deep muscles and their attachments to the spinal bones limit the amount of movement that occurs in the delicate spinal joints and their connective tissue and thus protects them from injury.
There is whopper of an inconvenient and seldom acknowledged but massively important truth about the core that you may not be aware of. It is that you cannot just rock up to your local gym, start planking and necessarily expect it to benefit your core. The reason for this is that a very significant number of lower back pain sufferers have complex muscles imbalances in their trunk region. Muscle imbalances that absolutely do not yield (and in fact are often made worse) by activities like planking.
The secret to navigating these seemingly murky waters is actually quite simple. In order to strengthen your core you need to be coached on the careful ‘isolation’ of your core. Specifically a very special group of muscles called ‘multifidus’. Multifidii are specific set of muscles that anchor the rest of your core to your spine and prevent injury and strain to the spine. Research has shown that if you can learn to isolate your multifidus and strengthen it you are very likely to have a meaningful reduction in your back pain.
All you need to do is find a practitioner who can help coach you on the isolation of these muscles (I can do that for you if you want) and then work consistently on getting them strong. This restores the muscle imbalance that you as a lower back pain sufferer most likely have in your trunk region.
#2 Manage Stress
It is no easy to say exactly how it is that stress impacts the likelyhood of you suffering with lower back pain issues, but there is no doubt that it does. There is a good reason why Cognitive Behavioural Therapy has made it on to international guidelines for the management of lower back pain.
The chances are that some combination of muscle tension, stress related postures and central activation of pain processors in the brain are all involved in the stress/lower back pain connection. The truth is though we don’t know much about how this works yet.
I’ll give you a glimpse through the eyes of a practitioner who is trained to look for subtle patterns relating to people’s pain. The vast majority of lower back pain episodes that I see in my clinic have been triggered by a mixture of ‘excessive business’ or out & out stress combined with some physical activity.
The good news is that if you are willing make steps towards managing stress it’s highly likely you will experience an improvement in your back pain. The bad news is that managing stress is not the easiest of jobs and does usually take time and persistence.
One excellent start point for better resilience and stress management with a view to reducing lower back pain is to start a regular floating habit. Floating helps pull you out of your ‘fight or flight’ nervous system pathways and into your ‘rest & relax’ nervous system pathways. Another excellent way to start the process of reducing stress is to get a meditation app for your phone and start a daily meditation process ( this advice is now bordering on cliche but the reality that’s because it does actually work if you are willing to persist). A third excellent way to reduce stress is to spend more time in nature away from stress triggers like your phone (underestimate the power of this at your peril). The bottom line is however that all of these approaches do take a willingness to be persistent.
#3 Support Your Feet
I believe that there are 2 major reasons why so many people ultimately find that their lower back pain stem from the ‘ground up’. Firstly we evolved (or were created if you prefer) to walk on soft ground during the course of our lifetimes, not concrete, not paving slabs and not tarmac. Secondly we live very sedentary lives relative to ancestral norms which means that the muscles in our entire lower bodies is far weaker than nature intended for us.
Your heels probably strike hard ground somewhere beteen 3 & 10 Million times every year depending on how active you are. No matter who you are this exerts unimaginable cumulative strain onto the tissues of your lower spine.
When your heel strikes concrete a powerful shockwave travels up your leg bones into your spine. The powerful muscles of the hips, trunk and core are the primary mechanism that protects us from this massive potential source of damage.. without them put spines would be toast in no time.
A major key to reducing strain on the spinal tissues when our heels strike hard surfaces is correct alignment. When your feet, ankles, knees and hips are on alignment the mechanical strain is spread out nice and evenly as Mother Nature intended. If you are not in alignment through all this bashing and crashing unnatural stresses and strains build up not only on the ankles, knees and hips but also in the lower spine. This persistent misalignment is a major potential cause of lower back pain for many people.
Good alignment of the leg has its foundations in your feet and major support in the muscles of the hip. If you have unusual or problematic leg and foot alignment (like those of you with flat feet or very high arches) a combination of hip strengthening and structural foot support like custom orthotics may bring great relief from your lower back pain. Many people who take this path also find major additional benefits for any foot pain, knee pain and ankle pain they may suffer.
Not only do we have the capability to heal our bodies from most stubborn niggly and non-life threatening complaints, I believe it is a big part of what we are here to do.
Every single one of us has a natural inclination to thrive and to improve our life. One area in which we can always improve and evolve is in relation to our bodies and our health. I believe that our seemingly innate desire to ‘get better’ and the great numbers of us who persistently feel ways in which we could be healthier are indicators that it is actually part of human nature to heal. In order to do so all we need do is listen to that little nagging voice. The voice that tells us to improve our posture, do some exercise, eat something less toxic and move our bodies. Having listened, then we need to do what it tells us, on as many days of the week as we can possibly muster.