Roughly 36% (Hoy et al., 2010) of us experience lower back pain each year. Think you are the only one? I bet if you took a quick poll, you will also find that almost all of your friends and family have experienced back pain at some point in their lifetime as well. Not only are you not alone in your struggles, but there are measures you can take to protect your back from pain.
Low back pain can be the result of a wide variety of anatomical structures within the lumbar spine, but it can also be idiopathic (of no known cause). Overactive or weak muscles, ligaments, compression or irritation of nerve roots and discs between the vertebrae tend to be the usual suspects, but represent only just a small portion of potential pathologies that can lead to pain and radiating symptoms (tingling, numbness, weakness) in your low back and even down your legs.
In a study conducted by Savage et al., (1997 - It has been rumored that he has the reputation of a "savage" of the lumbar pain variety), it was found that nearly 53% of those who reported lower back pain had an identifiable abnormality viewable in an MRI scan. That means only 47% of those who experienced back pain had no anatomical reason to feel that way. Pain is not as cause and effect as you may assume.
Don't Get Sliced Open Just YET!
Lower back pain doesn’t necessarily mean something is horribly wrong and you need to immediately go under the knife. Sometimes pain is just our body's way protecting itself and telling us it doesn’t enjoy what you are doing to it in that very moment, or possibly even an overreaction. Back pain is complex and multifactorial in nature. Saying that, I must first recommend that you see a physical therapist if you are experiencing back pain that is seriously debilitating or constant and unbearable, as making a few small tweaks is not a substitute for skilled conservative back pain management.
This blog post is intended to give general tips on how you can avoid flaring up of occasional back pain and implement techniques to benefit the stability and ability of the lower back.
1) Desk jockeys, turn your work station into a spine friendly environment!
Ideally, you are working a job that isn't sedentary. We know that this is not the case for most of us. So if you ARE the vast majority working at a desk, make sure you are at least moving around as much as possible (see Ryan's desk worker post), or better yet, have a standing desk. Typically, the sedentary desk worker will wonder why their back hurts after spending half of their waking hours staring at a computer screen with a back so rounded Sméagol would cringe. Sit up straight! The goal of good sitting posture is to effectively keep the spine in its most natural position, with concave curves in your lower back and neck and convex curves in your mid back (by your shoulder blades). This is basically mimicking proper standing posture in a seated position.
Make sure you are using an ergonomic chair with lumbar (lower back region) support or an additional lumbar support pad on a regular chair. This will allow your lower back to maintain the natural concave arch it is meant to have, giving the nerves, ligaments, joints and muscles of your back more space to operate effectively and pain free as they make their way down your back and legs. This could help alleviate that constant pain many get from sitting all day.
2) Don’t be Frankenstein! Bend using all of your body's available range of motion
When bending down to pick something up, try to bring your butt backwards and lower yourself between your knees as you drop down. Don’t be afraid to let your back bend proportionately throughout the movement as well. Contrary to popular belief, it is ok for your back to bend in a controlled and segmental pattern (rather than a violent hinging one). Any slight flexion of the spinal column is a natural movement that many will immediately remove from their repertoire once they feel the slightest tinge of pain in their lower back.
Narrowing down the range of movements your lumbar spine can perform is not doing you any favors in terms of the overall mobility of your back. Certain healthy individuals (lacking any lower back pathology) tend to think that they are protecting themselves from further pain by increasing tension in their lumbar spine and moving slowly to perform a movement, but they actually are just training themselves to be intolerant of relatively innocuous movement of segmental spinal flexion. Practicing this over and over, you will eventually become intolerant of more movements and become stiffer and less functional than a two by four. So unless you want to have the spinal mobility of this guy:
I recommend not avoiding basic movements. By incorporating both your legs and hips into bending over you can reduce the amount your back will need to bend without canning the motion all together.
3) Suck it in: (well… pull it in)
Performing exercises that strengthen the muscles of your core doesn’t mean grabbing a 45 pound weight and doing hanging crunches as fast as you can for 20 minutes straight. You can protect your back by simply pulling your belly button into your back. Here’s what you do: every night, before you fall asleep, imagine taking your belly button and pulling it in, like you are trying to touch it to your spine. Hold this for 10 seconds and repeat 10 times. If you want to feel if you are doing it correctly, try placing your pointer and middle finger just to the inside of those two bony bumps coming off your pelvic bone to the outside and a little below your belly button.
When you are performing this exercise, you should feel a muscle push up into your fingers, that’s your transverse abdominus (TA). Make sure when you are contracting your TA, you are also breathing regularly. Many people tend to hold their breath when performing this exercise, but you shouldn’t. You should always have a slight contraction of this muscle, so breathing throughout the exercise is necessary to cement good habits. Try exhaling as if you were fogging up a mirror. The act of breathing out in this manner can help further activate the TA muscles that act as the seran wrap of the abdominal cavity and stabilize your vertebral column.
This exercise strengthens the muscles that wrap around the front of your body and provide support to your back while simultaneously pulling your gut in, making you an immediate beach God/Goddess. By training these muscles, you can in turn, strengthen and protect your lower back throughout any activity!
There you have it. Three simple things that you can begin to incorporate right now and can help protect your lower back. Try to implement these techniques slowly. Two of them are simple modifications to what you are doing daily and the other is a quick and easy exercise that will get your stomach tighter in the meantime (double benefit). So unless you actually are Frankenstein, and don’t actually care about your long term back health, I suggest you start with these changes today!
References
Hoy D, Brooks P, Blyth F, Buchbinder R. The Epidemiology of low back pain. Best Pract Res Clin Rheumatol. 2010;24:769-781. http://dx.doi. org/10.1016/j.berh.2010.10.002
Savage RA, Whitehouse GH, Roberts N. The relationship between the magnetic resonance imaging appearance of the lumbar spine and low back pain, age and occupation in males. Eur Spine J. 1997;6:106-114.