Lower back pain has become a common problem in modern society with estimations showing that up to 80% of adults will experience an episode of back pain at some point in their lives. The rate of reported back pain has doubled over the past forty years in the western world and back pain is now the second most common reason for absenteeism from work. Stress is the most common (also a major contributing factor in back pain).
What is Lower Back Pain?
The most common type of back pain is musculo-skeletal lower back pain. The lower back has many muscle/ligament attachments and this can often be the area where tension can be felt the most. It also the main support for the body’s weight. The lower back is mainly composed of muscles which envelope and connects to the spine. The spine is a column made up of generally circular bones known as the vertebrae. Between each spinal vertebra (the composition of circular bones) are tough elastic discs which give the spine its flexibility. Fibrous ligaments connected to each nearby vertebra also work to support and strengthen the spine. The muscles that surround the spine help it to accomplish a wide range of motion. Enclosed within the spine is the spinal cord which protects the nerves connecting to the brain. These nerves which intertwine within the vertebrae are responsible for sending and receiving messages from all the different body parts to the brain, and vice versa.
This blog will concentrate on the more common acute or chronic lower back pain caused by musculo- skeletal issues. More complex back pain causes and issues will not be covered in this article, but it’s worth noting them here:
- Fracture – a crack or break in one of the bones in your back.
- Osteoporosis – a condition where bones lose density causing them to become weak, brittle and easily broken.
- A slipped disc – this is when a disc bulges so far out that it puts pressure on your spinal nerves.
- Spinal stenosis – a condition in which the spaces in your spine narrow.
- Spondylolithesis – when one of your back bones slips forward and out of position.
- Degenerative disc disease – when the discs in your spinal cord gradually become worn.
- Osteoarthritis – a wear-and-tear disease that can particularly affect the joints of your spine.
- Rheumatoid arthritis – an inflammatory condition in which your immune system causes inflammation of the lining of your joints and surrounding structures.
So why has back pain increased?
Poor posture, high levels of stress, obesity, sedentary lifestyle and poor lifting technique/lifting objects that are too heavy are all too familiar to the modern society and are a major contributing factor to lower back pain. The muscles within the back actually support the weight of your upper body rather than the spine itself, which is merely the part of your skeleton that the back supporting muscles attach to. Contrary to popular belief lower back pain does not usually come from the spine itself but rather from the discs, muscles and ligaments. When we complain of back pain, we often think of this as some form of spinal damage but in fact most of the time it is another part of the mechanism that has suffered damage.
So take the most common cause – poor posture: if the body is out of balance the muscles which are tight on the body will pull on the joints. Imagine your muscles are guy ropes on a tent all connecting into the one region. If you pull these ropes tighter and tighter the insertion where the ropes meet will be very tight. Now apply this to the lower back; tight muscles all connecting and putting stress onto the one area, the lower back. Sitting for long periods of time is a major factor. Humans are not designed to sit in a rounded position for hours on end. It causes the muscles to adapt and change: the pelvis will tilt forward and the muscles will tighten in the front of your hips, chest, lower back and neck. The effect on the opposing muscles is to make them overstretched and weak. This is found in the abdominal muscles, upper back muscles and glute muscles (bum).
Within this dilemma of back pain is also the complex matter of the core muscles. Core is a word that is buzzed about a lot in the fitness industry but rarely understood. The core is a group of muscles (multifidus, transverse abdominus, erector spinae, rectus abdominus, external & internal obliques and all the muscle of your pelvic floor) and their primary function is to provide stability for your spine. The six pack muscle group (rectus abdominus) plays a small role in spinal stability, but in gyms when people are working core muscles they concentrate on sit up type exercises that strengthen the rectus abdominus. To relieve the pain in your back you should be concentrating on muscles that stabilize the spine. These muscles are engaged when we work on unstable surfaces such as swiss balls or when we do multidirectional movements that link the upper and lower body together and cause the spinal stabilizers to fire.
Here are the main ways to challenge the back pain that our current lifestyles encourage:
To do this you should concentrate on stretching the tight muscles around the hip flexors, chest, neck and lower back. Simultaneously you should strengthen the weaker core muscles, gluteus muscles and muscles of the upper back that retract the scapula.
Correct Exercise Choices:
Although exercise is proven to be a great way to reduce or eliminate lower back pain, often the workouts that people are doing can aggravate these symptoms. It’s important to make the right choices and avoid exercises which will worsen lower back pain.
Avoid spending the majority of your workout in a seated position on resistance machines. This will have much the same effect as sitting at the office all day. The same muscles that have been shortened during a day at the office will be shortened further.
Aim for better balance of muscle groups; Repeatedly strengthening the muscles of the chest, trapezius and hip flexors (commonly known as Mirror Training) will lead to rounded posture. Also avoid undertaking a body builder type strength programme which isolates muscles groups, before first strengthening the stabilizing muscles and ensuring proper posture and muscle balance. Bodybuilding can have a negative effect on posture and movement. The body doesn’t work in isolation so in doing these movements, you are downgrading the way the body moves, which has a negative effect on the nervous system and leads to muscle imbalances
Avoid doing lots of sit ups on the floor (made worse by hooking your feet on to something) this will only add to the hip flexors/ lower abdominal muscle imbalances and increase the rounded posture. If there is a curve in the lower back the dominant hip flexors will be more active than the abdominal muscles in this position. As mentioned earlier there are far more effective ways to strengthening this area than doing 100’s of different versions of sit ups
Aim to follow up your exercise regime (running, cycling or aerobics) with a posture/stretching routine. These repetitive exercises will shorten some muscle groups so it’s important that you set time aside to do some additional exercises that concentrate on overall body conditioning, posture and flexibility.