Low back pain is among the most prevalent issues for the majority of Western Society and this is no more true than in Bristol. Let’s face it, we all know someone who has previously suffered with their back or who is currently suffering from a lower back issue. Unfortunately the COVID-19 pandemic has only cemented this and actually made matters worse with more people throughout the UK now working from home sitting at a DIY desk for hours upon hours with no real meaningful breaks. This starts to become a big issue for people and is one of the main culprits for causing and/or exacerbating low back pain and sickness absence from work.
But does having a low back issue causing discomfort and pain have to be a life long issue?
Below i will address this question head on and explain some of the practical, evidence based strategies that have helped myself and many of our own low back pained clients whilst looking at some common low back pain myths too. Please read on…
Firstly, what are the main causes of low back pain?
This is a very loaded question but one that many want an easy answer to. Low back pain is very case specific so what triggers and causes low back pain in one person will not in another. The triggers of back pain are hugely dependant on lifestyle habits including how much you sit down, how much you move, what type of moving you do, posture, structural changes in the body, multi-joint alignment issues and in some very rare cases genetics can also play a role. By no means is this an exhaustive list but it paints a picture to you of how multi-faceted low back pain is and the multiple layers of potential triggers to pain.
Due to this multi-faceted nature it is very difficult to say why someone is suffering from low back pain in a blog post and nor it should! Without a thorough examination of someone’s current and historical habits, lifestyle analysis and a pain provocation report with appropriate movement screen that is effective at narrowing down the main causes, we can not and should not diagnose without all this vital information. Only once the above process of examination has been done, can we then make a clearer judgement on the causes and triggers of pain and start designing a plan to reduce that pain for any individual.
Below I will examine 3 common questions that people ask regarding low back pain.
I haven’t had an examination by a health professional - can I help reduce the pain myself?
Although we would always recommend you go to a health professional that can do a thorough assessment of your back (not all can and /or will) there are still come immediate areas you can start to look at and address yourself to potentially reduce your discomfort. I will talk through 4 areas here:
Make a list of all the times your back pain is reduced or even goes away during the day and see if you can see any habits and trends leading up to those low pain score moments. This will start to re-focus your mindset on the positive lower points of little discomfort during your day and give you a better sense of hope. Far too often people focus on the high pain moments during a day, which can be important to understand but is not always helpful in empowering yourself out of pain.
Look to increase small but frequent brisk walking breaks during the day to help break up periods of inactivity especially sitting. Our bodies are designed to move and not be stuck in a single posture and position for too long, which can eventually cause aches and pains. Look to add 10-15min walking breaks 3-4 x per day where possible. If your pain actually increases during these walking episodes then stop, try and de-load your back by taking your weight off your lower back until your pain eases, then re-start your walking again. This might happen a few times during the 15min walk but that is fine as long as you aren’t feeling ill and/or in excruciating pain during the walk.
Stop stretching out your lower back and pulling your knees up to your chest or twisting them from side to side when lying on your back. Stretching your lower back might feel good and relieving at the time but this is a poor strategy and it often actually makes pain worse in the long run. Stretching a muscle causes a stretch reflex relaxation that temporarily lengthens a muscle for around 15-20min but then can come back with a vengeance. Instead find a position, posture or movement that is relieving and stay in that place until the urge to stretch your lower back goes away. Muscles tighten in response to pain and dysfunction in any part of the muscular system not just the lower back and it’s a natural response, but stretching is a very temporary relief that in no way deals with the source of a pathological issue causing the pain.
Analyse your workout routines during your week (if there are any) as these can actually be harming your back and actually re-creating your pain triggers and not actually making it better! This is very often an overlooked part of the picture as most people think and feel that the gym work they are doing must somehow be helping their lower back pain, after all its exercise and movement right? Unfortunately it’s not that simple, just like the lifestyle factors that effect peoples backs differently as discussed above, specific exercises that are relieving for one person will not be beneficial for the next. An exercise that is therapeutic for me will not necessarily be therapeutic for you, and this is all because every back pained person is different and unique. Therefore look over your go-to exercises (we all have them) and ask yourself “is this movement making my pain better or worse” if the answer is obviously the latter then stop doing it and make a different choice that does not cause pain. Over time this will be a beneficial strategy in reducing your painful back and eventually getting you back to a happier pain-free state.
I have seen many health professionals including several chiropractors but nothing has worked - what can I do next?
We hear this comment more often than not from people that come into our facility in Ashton, Bristol looking for us to help them. We are often one of the last places to look when it comes to pain management not just for low back pain but for many other common pain areas throughout the body.
Most people initially look to the shorter, quick fix solutions first, which when unsuccessful then look into more longer term, progressive treatments and movement plans. This is where our expertise from the personal training, functional rehabilitation and sports therapy arena come into play for people.
This is partly because as coaches we are much less time constrained compared to other health professionals who often only have 10-15mins with each person before seeing their next. We as movement coaches on the other hand have as much time as we need to thoroughly look at the person as a whole on a holistically relevant level. This extra time and flexibility to create a longer-term movement and rehabilitation plan to suit each individual with their specific need often works wonders and people start to gain a better sense of ownership over their pain and feel more empowered in doing so. WIN WIN!!
I have tried everything do I need to have surgery?
Having surgery and going under the knife is not a decision to be taken lightly, although often people and/or health professionals are all too willing to go through this course of action too soon even before effective conservative treatment options are explored. We should always be extremely aware of the consequences of having surgery and where at all possible this should be the absolute last resort for a back pained person. The risks are high and the end result of reduced pain is not guaranteed by any means, which many perceive it is.
It is our recommendation that if you have not had a thorough assessment of your lifestyle and examination of your lower back and habitual movement patterns by a health professional then this could be the missing link for your chance to use conservative treatment to reduce your pain and avoid going for surgery. Only in circumstances where you have tried all of the DIY strategies above and/or other conservative treatment consistently for at least 1 month and the symptoms still aren’t improving even slightly, then a trip to the consultant surgeon for a chat may be necessary.
Myth Busting for Low Back Pain
Below are some common misconceptions with regard to lower back pain and as always “it depends” comes into play for all of these statements as every back pained person is unique.
Myth 1: Having tight hamstrings is a cause of low back pain
Myth 2: Stretching out my lower back is helpful in the long-run
Myth 3: All movement and exercise is good for low back pain
Myth 4: My back pain runs in the family and it’s therefore genetic
Myth 5: Lifting weights is the worse thing I can do for my back
Myth 6: My bodybuilding routine will eventually make my back stronger and improve my pain
Myth 7: All health professionals are made equal and understand my back pain and it’s causes
Myth 8: If a chiropractor can’t fix my back with manipulations then it’s a life long sentence for me
These 8 myths are only a snapshot of the types of generalised mis-beliefs that get thrown around the internet far too frequently but there are unfortunately many many more. The only real way to understand what works for you is to find an appropriate professional that can help guide you in the right direction toward a pain-free back.
All in all having looked at a few of the reasons why lower back pain is so prominent in todays world, and also providing some real, easy to implement strategies to help reduce your back pain yourself, we can safely say that low back pain does not have to be a life sentence even though it can feel like that at times.
I have personally suffered with multiple bouts of sciatica and low back pain in the past and I still have to manage my increased risk of another bout of back pain coming back to this current day. I do use many of the strategies above on a daily basis, which works well for me and allows me to have a pain-free active lifestyle, but remember what works for my back pain management will not always work for yours or your friends back pain.
Any questions regarding your low back pain or anything more specifically written in this blog, then please contact us we would love to chat and potentially help.
Until next time,