It seems like there are more reported ways to treat low back pain than one can keep up with. So which ones really make sense and will provide a long-term solution?
Before we can answer that question we must first understand one of the primary causes of low back pain. I thought I would write a little bit about that today and relate to you what I’ve learned in over 18 years of treating people every day with back pain.
When I first examine someone with back pain I commonly see several “positional faults”. What I mean by this is that most people have one or more parts of their spine in the wrong position. For example they will have a hunched back and rounded shoulder or “bad posture”.
The problem with this is that when part of the spine is in the wrong position it leads to chronic stress on the muscles, ligaments, nerves, discs, and joints of the spine. This chronic stress leads to pain and inflammation. So these “positional faults” are many times the true root cause of your pain and long-term relief is unlikely unless they are corrected.
To understand why this matters if you are seeking low back pain treatment you need to understand a little bit about the natural shape and structure of your spine. Your spine has a natural S shaped curve. The critical thing to understand here is that either too much or too little curve can cause back pain. The most common positional fault I see on a day-to-day basis is an increase in the arching of the lower back, commonly this might be referred to as “swayback”.
In this situation the abdominal muscles become weak allowing the abdomen to protrude thereby pulling the back into an over arching position. This is why “Core Stability Training” or “Core Strengthening” is thought to help with low back pain.
The problem with this faulty position is that it mechanically compresses the joints, nerves, and muscles in your lower back. This physical compression leads to initial stiffness and tightness but can progress to severe chronic back pain and degeneration if not treated.
Attaining the optimal spinal curve is the key to spinal health in the long term and this is what your goal should be.
It is also the key to preventing back pain in both the short and long-term and eliminating back pain for those who already have it.
Doing this may take some work but with the right knowledge and instruction is is absolutely possible.
The second most common positional fault I see is an increased amount of bending in the upper back.
This commonly occurs due to poor posture, prolonged sitting, and the use of computer devices, especially when texting on your phone as pictured above. We are just not designed to maintain these positions for the amount of time that most people do.
When you are in this position for too long the muscles in the chest and shoulders become tight. This causes the shoulders to be hunched forward and the lower back becomes rounded. Over time the muscles in the upper back that are designed to hold you upright become weak allowing this position to become set in.
This leads to not only lower back pain but pain between the shoulder blades, upper back pain and neck pain. Self treatment for low back pain must include ways to fix your posture.
At the end of this blog we will go over one simple things you could do to help you posture.
The third most common thing we see is the head being much further forward than it should be, we call this “forward head posture”.
Optimally your ears should be aligned over the tips of your shoulders when viewed from the side.
Again due to computer use, poor posture, and just plain old slouching most people are significantly out of balance in this respect.
Which do you think is best???
This causes low back pain because when the head is forward the low back is also rounded. This also commonly leads upper back pain, neck pain and headaches. Restoring balance of the head and neck is critical to restoring balance in the rest of the spine.
Here is one of my favorite go to techniques correct all three of these problems at once. This technique is actually a basic stance in the martial arts, and is also pretty much the same stance for any athlete getting into a ready position.
This position works to restore postural balance for anybody and everybody and is my favorite way to initially engage the core and hip muscles together which is very important.
With practice you too can master this technique!
1. Stand with feet shoulder width apart and pointing straight ahead
2. Knees should be unlocked and slightly bent
3. Tighten the abdominal muscles by slightly pulling your belly button in and flattening the low back
4. Shoulders should be back and down
5. Head should be back and over shoudlers
Be sure to breathe normally, do not hold your breath (if you feel you are doing this you are pulling in the belly button too much – relax a little).
Hold 5-60 seconds, repeat 5-10 times, perform 3 times daily.
I hop this has helped you to better understand how the positiono of your spine affects your low back pain and allows you to better treat your low back pain.
If you have any questions or comentsbe sure to reach out.
Wishing you a pain free life,
Joe Ruzich, PT