Pain Relief, physical therapy

The Low Down on Low Back Pain

Ok y’all, this one is a doozy. There are so many directions I can go with this and you will see many posts on back pain in the future. But I’ll do my best to be concise and simple. Here we go!

Back pain accounts for easily 50% of my clients. One statistic I read recently stated that 80% of the population will experience back pain at some point in their lives. I’ve already joined that boat after my horrendous sciatica experience when I was 6 months pregnant.

To top it off, there are about 3 million different treatments for it – PT, chiropractics, meds, surgery, inversion tables, massage, even hypnosis! And some people have been to 5 doctors, 3 PTs, chiropractors, have had surgery, and are still in pain. So what do you do and where do you start?

Let’s go wayyyyy back and start at anatomy. Look at your spine, see all those curves? See how each of those vertebraes are nicely linked with one another? Don’t you think that your spine works together when you move? How can I possibly treat your lower back without looking at the ENTIRE spine?

Do you know how many muscles attach to your spine? If you do, you are officially smarter than google, because I literally COULD NOT FIND IT! I know that there are over 45 muscles that attach to your pelvis alone, and there are over 735 muscles in the body. My guess then would be around 150 muscles attach directly into the spine. That also doesn’t include muscles that directly impact the spine, but don’t attach to it, like the abdominals. All of these muscles push and pull on the spine in a multitude of directions, which allows us to move in all the different ways we can. Muscles in our upper back help keep us lifted. Muscles in our lower back keep us stable so we can rotate our trunk. The most influential muscle that creates most of our movement problems – The Diaphragm.

So what’s the point in all of this? If you want to know what I feel is the BEST treatment for low back pain, you have to look at ALL of the factors that influence the back and how they move in one unified system. Let me rephrase: the best treatment for your back is to NOT JUST TREAT THE BACK! If you are only seeking treatment for your lower back and the person you are seeing is NOT looking at all the other areas that impact that area, then you are not going to get the long term benefits you are desiring.

Your back issue is a symptom of a much larger biomechanical problem. The disc pain is NOT the problem. The movement pattern is the problem. That movement pattern is what is putting too much pressure on the disc in the first place. So you can have the shots, and the surgery, and the massage, and the stretching, but if the neuromuscular pattern is not being addressed, then the disc will continue to suffer. This is why people continue to cycle in pain and why treatment is often a short term fix.

Here’s the rub. Depending on how long you have had this issue, you have been moving wrong for a very long time. If you want the long term results you desire, you will need to be consistent and patient. Re-patterning can take a long time. But let me help you think about this differently: if you went and had surgery, didn’t you have to change the way you did things? If you have been in chronic pain for a long time, I’m sure there are concessions that you have already made to prevent your back from hurting more. If you are already making changing to prevent you from hurting more, why not make the concessions that will help you hurt less?

How do I re-pattern? First, I start with your diaphragm and your diaphragm test. You can take the test on your own here. I look at your movement patterns, restrictions, pain areas, muscle activation abilities, and your ribcage. I look at your ability to breathe properly, observe correct positions you can stay in, and overall movement of your arms and legs. I look at your ability to squat, touch your toes and your ability for your spine to flex, sidebend and rotate. Depending on the client, I may also refer to psychology, massage, acupuncture, personal training, and/or nutrition to help on the journey. A multifactoral approach is best!

We start with learning to breathe correctly in correct positions. This can take a long time, but it is the most important step. Once you are able to breathe correctly in the correct positions, we add in muscle activation. I like to start with hamstring activation, but it depends on pain and my client’s abilities. We slowly add in more and more muscle groups and then explore movements within this new pain free area. It can go in a number of directions from here, depending on how you are doing.

There is no quick fix for chronic back pain. There is no quick fix for chronic pain in general. However, the more factors that are taken into account, the higher the likelihood for excellent results. Looking at underlying movement patterns will help resolve load distribution on painful areas in a more permanent way, so that hopefully you will be able to return to living the way you want.

~ Courtney

Feel like a movement assessment is right for you? You can book appointments HERE

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