For this week’s blog, we’re just going to touch on some very common recommendations for lower back pain. Keep in mind, the advice for anyone with lower back pain needs to be individualised. For any advice to be appropriate for someone with lower back pain, the practitioner needs to know what the diagnosis is and what structures are involved. For many patients with lower back pain, the most important factor is how the injured tissue responds to different forces applied to the area. In short, please take the following information with a grain of salt. Like any of our blog entries, these “tidbits” are more to serve as talking points for you and your practitioner.
Many people with lower back pain are under the impression that every injury needs to be stretched. This is far from the case. Perhaps this is true for some people with long-term, chronic back pain that is related to a lack of mobility. For the average person with new-onset lower back pain, it is common for a practitioner to instruct a patient to discontinue static stretching in the lower back. Prolonged static stretching to the end range of an irritated structure will likely only perpetuate the injury and aggravate the involved tissues.
Many spinal injuries or new cases of back pain are symptomatic because of the forces being applied to them. If you created or exacerbated your back pain through training, a continuation of those forces being applied to the area will only aggravate them. For example, a spine that was injured through a compressive force will be slow to recover if it is continually being compressed during exercises like military press, standing bicep curls, squats, and deadlifts (to name a few). Of course, most cases of back pain are encouraged to continue “moving”, but this is very different from going to the gym and exacerbating the injury. If you are fortunate enough to be working with a personal trainer, often they can suggest alternatives for various exercises that may (along with the guidance of the practitioner) allow someone to continue toward their training goals without jeopardizing recovery. At the same time, many spinal injuries simply need rest from vigorous exercise.
How are you moving?
Are you moving in a way that is “spine sparing”? Yes, you may have discontinued training hard at the gym for the time being, but do you move in a way that utilizes too much spinal motion? Do you sit and rise from sitting using all your back muscles and moving the joints of the lower back? When you bend over at the kitchen counter, do you bend in the lower back or do you bend at the hips?
Remove triggers for the pain
Like possibly taking a break from your exercise routine, your day to day routine may involve activities that subject your spine to forces that it doesn’t agree with. You need to identify those painful movements or postures and correct them. Common examples include sleeping posture, sitting at your work desk, the way you sit in your vehicle, the way you sit on your couch in the evening or even the way you walk.
As mentioned earlier, most cases of back pain are encouraged to move. At one time in the past, rehabilitation professionals would suggest rest for back pain. For some, a small amount of rest is helpful. For most, we use the term relative rest. It would be rare that we encourage someone to lie in bed for extended periods if they have back pain. Usually, lower back pain patients are encouraged to move as much as their pain allows. This likely wouldn’t mean running as more isn’t necessarily better. Instead, lower back pain patients are encouraged to walk briskly on an intermittent basis as this allows various muscles to activate and dissipate the compressive forces that normally act on the spine.
In short, it is challenging to write a blog entry on “lower back pain”. There are so many causes for lower back pain and so many different structures that can be involved. Recommendations should be specific for every patient. At the same time, there are general concepts that can hold true for most people that are in pain in the lower back. As mentioned earlier, however, these points are perhaps best viewed as talking points. If you have stubborn back pain that isn’t resolving, maybe you should re-evaluate whether your day to day activities are aggravating the situation. Your knowledgeable health care practitioner should be able to assist you in navigating your return to normal activities as you recover from your condition.
Written by: Dr. Kevin McIntyre
Have back pain? Give us a call at Burlington Sports Therapy – 905-220-7858 or email us at firstname.lastname@example.org