• Nashville PT

All About Low Back Pain

(By Christi Williams, DPT, OCS, Cert. MDT)





Are you one of the millions of Americans who have had to deal with low back pain at some point in your life?


If not, consider yourself LUCKY because unfortunately the statistics are not in your favor! There is evidence to support that anywhere from 50% - 80% of the adult population will have low back pain at some point in their life, and roughly 40% will have back pain in any given year! Basically, low back pain is so common, that having an occurrence of it is pretty much considered “normal” or “to be expected”. Because it is so common, and because in some cases it can become so painful that it is debilitating, low back pain is one of the most common causes of disability in the workforce. Interestingly, the incidence rate in sedentary workers is equal to workers performing manual labor. What’s worse yet is that the recurrence rate of low back pain approaches nearly 90%! So basically, if you’ve had low back pain in the past, you are almost certain to have a recurrence of low back pain at some other point in your lifetime.


So why is low back pain so common? Well, there’s a lot of reasons that someone may develop low back pain, however I’d like to focus on the 2 most common everyday lifestyle factors that predispose someone to developing pain in this region. They are:


1. Our poor sitting posture

2. The frequency in which we perform bending activities throughout our everyday life


Let’s start with sitting posture. Approximately 58% of spine patients state that their pain started “for no apparent reason”. In other words, there was no injury or specific movement that caused an acute pain response….it just showed up one day and they don’t have an explanation for what caused it. Well, we know that we shouldn’t sit slouched – I mean, let’s be real, our parents taught us that way back when we were kids. But in all seriousness, studies have shown that the pressure inside the discs in our spine increases when we are in a sitting position compared to when we are standing, and when we sit slouched, the pressure increases even more compared to when we sit up straight. Add that to the fact that most of us sit all-day, every day at work (and none of us sit with perfect posture all day) and that stress on the disc really becomes accentuated over time. So, sitting a lot coupled with the fact that the majority of our everyday activities involve bending, you can begin to see how low back pain is almost inevitable.


Let’s take a look at how much someone bends in a typical day. Just think about it….from the moment you wake up in the morning, to the time you go to bed at night, the majority of what you do around the house involves bending! Putting your socks on, leaning over when you brush your teeth, getting clothes out of the dryer, vacuuming, yard work, you name it – it typically involves some bending. And how often do you move the opposite direction? I don’t mean standing or sitting straight, I mean actually extending your spine backward as far as it goes. Can you think of very many activities that require that movement? That’s because there aren’t very many. Maybe when you rinse your hair in the shower, but my point is that for all the bending we do in a day, we rarely stretch things out the opposite way to counterbalance these forces. By the way, in case you haven’t already guessed, bending over from a standing position places more pressure through the discs in your spine than standing straight does, and when you add weight to the equation, such as when you are picking something up, the pressure through the discs increases significantly!


So, given the fact that bending and poor sitting posture are two common contributors to low back pain, how do we go about preventing low back pain in the first place? We can’t just stop sitting and we can’t stop bending (in fact, if we stop a movement all together, it creates more problems down the road).


Here are a few tips that you can use to prevent low back pain as it relates to sitting and bending:


1. Get yourself a good office chair, and/or use a lumbar roll in your chair to avoid that slouched positioning




2. Avoid excessive bending combined with twisting motions – especially if you are lifting something. Instead, take the extra time to pivot or turn your body as a unit.

3. Use your legs to lift rather than your back. If you squat down to pick an item up rather than bend over, comparatively, the pressure in the discs is reduced significantly when you avoid bending and lifting with your back.

4. Minimize the amount of bending activities you do in a day (by using your legs) especially if you currently have back pain. Try to give your back some time to rest & heal by taking some unnecessary stress off of it. While it’s not recommended that you stop moving altogether, minimizing the number of times you bend and being sure to sit with good posture are 2 things that can help immediately with the healing process.

5. Do some simple stretching to counterbalance the bending loads we place on our spines. A standing extension stretch after you’ve been sitting for a long period of time, or a press-up exercise before and after you do a lot of bending activities (gardening, exercising, etc.) is very helpful to take some of the stress off the area that is being stressed by the bending activity.






And if you already have low back pain or have had surgery in the past on your spine, be sure to contact a physical therapist for an evaluation so they can tell you exactly what stretches and exercises will help you to heal quicker and will not cause you to get worse! If you are experiencing back pain combined with pain in one or both of your legs, or numbness and tingling or symptoms that spread to other areas of your body (like sciatica) it is VERY important to have a full physical therapy assessment before beginning any general wellness or prevention exercises. When it comes to low back pain there is no “one exercise cures all”. It is very individualized to your specific issue at hand and certain exercises that help one person can actually cause another person to get worse. And if you are someone who is dealing with sciatica, you do not want to put off treatment for too long because this is something that can become very serious if not properly addressed.


Contact us today for more information! If you’re not sure if physical therapy is right for you, schedule a consult and we will help determine if the type of pain you are experiencing is something that is treatable with physical therapy or if you need further assessment by your physician. Most low back pain can be resolved with conservative intervention (that’s the good news) so don’t wait to get started, do it now before your condition worsens and requires more extensive intervention such as expensive imaging or even surgery.


One other thing to consider is that you do not have to wait to get an in-person appointment. Schedule a virtual visit with us and we can evaluate you and get you started on a program that is customized and specific to you – and we can do it NOW!


References:

The Lumbar Spine: Mechanical Diagnosis & Therapy. Volumes 1 & 2. Robin McKenzie, Stephen May. March 2003.


Mechanical Diagnosis & Therapy Part A. The Lumbar Spine. Course Manual


Wilke, HJ, Neef P, Caimi M, Hoogland T, Claes L. New in vivo measurements of pressures in the intervertebral disc in daily life. Spine 1999; 15;24(8):755-62.

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