Chronic Low Back Pain & Lumbar Injuries

Back Pain Facts & Statistics:

  • Low back pain is the single leading cause of disability worldwide, according to the Global Burden of Disease 2010.
  • Back pain is one of the most common reasons for missed work.  In fact, back pain is the second most common reason for visits to the doctor’s office, outnumbered only by upper-respiratory infections.
  • One-half of all working Americans admit to having back pain symptoms each year and experts estimate that as much as 80% of the population will experience a acute or chronic pain to the lower lumber or suffer back injury at some time in their lives.
  • Most cases of back pain are mechanical or non-organic—meaning they are not caused by serious conditions, such as inflammatory arthritis, infection, fracture or cancer.

Based don these facts, it won’t be hard for you to believe that about 80% of our NST patients present low back pain and injuries to the lower lumbar spine.  You can see why we’ve become so well-versed in back injuries, and such hardcore advocates for spinal stabilization (we literally teach seminars on this and have written extensive curriculum on the topic).

But… we don’t address the injury or pain first. The problem is not the problem.  The problem is your attitude about the problem.

If you think this is just ‘the norm’ and something you have to live with, and you accept that you’re locked into a life full of limitations, then you are part of the problem.  So we need to work on that first.  

Pain is your body’s cry for help.  It is a signal that something is wrong.  Silencing it with medications does not fix the problem because pain is not the problem.  Taking pain medications, or even having surgery at the site of pain does not address the issue causing the pain or injury, therefore you may feel temporary relief but you’re still limited to what you can do and your chances of reinjury, new injuries and/or the pain returning are about 80-100%. This recent study showed that common treatments of medications are not much better than the placebos given! Hear that?  You’re wasting your time and money at the pharmacy!

 

It’s like the “CHECK ENGINE” light in your car.  If it’s on, you don’t take it to the auto shop and ask them deactivate the malfunction indicator light so you don’t have to see it anymore… right? No, I’m assuming you’re like any other responsible car owner and you take it in to have its e n g i n e  c h e c k e d.

 

The same goes for chronic pain, injury or re-injury cases.  We do not ‘treat’ the pain.  We find the cause of pain and injury, and then we fix that so it does not re-occur.  In our clinical practice, these are the most common leading causes for low back pain and/or injury to the lumbar spine:

 

Postural dysfunction:

Muscle imbalance – depending on which postural dysfunction a client presents, there will always be an imbalance of muscle between any/all planes of the body. This creates instability on one side, and favor to another.

Muscle weakness – sedentary lifestyles or those who perform cardio/ endurance activities only are missing the boat on strength training benefits.  Without strength, your spine is not supported.  Especially in the muscles of the trunk and core.

Breathing mechanics

Circulation –  most clients are not breathing correctly and this could be a case of “what came first: the chicken or the egg?” but inevitably it doesn’t matter because if you present shallow breathing, then you are not getting full circulation to the lower half of your body.  This means that the cells in the tissues of the lower lumbar are not receiving oxygen, which means the tissue cannot be repaired.

Posture – breathing affects your posture, and shallow breathing draws the body inward leading to forward head and upper cross syndrome, which leads to muscle weakness and imbalance. (see postural dysfunction)

Painkillers and antidepressants

Yes, ironically we have traced most back pain issues to these medications. Why?  Because their leading side effect is constipation, which leads to improper breathing mechanics (see above), which takes you back to postural dysfunction (see above), which promotes further instability, pain and injury risk.

Impatience

Athletes or parents of athletes who have presented us with cases of re injury and limitations to perform their sport have something in common about 75% of the time; no patience. They did not:

  • allow enough time to recover
  • do the corrective stretches and exercises
  • limit their performance in practices when in pain

 

Even in a review of the top 100 studies on lumbar spine surgery, the conclusion was this:

Surgery for various conditions in the lumbar spine is common. Despite its prevalence, our knowledge of the underlying pathological mechanisms remains limited and the indications for surgical treatment remain controversial in many areas. Basic science and clinical research remain paramount in the understanding and advancement of the field of lumbar spine.”

 

The doctors and scientists also agree that there is a need in understanding the causes leading to spinal surgery, and thus a greater need to incorporate therapies for prevention.

Our suggestions:

  • strengthen the core
  • build muscle in the trunk and back
  • learn how to breathe
  • reduce or manage stress
  • stand up an move more
  • improve your diet (thus digestion, thus posture)

 

If you need surgery, then get the surgery.  But if you haven’t gotten that far yet, don’t allow yourself to.  And if you have had the surgery, don’t sign up for another one or submit your life to popping pain pills and missing out on activities that keep you healthy and fit. 

 

Resources:

Efficacy of classification-based cognitive functional therapy in patients with non-specific chronic low back pain: A randomized controlled trial
http://onlinelibrary.wiley.com/doi/10.1002/j.1532-2149.2012.00252.x/full

Opioids Compared With Placebo or Other Treatments for Chronic Low Back Pain: An Update of the Cochrane Review
http://journals.lww.com/spinejournal/Abstract/2014/04010/Opioids_Compared_With_Placebo_or_Other_Treatments.10.aspx

Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians
http://annals.org/aim/article/2603228/noninvasive-treatments-acute-subacute-chronic-low-back-pain-clinical-practice 

The Top 100 Studies on Low Lumbar Spine Surgery
http://journals.lww.com/spinejournal/Fulltext/2015/05150/The_Top_100_Classic_Papers_in_Lumbar_Spine_Surgery.15.aspx 

Back Pain Facts and Statistics
https://www.acatoday.org/Patients/Health-Wellness-Information/Back-Pain-Facts-and-Statistics 

The Content on this website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. 

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