Low back pain can be regarded as a pandemic, as it strikes people from all walks of life. The lower back, or lumbar spine serves as the “keel”, if you will, of the human frame. It is comprised of five (5) lumbar vertebrae– the largest of the 25 bones that make up the spinal column. It is surrounded by several layers of muscles that work synergistically to allow proper spinal movement and responsiveness to dynamic loads. When everything is functioning as designed, the lumbar spine is a work of art. But, when something goes wrong– it can quickly put you out of commission for days or weeks.
Some of the most common causes of low back pain are:
1) Disc degeneration
2) Facet syndrome
3) Spondylosis; spinal stenosis
4) Arthritis– osteoarthritis and rheumatoid
5) Sprains/ strains
A smaller percentage of low back pain cases are caused by diseases such as cancer or rheumatism.
Treatment for low back pain varies, depending on the source of pain. Most primary care physicians will prescribe muscle relaxants and pain medications for non-specific low back pain. If an inflamed disc or facet joint is suspected, a cortisone injection or epidural injection may be attempted. Cortisone is a powerful anti-inflammatory and can reduce pain quite quickly, if inflammation is involved. In some cases, the patient is referred to a physical therapist or chiropractor for spinal manipulation and exercise therapy.
A lesser known treatment for lumbar pain due to disc herniations is non-surgical spinal decompression, a procedure that literally pumps the injured disc so that healing is accelerated.
But the absolute best way to deal with low back pain is to not get it in the first place! This is the preventive approach, and is highly recommended. The keys to low back pain prevention include:
1. Lose the weight! If you are heavy in the abdomen, it will put a huge strain on your low back over time. The result is disc degeneration and facet syndrome, and possibly arthritis.
2. Practice proper posture. Head up, shoulders back, chest out, slight extension of the lower back (hips rotated forward).
3. Use your legs when lifting things, not your back muscles. Your leg muscles are twice as strong as your back muscles, so use them! Keep the object you are lifting as close as possible to your center of gravity; brace your back, and transfer the weight to your legs. Move the object (raise or lower) by bending your knees. This includes lifting small children.
4. Practice proper ergonomics. If your job involves a lot of hours sitting, place a lumbar wedge on your seat. Stand up every couple of minutes to take the pressure off your back. Don’t slouch in your chair; keep your head over your spine.
5. Engage in exercises and stretching. There are many books and other references on this subject.
One overlooked exercise for preventing low back pain is proprioceptive exercises. Proprioception is a technical term that describes the feedback loop that muscles use to know when to contract and relax. It is a highly complex neurological event that involves the spinal cord and brain. Some researches believe that a breakdown in this system leads to poor joint movement and accelerated spinal degeneration. So, its best to exercise this feedback system; very much like doing brain exercises to improve memory.
In proprioceptive exercises, you create an unstable foundation and let the various muscle groups of the spine coordinate and contract to keep you balanced. This involves using an inflatable disc, bonsu ball, or a wobble board. You basically stand on top of the disc and do various movements like knee bends. You can also add handweights and do curls, flys while balancing yourself on the disc. Exercising in this fashion will help improve muscle responsiveness, reducing the chance of injury. Muscle responsiveness refers to how the quickly the back muscles respond when subjected to changing loads, such as picking up a piece of heavy luggage.
So, make sure you incorporate all of the above techniques in your exercise regimen and daily life. It will pay huge dividends, in the form of a healthy, pain-free back!
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Dan W. Perez