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If you are among those who have already experienced a bout with low back pain, then you know
how debilitating it can be. In the western world, 80% of the population will experience
disabling low back pain during their lives.(1) Back pain is the second most common reason
patients visit doctors and costs the U.S. economy $25 billion per year.(2) Low back pain
clearly represents the single greatest and most inefficient expenditure of health care
resources in our society today.
Understanding the anatomy of the back will help you understand why and how back problems
occur. The spine is composed of 24 bones called vertebrae. The lower back or lumbar spine
has five vertebrae whose functions are to bear weight and provide a protective covering for
the spinal cord. In-between each pair of vertebrae are cushions called discs. The main
responsibility of the disc is to absorb the compressive forces to which the spine is
subjected.
Most back pain is preventable and often is caused by too little exercise, overuse, poor
exercise or work positioning, lack of flexibility, and poor posture. Smoking can cause
decreased blood flow to the spine as well as a loss of bone density.(3) Even obesity
is a cause of low back pain due to the increase pressure the excess weight puts on the
spinal discs. All of the above may result in arthritic or degenerative changes in the
spine, disc herniations ("slipped discs"), muscle spasms, spinal joint irritation and
dysfunction and nerve irritation.
Over time, spinal arthritis may develop. The discs narrow and wear out and the vertebrae
crumble often forming spurs which narrow and compress the area through which the spinal cord
and nerves pass.
A disc herniation occurs when the outer wall of the disc weakens and the jelly like middle
causes that outer wall to bulge out. This bulging may "pinch" the nerve exiting from the
spinal cord or the spinal cord itself. The middle may even squirt out and form a separate
fragment, like a piece of floating cartilage in the knee.
Non-musculoskeletal and potentially more serious problems like kidney disease, certain
types of cancer gallbladder disease, prostate disorders (all men over 40 should have a
prostate examination yearly), ovarian and uterine disorders, and aortic aneurysm may also
cause back pain. A thorough examination by a medical doctor, osteopathic doctor or doctor
of chiropractic to properly diagnose back pain is essential.
Initial treatment for lower back problems includes stopping your activity immediately and
icing the lower back for 20 minutes. Lie on your back directly on top of the ice pack with
your knees bent. Keep a thin towel or shirt between the ice pack and your skin.
If your low back pain persists, see a chiropractor or medical doctor. Treatment guidelines
were published by the U.S. Agency for Health Care Policy and Research entitled Acute Low Back
Problems in Adults which stated "relief of discomfort can be accomplished most safely with
nonprescription medication and/or spinal manipulation."
The key to low back pain is really prevention. A proper warm-up before any sports activity
is important to preventing low back pain. This means walking for at least five minutes and
then stretching after the walk.
Many of us are simply out of shape. Too many of us play a sport to get or stay in shape.
It should be the reverse- you must get in shape to play a sport. This means a complete
exercise program including aerobic exercise (30 minutes a day, at least three times a week),
strength training (twice a week working on all the major muscle groups) and stretching.
The most important area to exercise is the midsection: the abdominal
muscles, the twisting muscles or obliques and the lower back muscles.
A strong midsection will protect you against low back pain.
See Active Release Techniques® and
Graston Technique for more information
on injury care and prevention.
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LOWER BACK PAIN