When low back pain persists for more than 3 months it is officially chronic. Many of my chronic low back patients however, have suffered for 2 or more years. Many of them have given up on ever overcoming their condition.
Almost inevitably, patients only suffer chronic low back pain because they have never encountered a practitioner that is willing to treat them properly.
Chronic low back pain should never exist. It is ALWAYS the result of NOT RECEIVING PROPER TREATMENT.
Many doctors and therapists are happy to give temporary relief to their patients and accustom them to continually seeking care for the foreseeable future. And often, the notion of depending on your doctor/therapist for the rest of your life is encouraged.
In this article I hope to show some of the science behind the proper treatment of chronic lower back pain.
I pick chronic pain because it is usually trickier to fix than short term back strains. And it requires more work than simpler forms of low back conditions.
WHAT CAUSES CHRONIC LOW BACK PAIN?
The following are nearly always present in chronic cases of low back pain.
- degenerating, bulging or herniated discs
- weakened core muscles
- inflexible hips
- harmful work and recreational habits (i.e.: bad sitting posture, bad lifting technique, etc)
If your approach to eradicating low back pain does not address all of the above, you will not overcome the condition.
Obviously, a practitioner cannot strengthen your core for you, nor achieve flexibility for you or change your work habits. This will be something you will need to do.
Hence the lack of popularity for the type of program that involves patients doing exercise rehabilitation. It is much more appealing to pay someone to fix you. And because of the temporary relief given by passive treatments (i.e.: massage, manipulation, physiotherapy modalities, drugs, etc) they are often the “go to” solution.
Because the human body thrives when it is strong, flexible and active, no chronic pain will ever disappear without those elements. And obviously, this type of therapeutic approach is mostly comprised of the patient doing the work.
So the bad news, you are going to have to work and change your lifestyle if you truly desire to put low back pain behind you. The good news is… you can overcome even years of chronic low back pain.
YOU SAID SCIENCE. WHERE’S THE SCIENCE?
When the lumbar spine is in a chronic state of pain, the disc is almost always involved. Even if it is not bulged or herniated, it can be applying pressure to the bone immediately above or below (or both). Over time, this can cause micro stress fractures in this bony region — known as the endplates — and with that comes pain.
What causes this excess pressure? Poor posture, poor lifting techniques as well as lack of movement (sedentary lifestyles) are major causes. Spines transfer stress very well if they are used appropriately, but improper use will change the way stress goes through this unit and micro damage accumulates either in the disc, the soft tissue surrounding it or the bones of the vertebrae themselves.
With pain comes the instinct to be less and less active and to reduce range of motion. As a result the lumbo-pelvic hip complex looses flexibility, co-ordination and strength.
Unfortunately, this causes secondary pain such as muscular strains in the low back and hips. Also, this inactivity tends to exacerbate the original low back pain as well. Essentially, the biomechanical chain is not only weakening but the lack of flexibility and co-ordination means that every time you lift or perform a sports motion, the joints in this complex are experiencing more and more wear and tear.
Your muscles, ligaments, tendons, fascia as well as joint cartilage are parts of a complex machine. And like any other machine, there needs to be co-ordinated interaction between all moving parts. And as a living biological system, too little or too much stress will be harmful.
Once you have had the exact cause of your pain diagnosed, a customized program of exercise rehabilitation, hands-on treatment and ergonomic changes is the most effective and evidence-based method to cure your back pain. Even if it has been a part of your life for years.
See our exercise rehabilitation section of the clinic’s website for pricing and scheduling details.
A proper program will have you start with very basic exercises and stretches. Yet, the goal of our protocol is to slowly and safely evolve you to being able to safely perform compound movements such as deadlifts, squats and olympic type lifts. Prioritizing safe technique and NOT excessive heaviness, lifting in these fashions will allow you — and your lumbopelvic hip complex — to be able to lift, work and play all the while keeping your back strong and healthy.
Contact us if you are interested in more details. Thank you!