Tuesday, February 3, 2015

Oh My Aching Back: 5 Tips For Back Health

By Brian C. Burnett, D.C., M.S.

It's February 2015, and you're one month into your New Year's goal of loosing weight and getting in shape.  You're motivated, focused and nothing is going to stop you from loosing that weight this time, except that aching pain in your low back.  You've been doing so good with your workouts, but this pain in your back is potentially going to derail your fitness goals.  Don't worry, you're not alone and there is something that you can do.

Here are some statistics on low back pain.

  • 31 million Americans experience low-back pain at any given time.1
  • Low back pain is the single leading cause of disability worldwide, according to the Global Burden of Disease 2010.
  • One-half of all working Americans admit to having back pain symptoms each year.2
  • 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.
  • 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.
  • Americans spend at least $50 billion each year on back pain—and that’s just for the more easily identified costs.3
  • Experts estimate that as many as 80% of the population will experience a back problem at some time in our lives.4

What Causes Low Back Pain?

The lumbar spine is very complex with many possible pain causing structures.  If you are suffering from low back pain, it is important for you to be evaluated by a health care professional, like a chiropractor, to find out the true cause of your pain.  Here are a few of the reasons your low back may be hurting.

  1. Soft tissue sprains/strains: There are a lot of muscles, tendons, and ligaments that hold the lumbar spine in place.  If you are carrying some extra weight in your midsection and have just started a new exercise program, it is very easy to injure these soft tissue structures because they have not adapted to the new physical demands that have been placed on them.  
  2. Facet Syndrome:  The facet joints are where two vertebrates come together.  When injured, these joints can be a source of a lot of pain.  One cause of facet joint pain is from tight muscles caused by inactivity or a lot of sitting.  When you sit for long periods of time the psoas muscle becomes tight and shortened.  This can cause hyperlordosis of the lumbar spine, which can lead to injured facet joints.
  3. Herniated Disc:  A herniated disc can be one of the most painful of low back injuries.  It can occur from trauma to the lumbar spine, like a car accident, but is more likely to occur in middle aged adults from simple activities like bending over to tie your shoes.  Your core is designed to protect your low back.  As we get older and fail to keep up with an exercise program, the core gets weaker and cannot do its job of protecting the low back.  
5 Tips to Low Back Health

  1. Movement, The Medicine for Life
    • Inactivity is one the biggest culprits in many of our modern health ailments, including low back pain.  Modern technology has given us so many advances to save time and be more productive, but it has also increased our level of inactivity.  Our muscles and joints are made to move, and as the old saying goes, "if you don't use it, you loose it."  Your joints can actually begin to degenerate from inactivity.  This is why I encourage my patients to engineer movement into their daily lives.  Park at the far end of the parking lot when you get to work so you will walk more.  Take the stairs instead of the elevator.  At the top of every hour take a 2-3 minute break to get up, walk around and do some simple stretches and exercises that I will teach you.  
  2. Listen To Your Mother And Sit Up
    • The human body is made to function within a certain biomechanical range.  When you have poor posture, the body does not function properly and external stress is placed on muscles and joints.  At first you won't notice the stress because your body does an amazing job of adapting to stress.  However, over time the stress will find a weak point, like your low back, and injuries will occur.  Practice good posture to prevent low back injuries.  Walk tall with your head up and your shoulders back.  When you sit in a chair at work, make sure you have good lumbar support and you are not slouching into the chair.  
  3. Exercise
    • For good low back health, you want to focus on strengthening the "core".  Most people think the core is just the abs, but it is also composed of the diaphragm, the pelvic floor, and the posterior chain.  The core is your center of gravity which serves to stabilize and protect your low back and surrounding structures.  By strengthening your core you can prevent injuries and have a healthy back.  Here are some simple exercises that you can do at home or in the gym to get started.
      • Back extensions: Lay face down on a yoga mat.  Press up with your hands and lock your elbows while keeping your hips on the floor.  In yoga this is called, "the cobra pose".  You should feel a good stretch in your low back.  If you have pain, just press up to where you feel pain and stop.  Hold the position at the top for 5-10 seconds and then come back down.  Back extensions are a great exercise to get movement into the low back.
      • Planks: Get in a push-up position while resting your weight on your elbows.  Hold this position for 20-30 seconds. This will provide a great isometric contraction of the abdominal muscles and help to strengthen the core.
      • Glut Bridges: Lay on your back and bend your knees.  Engage your core by tightening your abs and pelvic floor.  Squeeze your buttocks and lift up off the ground.  If this is to easy for you, try lifting one leg off the ground or planting your feet on a Bosu Ball.  This exercise is a great way to strengthen your posterior chain and protect your low back
  4. Weight loss
    • Studies have shown that a small amount of weight loss, like 10-15 lbs, can have significant improvement on low back pain.  It's no surprise that when you are carrying around a few extra pounds that that will place undue stress on the joints in your low back.  If you haven't already, start incorporating a healthy meal plan into your daily routine and you will double your weight loss results while decreasing your low back pain.
  5. Chiropractic
    • Chiropractors are doctors who treat the whole body, but specialize in neuromusculoskeletal condition, like low back pain.  As I mentioned earlier there can be many causes of low back pain, so it is important to see a specialist, like a chiropractor, who is trained to identify the cause of low back pain.  Chiropractors use many different techniques and methods that are safe and noninvasive to treat low back pain.  


1. Jensen M, Brant-Zawadzki M, Obuchowski N, et al. Magnetic Resonance Imaging of the Lumbar Spine in People Without Back Pain. N Engl J Med 1994; 331: 69-116.

2. Vallfors B. Acute, Subacute and Chronic Low Back Pain: Clinical Symptoms, Absenteeism and Working Environment. Scan J Rehab Med Suppl 1985; 11: 1-98.

3. This total represents only the more readily identifiable costs for medical care, workers compensation payments and time lost from work. It does not include costs associated with lost personal income due to acquired physical limitation resulting from a back problem and lost employer productivity due to employee medical absence. In Project Briefs: Back Pain Patient Outcomes Assessment Team (BOAT). In MEDTEP Update, Vol. 1 Issue 1, Agency for Health Care Policy and Research, Rockville,

4. In Vallfors B, previously cited.

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