Low back pain is a common and potentially debilitating condition 90% of people are likely to experience an episode of it in their lifetime. I hurt my back when I was a naïve first year student (18). I got a bit cocky in the gym lifting weights when I felt something ‘pop’ and my left foot go numb. I don’t know what was hotter- the searing pain travelling down my leg or my teenaged red face hobbling my way out of the gym in embarrassment. It got better after about 6 weeks but it was hard going. My Everest at that stage was stepping over the rim of the bath to get into the shower. No one really appreciates how much they use their back until it hurts.
Most people get better with good quality rehab and time for their bodies to heal BUT just because it disappeared doesn’t necessarily mean you’d be okay with a second bout. It’s one of the most common questions I hear in clinic: ‘I’m worried this will be back next year, how can I ensure that doesn’t happen?’ It’s a great question. Some things we can’t change can leave you predisposed to low back pain (age). There are a couple of easy answers but a whole lot of misleading nonsense out there, so let’s take a look at the most common things discussed in clinic:
This is one that most people discuss but actually, the evidence supporting this is rapidly dwindling. We are starting to understand that there is no ‘textbook’ posture and that if your body has been in a certain position for the past 20 years- it most likely has adapted to that. If it ain’t broke don’t fix it. Now if someone has made a change in what they do in their day to day then adopting new postures they are not used to could irritate things- that’s when we maybe need to look at change. Also adolescents sometimes need to change their posture as they grow if they are getting pain form this. Changing posture can certainly help but it’s by no means the be all and end all.
This is the one we have the strongest evidence of. If you aren’t already getting your recommended weekly exercise then it’s time to get moving if you want to reduce your incidence of back pain. While there has been a lot of research into what is the ‘best exercise’ they all come out with similar results. The exercise you stick to is the best one. Be that soccer, the gym, hiking, yoga or boxing- the trick is to do something you enjoy. Ideally you want to look for an exercise that takes your back through its full range of motion, but any movement is better than none. Backs are not fragile, in fact they respond to load and get stronger!
It is worth noting that those who exercise to an extreme (elite athletes/ professionals) have a higher incidence of low back pain.
3. Monthly manipulation
This doesn’t work. It’s snake oil. When your back is manipulated, it’s not ‘realigning you spine’, it’s not ‘putting something into place’, it’s a pop caused by gas release from forcing your spine into end range. It’s like cracking your knuckles. This can help with short term pain relief but will not keep pain away.
It’s an expensive way of going about things that doesn’t have any good quality evidence to back it up. If your spine was so vulnerable that it would just ‘slip out of alignment’ then you wouldn’t get very far. Your spine is held together by its bony structure, strong ligaments and surrounded by large amounts of muscle. It’s stable and strong, not a jenga tower.
4. Workplace setup
There is evidence that a good quality workplace setup CAN help reduce low back pain recurrence. If you’re going to spend 8 hours a day in the same position then making sure your screen is at a good height, your desk is suitable and have a supportive chair that would be benficial. In an ideal world I think everyone should have a variable height standing desk so they can incorporate variety and movement into their working day. Here’s some PDF guidelines from WorkCover Queensland for making sure your desk is set up right.
5. Foam Roller
I mean it feels nice for a little while after but there’s no proof it has anything other than short term benefits. If you want something to stay away- I’d devote your time somewhere else.
6. Lifting Technique
This one is getting a lot of debate at the moment. There is evidence supporting and evidence refuting it. It’s good to have clean technique when lifting but there seems to be a common misconception that your back needs to be bolt upright as you lift and it all needs to come from your hips and knees. This isn’t the case- the best way to lift is by sharing the weight evenly across all your joints as best as you can- this includes your back. If you look at a bodybuilder deadlift (usually the biggest lift), they allow themselves to bed in the middle a bit too! If you lift like you’re doing a full squat, that’s an awful lot of force through your hips and the very base of your back. Treat it like Eddie Halls lift if you’re going heavy instead!! Pick up a pen however you want- there’s no specific way to lift for something super light as a one off. If in doubt check with a physio or the manual handling trainer in your work place.
SO the key to keeping away back pain is to keep fit, stay mobile, make sure your desk is well set up in work and lift sensibly. No one can guarantee your back pain won’t recur and the reality is that if you have had back pain before, you are more likely to get it in the future but try these and all the evidence we have says it should help!!