The Low Back Pain Epidemic- considerations and supportive options
Category: Strength & Rehabilitation
The Low Back Pain Epidemic
Have you ever experienced low back pain so severe that it prevented you from participating in routine activities? For some, this pain can become so crippling that it not only disrupts daily activities, but can make it difficult to get out of bed.
If you think you are alone, do not worry because you most certainly are not. Did you know that approximately 80 percent of the United States population has experienced some form of low back pain in their lifetime?1 Eighty percent of this population is likely to experience recurrent low back pain as a result of previous injury. Low back pain is the number one cause of healthcare related costs within the United States and approximately 55 billion dollars is spent annually on low back pain related healthcare causes alone. Low back pain is the number one cause of employee absenteeism and workers compensation claims as well.1
Who is as risk?
Some populations are more at risk for low back pain than others. Those who participate in labor intensive occupations are more likely to experience low back pain due to the physical demands required of their jobs.2 A majority of work related low back injuries are a result of poor body mechanics throughout the course of time.2
Statistically, women between the ages of 35-55 years of age, who are widowed, separated, or divorced, with a lower level of education are more likely to experience low back pain.3 Women are also more likely to experience low back pain due to female sex hormones. Those who are widowed, divorced, separated, or of a lower education level often have a psychological factor that influences the rate of healing.3
Those who are smokers, overweight or obese are also more likely to experience low back pain.4 Cigarette smoking can delay the healing rate of those experiencing low back pain. Those who are overweight or obese experience increased compression of the muscles, joints, ligaments and discs within the spine. The spine is not used to this extra load and low back pain can occur overtime as a result.4
There are multiple causes of low back pain. The most common causes are due to poor posture, improper lifting techniques / body mechanics, disc or joint degeneration common with age or muscle imbalances.1
* Note: This is why it is critical to recruit the services of a qualified coach, personal trainer, and or physical therapist to help assess, address, and educate you on proper movement, individual considerations, and designing a plan to improve symmetry and quality of movement. For assistance in this area, our team is available to you: support@EnFuseFitness.com
Signs and Symptoms
Pain often occurs below the ribcage in what is called the lumbar region.1 Depending on the severity of the injury, pain can be referred into the posterior hip and thigh, anterior groin and thigh, knee and / or lower leg. Typically, the further the pain travels down the leg, the more severe the injury. Occasionally, one may experience pins and needles as well as pain in specific areas of the body.1
Age related Lumbar Pathologies
- Disc problems- common amongst 35-55 year olds
- Symptoms- low back pain below rib cage, myotomal weakness (muscle weakness) and dermatomal deficits (sensory deficits) on one side of the body in specific area, numbness and tingling (these symptoms occur when the nerve is compressed)
- Ankylosing spondylitis- males 18-45 years old
- Bilateral hip pain and stiffness upon waking in the morning, genetic factor, stiffness of lumbar spine
- Spondylolysis- athletic adolescents, extension sensitive (do not like extending back), occurs as a result of loading while in extension, common in football player, gymnasts
- Arthritis/spondylosis- 45+ narrowing of vertebral column, can compress nerve/spinal cord if severe- occurs with age
When to see a doctor:
- If symptoms are progressing and there is nothing that you can do to alleviate your symptoms.
- Bowel/bladder incontinence, saddle anesthesia
- Spastic gait (abnormal gait), numbness and tingling bilaterally
- Severe night pain unrelated to movement
- Recent unexplained weight loss >10 lbs
* Note: We have a fantastic network of professionals: osteopathic doctors, physical therapists, and chiropractors. Should you need some help and or guidance, please email our team- support@EnFuseFitness.com
As mentioned previously, there is no single cause for low back pain, and symptoms vary from individual to individual. Therefore, there is no single treatment method beneficial towards all individuals experiencing low back pain.
Studies have shown that patients presenting with low back pain can often recover without intervention.
- 44% better in one week.1
- 86% better in one month1
- 92% better in two months1
Patients can be divided into different classification systems which define the method of treatment in which they would benefit most from.5
Those who prefer flexion: enjoy sitting, bending forward, lying on back with knees bent, lying on back on a soft mattress, rising from a chair, and side lying with hips and knees flexed. Often, these patients present with tight hip flexors and erector spinae (back muscles). Patients often feel worse with extension. More common in patients greater than 50 years old and arthritic patients.5
Knees to chest: Patient lies on back and brings knees to chest.5 Hold for 15-20 seconds then slowly lower legs back onto table surface keeping knees bent.5
Childs pose: stretches back muscles and puts patient into flexion. Psoas muscle is on slack.5
Posterior pelvic tilt: patient lies on back with knees bent. Pelvis is rotated so that sit bones move anteriorly and hip bones are moving posteriorly. Back is flat on table and core is drawn in.5
Psoas Stretch: Hip flexor stretch. Half kneeling on ground, patient performs posterior pelvic tilt and shifts weight forward at hips. It is important to maintain posterior pelvic tilt throughout stretch. Stretch should be felt in anterior thigh. Performed 3x30 seconds on each leg.5
Those who prefer extension: enjoy lying on stomach, lying on back on hard surface, backward bending, standing and walking. Often, these patients feel worse with flexion based movements.5 Symptoms can travel distal to buttocks.
Prone press up: performed passively, pushing through arms to extend spine. It is important to refrain from using the spine to extend.5
Glute Bridges: Double leg glute bridges. Patient lies on back, drives through heels to lift glutes off of table. Hold for 3 seconds at end of range, squeezing glutes and lower body back to table. Performed for 3x15.5
Self traction: Traction is to be performed with patients who are sensitive to load.6 This means that, the patient will benefit from opening or spacing of the segments within the spine to decrease compression on the nerve or stretch the muscles around the spinal segments. Traction can be performed in a variety of ways.6
Leaning on countertop: stand facing countertop and place hands on table. Keep arms straight and bend knees to unload back.6
Seated Traction: place hands on arm rests of chairs and push down on arm rests of chair to unload. Do not let bottom lift off of chair.6
Doorway Traction: lie on back with hips centered in doorway. Place stick at hip level and push stick into doorway along hips to unload back.6
* Note: For less severe cases and to help build a pain free body, the team at EnFuse can work with you to build a fitness routine focused high quality of movement with a designated warm-up section that outlines individual specific exercises / stretches. For guidance or support, please email- support@EnFuseFitness.com
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- Low Back Pain Treatment | Pain Management - Encino. Southern California Pain Institute. http://www.socalpain.com/low-back-pain-treatment/. Accessed June 1, 2017.
- Gatchel RJ, Polatin PB, Mayer TG. The Dominant Role of Psychosocial Risk Factors in the Development of Chronic Low Back Pain Disability. Spine. 1995;20(24):2702-2709. doi:10.1097/00007632-199512150-00011.
- Hoogendoorn WE. High physical work load and low job satisfaction increase the risk of sickness absence due to low back pain: results of a prospective cohort study. Occupational and Environmental Medicine. 2002;59(5):323-328. doi:10.1136/oem.59.5.323.
- Weight Loss for Obesity and Back Pain. My Bariatric Life. http://www.mybariatriclife.org/weight-loss-for-obesity-and-back-pain/. Published January 4, 2016. Accessed June 1, 2017.
- Mooney MDV. Back Exercise for Pain Relief. Spine-health. https://www.spine-health.com/treatment/physical-therapy/back-exercise-pain-relief. Accessed June 1, 2017.
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