What Causes Lower Back Pain, How Do We Overcome It and How Do We Keep Our Backs Healthy – Pt1

What Causes Lower Back Pain, How Do We Overcome It and How Do We Keep Our Backs Healthy?

Introduction

Low Back Pain (LBP) has been described as the most common, most costly and disabling musculoskeletal condition. Since World War 2, a dramatic increase in LBP disability has been observed, at a rate disproportionate to all other health conditions.  In New Zealand, this is reflected by the numbers of, and on-going costs of around $300 million a year and time off work.

Before we go any further, ‘Back Care’ needs to be defined. For the purposes of this article, when the term Back Care is used, it is referring to the lower back region. It is of course possible to get pain in your middle and upper back regions too.

Now, I’m sure you have either had back pain or known someone close to you who has suffered from back pain at some time.

There are many different types of Back Pain and their causes can be complex.

Some back conditions include:

  • Disc derangement
  • Sciatica
  • Spinal Stenosis
  • Sondylolisis
  • Spondylolisthesis
  • Spondylitis

It is not the intention of this article to outline appropriate rehabilitation protocols for each condition, or indeed to explain each condition, but to provide some basic steps to follow to achieve an optimally functioning back.

Firstly, if you are suffering from back pain, you should see a professional. This is especially true if it has lasted longer than two weeks.

Any professional rehabilitation program should involve a ‘client centred approach’ which means that the back pain sufferer is treated as an individual who has back pain and not back pain that has an individual.

However, many professionals treat the back pain and not the person who has the pain.Back pain solutions

What Does This Mean?

Let us say a patient enters a professional’s clinic and the professional diagnoses a lumbar disc bulge, they would then give the same treatment to that person as they would to anyone with a disc bulge.

For instance, a General Practitioner may suggest medication and rest, a surgeon may suggest surgery, a physiotherapist may suggest manipulation and rehabilitative exercises, a massage therapist may suggest massage and a personal trainer may suggest exercise. All these can and do play a role in a successful plan to overcome back pain.

However, whatever the injury, the causes can be varied. Without finding out the cause (aetiology) it is less likely that a return to normal function and a reduction or elimination of pain will be achieved.

It can almost be guaranteed that most professionals you visit will only investigate the area that is in pain and the surrounding area. In this instance, they may investigate the lower back and perhaps the rest of the spine and pelvis. However, back pain can be caused by a problem in the head, jaw, neck, foot or even an internal organ amongst others. 

So what can cause Back Pain?

De Rosa and Porterfield state, “… at present, identifying with any certainty the exact tissues involved in most low back pain is virtually impossible” (quoted from 1).

Bogduk states, “Virtually every structure in the lumbar spine has at one time or another been implicated as a possible source of low back pain. As a result, controversy outweighs conviction in the field of low back pain. There is however, an increasing amount of information that sheds light on this field” (2).

There are very frequent references in literature however, for the need for postural correction as part of the treatment.

Below, is a list of possible primary and secondary causes of lower back pain:

  • poor posture
  • faulty ergonomics
  • muscle imbalance
  • faulty lifting techniques
  • poor abdominal wall function
  • Visceral-Somato Reflex
  • Spinal fractures
  • Spinal tumours
  • Spinal infections
  • Degenerative disease

By no means is this list exhaustive.

Poor Posture

Posture is usually defined as the relative arrangement of parts of the body. Good posture is that state of muscular and skeletal balance which protects the supporting structures of the body against injury or progressive deformity irrespective of the attitude (erect, lying, squatting, stooping) in which these structures are working or resting. Under such conditions the muscles will function most efficiently and the optimum positions are afforded for the thoracic and abdominal organs. Poor posture is a faulty relationship of the various parts of the body which produces increased strain on the supporting structures and in which there is less efficient balance of the body over its base of support.” (1)

In today’s society, good posture has almost become extinct. With a general lack of activity and an increase in sedentary jobs, poor posture has become the norm.

Bad posture is a bad habit and unfortunately, is of rather high incidence. Postural faults that persist can give rise to discomfort, pain or disability. The range of effect from discomfort to incapacitating disability is related to the severity and persistence of the faults. ” (1)

lower back pain solutions with corrective exerciseFaulty Ergonomics

One of the biggest causes of poor posture today is sitting at desks and use of computers and telephones. Many workers today sit slumped for eight hours a day, looking down at their computer, whilst hunching their shoulders to use their keyboard. Those who spend many hours driving a vehicle are also very prone to poor posture.

The incidence of postural faults in adults is related to this tendency towards a highly specialized or repetitive pattern of activity.” (1)

Being seated for eight hours a day using a computer can be described as ‘repetitive’.

Sitting with poor posture for long periods of time can cause muscles that are in a shortened position to stay shortened. Also, muscles that are in a lengthened position for long periods tend to stay lengthened and normally become weak. 

Summary:

  • Back pain is very common today, from July 2017-June 2018 there were 273,289 back claims with ACC.
  • There are many different types of back pain.
  • Each individual category of back pain can have a number of different causes. It is vital to find the cause to ensure successful rehabilitation.
  • Any rehabilitation program should be client centred and not symptom centred.
  • Poor posture and muscle imbalance are common amongst those with back pain.
  • For a full assessment and to find the aetiology a C.H.E.K Practitioner is best placed to help you. “If you’re not assessing your guessing”.
  • Following the assessment, a C.H.E.K Practitioner can give you a corrective exercise program and advise you on nutrition and lifestyle factors. They can also refer you to appropriate allied health practitioners to ensure you are successful in reducing or eliminating your back pain.
  • There are a number of lifestyle factors you can adopt on your own to help prevent back pain.

Call us today and lets take charge of your pain! 027 660 4623

References:

  1. Kendall F et al, “ Muscles, Testing & Function”, Williams & Wilkins, 1993.
  2. Bogduk N, “ Clinical Anatomy of the Lumbar Spine”, Churchill Livingstone, 1997.
  3. H.E.K P, “ Scientific Core Conditioning”, Correspondence Course, C.H.E.K Institute, 1998
  4. Richardson C, et al, “ Therapeutic Exercise for Spinal Segmental Stabilization in Low Back Pain”, Churchill Livingstone, 1999
  5. Lee D, “The Pelvic Girdle”, Churchill Livingstone, 1999.
  6. H.E.K P, “ C.H.E.K Certification Program Level 1”, Course Manual, C.H.E.K Institute, 2001
  7. H.E.K P, “ Scientific Back Training”, Correspondence Course, C.H.E.K Institute, 1998.

Disclaimer
No person should rely on the contents of this article. We expressly disclaim all and any liability and responsibility to any person in respect of anything contained in this article. It is advised that you always follow the advice of your Doctor.

Sleep and Maintaining a Good Body Clock

Sleep and Maintaining A Good Body Clock 

Each of us have an internal body clock called the Suprachaismatic Nucleus that regulates our daily sleep – wake patterns. This is often referred to as the “Body Clock” and it governs the release and timing of most mood, energy and sleep related hormones. The body clock is dependant on light signals to function properly each day, dawn and dusk allows us to know when wake up or go to sleep. For many people their lifestyles, living conditions, work, health and other conditions don’t allow them to get the correct wake – sleep signals anymore. When we don’t get these correct signals, our sleep – wake patterns suffer and this can develop into a sleep disorder. When we have disrupted sleep patterns our body becomes stressed from the release of hormones at incorrect times in the day.

Good quality sleep gives the body a chance to repair, recover and heal. We get our physiological recovery between 10pm and 2pm and our psychological and nervous system recovery between 2am and 6am. If you are getting into bed at 12pm on a regular basis it means that you are missing two hours a night of your physical recovery. This can result in all sorts of aches pains and niggles that will not get better.

Refer to the charts below for more details. When our bodies are healthy we can get away with the odd late night here or there without affecting us to much. However, when we abuse our sleep times on a regular basis, this becomes a major stress to the body, upsetting hormonal balance and causing adrenal fatigue. When the body is under stress of any sort, the immune system suffers…THERE ARE NO EXCEPTIONS TO THIS!

Sometimes we cannot change our sleeping situation, for example, shift workers or parents with new babies. In these situations it is important to look after yourself in all other areas of your life to reduce overall load.

Our daily sleep – wake patterns are called circadian rhythms. ‘Circadian’ is Latin for ‘about a day’. If you struggle with sleep a circadian rhythm disorder is probably a factor. The body clock uses signals like sunlight and darkness to know when to produce the active hormones and when to shut them down and release the night time withdrawal and sleep hormones. Our bodies crave and need regularity in all areas of our lives and this is not just related to sleep. Our bodies thrive when we have regular eating, sleeping, hydration, exercise and other important life principles. If we have the required regularity then our system will be in time with our body clock. When we lose the regularity that our system needs them we suffer in many areas. 

Things that inhibit sleep 

Many things can disrupt our sleep – wake cycles, working late in bright lights, especially florescent, electromagnetic stress from computers, TVs flickering, training at high intensities late in the evening, coffee, V drinks, sweet deserts. Alcohol and sugar can both make you crash to sleep but then wake later in the night through a drop in blood sugar level, to find yourself tossing and turning in the early hours and feeling hungry.

Toxicity in the body is a common thing today as people eat more and more processed foods, bad fats, food coloring and preservatives. Entrainment is another factor. People can retrain a sleep pattern with in 7 to 21 days, for example if you stay up till midnight for three weeks in a row your internal body clock will be trained to wait till midnight to start cortisol reduction. This means melatonin, the sleep recovery and repair hormone kick in very late and you will be robbed of recovery time. This over time leads to chronic fatigue, adrenal stress, suppressed immune function and poor or impaired physiological repair resulting in aches pains and niggles.

The Sleep/Wake Cycle

Figure 1: Natural sleep/wake cycle.

 

Many of our hormones are produced in tune with the cycle of the sun. Stress/activating Hormones (black Line) are produced as the sun rises and peaks around mid-morning. As the day progresses, the levels of the stress hormones decrease. The body then begins to increases production of growth and repair hormones, (white line) as the sun goes down. Our bodies are designed to wind down from sunset till about 10 pm when sleep and physical repair should begin. Psychogenic repair takes place predominantly from about 2 am to 6 am.

Figure 2: Disrupted sleep/wake cycle.

 A typical day for many involves elevated levels stress levels, resulting in increased levels of the stress hormones throughout the day (black line), resulting in decreased levels of growth and repair hormones (white line). Although the healthy body can bounce back from Intermittent circadian stresses, chronic (long-term) circadian stress often leads to depressed immunity, illness and chronic fatigue.

Source—How to eat move and Be Healthy, Pages 202-203, Copyright 2004, Paul Chek.