Lower back pain is now so common that it is considered the leading cause of disease worldwide.
Imagine that, something so simple to fix as back pain is the BIGGEST cause of the strain on our health service.
The advice the given on the NHS website is to:
- stay as active as possible – rest rarely helps (good advice)
- try exercises and stretches for back pain (we’ll come back to this)
- take pain killers (I’d advise only as a very last resort, since all they do is mask the pain)
- use hot or cold compress (it doesn’t say which but the difference is HUGE)
Overall, this advice isn’t terrible.
All of these will help on some level, but it’s the DETAILS that matter.
Conventional wisdom, including this advice from the NHS, is a symptom based approach. It only deals with the area of the pain, not the cause of the problem, which is why many people suffer with repeated (and increasingly worse) bouts of pain.
It’s been my experience for many years now, that in most cases, lower back pain is caused by a tightness in the hip flexors and lower abdomen region, and is nothing to do with the lower back at all.
I’ve had clients who have had intermittent back pain for over 30 years and within a week or two of doing my exercises, their pain – and their apprehension for moving in certain ways, has completely gone.
Let’s use the NHS advice to show the difference in approach:
Stay as active as possible
This is probably the only point that we completely agree on. Movement is the key to successful relief from this issue (and any other actually). Unfortunately, most people take this to mean that they should “push through” the pain in order to move, which is completely counter-productive.
When you have pain, your brain clicks over into protection mode in order to prevent more damage. It will make you less willing to move and tighten the surrounding muscles to try to increase support for the damaged or strained tissue.
Forcing movement at this point will only serve to increase the tightness as your body is pushed further into protection mode through fear of further damage.
Small, gentle, pain free movements are the key to reducing this protective reaction, and reassuring the brain that movement is actually a safe, non-damaging thing to do.
Try exercises and stretches for back pain
While on the surface this might seem like good advice, in this situation, is really is the details that matter.
These are the exercises recommended by the NHS for lower back pain
This has to be the worst advice I’ve ever heard.
Why?
Because not only are these exercises only focused on the symptom (stretching the lower back), they’re actively encouraging MORE tightness in the area that’s causing the problem in the first place.
The first one “Bottom to Heels Stretch” puts the hip flexors in their shortest possible position, which only serves to encourage more tightness in this area, which actually puts more strain on the lower back.
The next one “Knee Rolls” again has the hips in a bent position which does nothing to reduce the tightness in the hip. The focus of this exercise is to lengthen the lower back muscles and it’s at the expense of the hip flexors.
“Back extensions” might be useful for some people since it does focus on lengthening the stomach muscles, but in many cases the tightness in the hip causes a forward tilt in the pelvis which exaggerates the arch in the lower back. This exercise only serves to create more tightness in that excessive arch.
The “Deep Abdominal Strengthening” and “Pelvic Tilts” exercises are actively causing more tightness in the exact area that causes the problem in the first place. Some folks will argue that by strengthening the core it helps to support the lower back and therefore reduces pain, but in my experience, what actually happens is that the movement of the lower back becomes reduced to zero from the stiffness created by these exercises. When movement reaches zero, the pain will stop, but the strain of movement is then placed higher up the spine, which leads to other problems over time, including neck and shoulder issues.
To truly get rid of lower back pain, tightness in the hips, inner thighs, lower abs and spinal rotation must be addressed FIRST, before any strengthening can take place. Then the strengthening should incorporate the entire range of movement of the hips, abdominals and spine, rather than the current recommendation of portions of the range of movement.
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Take pain killers
I said that I would only recommend this as a last resort, and I would – because pain killers don’t remove the pain, they disguise it.
Pain is your body’s way of warning your that moving like that could cause more problems and you remove that warning system, it’s likely you’ll over do things and hurt yourself more.
Sticking to small, gentle, pain-free movements as much as possible is the best way to increase the amount of movement you do without pain as your brain learns to trust that moving is safe.
Use hot or cold compress
This advise in itself is way too vague to be useful. Firstly, cold temperatures make muscles tense up, which can actually make the pain worse once the numbing has subsided, so I wouldn’t recommend that treatment for this particular issue. It’s not very likely that there will be any inflammation that the cold could help with.
Heat on the other hand, helps muscles to relax – but where you put that heat makes a world of difference.
If you put it on your lower back, you’re likely to relax the muscles that are actually stabilising your spine, allowing it to be lengthened further, which may increase your pain.
But if your put the heat on your lower abdomen, that can do wonders for your pain.
The heat relaxes the muscles that are too tight, causing your pain in the first place, this makes them easier to move so a small period of heat application, followed by some gentle, pain free movements may speed up your recovery.
Having had the ligaments of my spine strained when I was in my early 20s, I have first hand experience of both how debilitating lower back pain can be, and the effectiveness of conventional wisdom.
It wasn’t nice having to ask my 70 year old neighbour to put my bin out because I couldn’t manage it, but even the thought of doing it myself would make my back hurt.
I know that this approach will probably upset a good many people, and that’s fine.
I’ve been through it and it didn’t work for me.
My question is this:
If this conventional advice was really working, why is lower back pain still such a huge problem?
I believe we’ve given this traditional stuff long enough to see whether it works or not, and I think the stats speak for themselves.
Let’s give something new a try. What have we got to lose?
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