Why Does Your Low Back Hurt, and What the Heck are you Going to do Bout It?
Do you ever wonder why low back pain is such a nationwide pandemic and it always seems like no one actually knows the real answer as to how to fix it?
You hear these questions time and time again: “Do I just rest until it feels better? Do I go to the chiropractor? Do I try to stretch it out? Do I use heat or ice?”. But no matter how many times you ask the question, or how many different people you ask, the answer is always different.
The only consistent answer or procedure you might encounter is when that low back is really bothering you enough to actually schedule an appointment with your primary care provider, or even go to the walk-in clinic, just to sit around for lengthy periods of time in the waiting area, go through a battery of x-rays, wait some more for the radiologist to read the x-rays, just to find out “Everything looks great Mr. Smith, here are some muscle relaxers. Go home, take these, and rest until it feels better”.
So you do just that. And sure, your back might feel better after a few days if you’re lucky, but sometimes it's weeks, and what’s worse is you’re now anticipating when it’s going to happen again because you never really figured out a true answer as to what the heck happened in the first place because “everything looks great”.
The fact of the matter is this: there is no one-size-fit-all approach to help fix your low back pain. What works for some might not work for you, and vice versa. Your lumbar spine, or low back, is a very sensitive environment with dozens of different muscles, muscle types, joints, and millions of tiny sensitive neural connections, constantly communicating with your brain, telling it what the heck is going on at any given moment.
But just because there are so many different causes of low back pain, doesn’t mean we are hopeless in finding the solution to fixing it long term. In fact, we can actually categorize your low back pain in one of three different buckets
Direction Specific Low Back Pain
Low Back Instability
Manipulation/Mobilization Requirement
Direction Specific Low Back Pain
We list this first on the list for a reason: MOST low back pain will fall under this category. I’m going to paint a brief picture for you.
You’ve been sitting at a desk, on the couch, or on the computer for a long period of time and you stand up to find that you can hardly stand up straight, you have a dull, achy, and deep searing pain that seems like it encompasses your whole low back area. You grab for the nearest waist height object to steady yourself for a few steps, and once you get going it seems like it gets a little better.
Sound familiar? If so, you are someone who has simply just spent a little bit too much time in one position, and your spine has started to change itself to hold this position more efficiently. When you change this new resting normal, your brain sends a huge red light, alarm ringing, don’t take another step message saying “hey, this is different from what we were just doing”.
But don’t you sweat it just yet! All you have to do in these situations is find what direction you can move your low back in to find some immediate relief, and repeat that movement several times per day for a few days and you should be all good to go!
Low Back Instability
Unstable lumbar spine environments are a little more rare than direction specific low back pain, but they do still happen relatively frequently.
Think about your deep, deep core muscles as being your body’s natural low back brace that should be working 24/7 behind the scenes without you even knowing it. In some instances, this built in low back brace will start to “turn off” or not work subconsciously, which allows your low back to move too much, become unstable, and cause you a great deal of pain.
This typically presents as you moving along just fine throughout your day, but for whatever reason, the smallest little twist or movement stops you dead in your tracks with the most intense and sharp pinpoint pain you can imagine. And when I say small, I mean small. Something as minute as leaning forward when brushing your teeth or bending over to put your sock on.
This phenomenon is usually compensational in nature, resulting from a lack of good movement elsewhere in the body, forcing your low back to let its guard down and move a little too much.
To fix this usually requires you to put a little more effort in to strengthen some of those deep core muscles. Examples of these exercises include dead-bugs, curl-ups, and bird dogs. I know, these sound very strange and foreign. Give these a quick google search!
Manipulation/Mobilization Requirement
Ever hear of someone who says they went to a chiropractor, received a spinal manipulation type treatment, and all of their problems went away like some sort of miracle?
This person is most likely someone who has a hypo-mobile spine and just needs more movement through the joints of their spine. Although this can be done in some instances by yourself, it is more easily accomplished with the help of a healthcare provider.
The good news is that this is actually a very rare situation, which is why it is listed third on our list, and should be explored if you have not found relief by trying the above recommendations.
And of course, if you find yourself resonating with one of these scenarios, but cannot seem to find the solution to your problem, or you feel like you might fit into a couple of categories, do not hesitate to reach out to a licensed musculoskeletal specialist, like a chiropractor or PT for help!
Yours in health,
Kevin Noel, DC CSCS