It would be an understatement to say that lower back pain is a problem in the US. More than 65 million Americans are currently suffering from lower back pain at an annual cost of over $50 billion. Can you guess one reason for the hugeness of the problem? Yes, it’s obesity/overweight.
In one meta-analysis published in January 2010 in the American Journal of Epidemiology that reviewed 95 research studies, it was found that excess bodyweight had “the strongest association” with seeking care for low back pain. Further, obese individuals had a higher prevalence of low back pain compared with those classified as being overweight.
An estimated two thirds of Americans today are overweight or obese, according to the American Obesity Association, and other countries are facing the same problem, so it’s no wonder lower back pain is on the rise. But despite the extent of the problem and advances in medical diagnosis, it is often difficult to determine exactly how to treat the lower back pain. Let me explain.
If an individual goes to a doctor complaining of lower back pain and the doctor finds that this individual has a herniated disc, the course of treatment may be physical therapy and perhaps surgery. However, consider that in one study involving magnetic resonance imaging of the spine, 64 percent of the subjects examined were considered candidates for surgery even though none of these subjects had been complaining of any back pain! To add to the confusion, it’s possible to make a case that eating a grilled cheese sandwich could cause back pain. Seriously.
Nick Liatsos, a physical therapist who presented a seminar about lower back pain at the Poliquin Strength Institute, says that the fascia of the colon is connected to the discs. If a grilled cheese sandwich contains gluten, and an individual eating that gluten is gluten sensitive, the colon can contract and physically twist the lumbar vertebrae, causing pain. Sure, that exact scenario is unlikely and I’ve yet to see a study looking at the association between low back pain and the consumption of grilled cheese sandwiches, but I have seen research showing that depression and a history of smoking can be considered risk factors for lower back pain.
Because it’s often difficult to determine the exact cause of back pain, it’s important to take more personal responsibility to prevent and, when necessary, resolve lower back pain. Here are five simple ways to do this:
1. Keep a back pain journal.
By recording exactly when you feel pain, how much pain you felt and for how long, and what you were doing before the pain occurred, you can help determine ways to minimize your risk. If your back hurts when you wake up in the morning, perhaps you need to consider investing in a new mattress? If your back hurts after you run – and you like running and want to continue this activity – perhaps a visit to a podiatrist is in order to see if your shoes are the problem or if you need a pair of orthotics.
2. Lose weight.
Just as many women experience lower back pain during the later stages of pregnancy, being overweight or obese causes changes in posture (such as an increase in anterior pelvic tilt) that may affect normal biomechanics and cause back pain. After she gives birth, a woman typically finds this pregnancy-related back pain resolves, provided she did not have back pain before the pregnancy, suggesting that losing weight may be an effective way to resolve many back pain problems.
The problem with many “back pain” exercise programs is that they are often excruciatingly boring and therefore are unlikely to be performed on a continual basis. This is one reason physical therapists often insist that their patients with lower back pain perform their exercise program at the clinic, because otherwise the exercises will not get done. Because virtually any type of exercise is better than no exercise for those with a history of back pain, find a physical activity you enjoy and will continue to perform on a regular basis – if you like to swim, swim; if you think you can dance, dance. And try staying active throughout the day – I realize that some jobs require prolonged sitting, but with any job you can find ways to get up and move.
4. Hire a trainer.
Although the idea of a hiring a personal trainer may seem out of your budget, consider hiring one on an infrequent basis – perhaps once a month. Having someone who will provide you with some objective assessments, and with accountability, will help keep you on track to lose weight and can teach you how to properly perform exercises to strengthen muscles that may cause back trouble if they are weak. In fact, it has been shown through EMG measurements on elite tennis players that there is a direct relationship between muscular imbalances in the erector spinae and lower back pain. As such, a good start is to have a PICP coach assess your structural balance.
5. Get a massage.
It is amazing how many people are reluctant to get a massage until they are in pain – it’s equivalent to waiting until you get a cavity before you go to the dentist to get your teeth cleaned. However, the fact is that if you exercise, there is a good chance that you will develop adhesions in the muscles that can affect biomechanics and may cause back pain. Getting regular massages and seeing a practitioner certified in Active Release Techniques© will help restore optimal tissue texture and tension. I would also recommend seeing someone certified in Fascial Stretch Therapy™, which involves having a practitioner stretch you while you lie on a treatment table – after your first session, don’t be surprised if you get off the table and say to yourself, “I feel taller!”
Because a single back surgery to repair a disc can easily cost more than $50,000, when you factor in the costs of the hospital stay and physical therapy, it’s far better to avoid going under the knife in the first place. Advances in medicine have provided us with many effective ways to treat lower back pain, but rather than waiting to become a statistic, how about taking a proactive approach and try to prevent this problem?