Addressing Lower Back Pain
Lower back pain
I have been living with lower back pain for the last 20+ years of my life and I thought I would share some of the pertinent points I have learned over these last 2 decades with you. This process has been one of trial and error. The information you are about to read is by no means a clinical assessment and is not intended to diagnose or treat any issues you have. It is simply a recollection of the things I have done (and not done) and had some success with. Know this, low back pain can come from a multitude of causes but I am specifically referring to the chronic, deep, dull ache that has plagued me for too long. Over the years I have made visits with physiotherapists, chiropractors, osteopaths, medical doctors, massage therapists, acupuncturists, physical therapists…… the list goes on. None, I repeat none have solved the issue. I have been told I have excessive spinal curvature, a leg length discrepancy, muscular imbalances etc. and have followed all protocols given to me by these practitioners to no avail. Why am I telling you this? Just because a supposed expert in the field says you have an issue due to x, y and z, be skeptical. No one knows your body better than you. Do your own research; experiment at home with self help techniques before parting with hundreds if not thousands of dollars. Find out what works for you and keep doing that. The human body is a highly complex structure and no two are the same. It is so easy for practitioners to ramble on about things that can cause your lower back pain and we swallow the pill whole. When it boils down to it, even after running preliminary functional tests, it is still their best (not always) guess. When a podiatrist (who was working alongside my osteopath) made a custom orthotic for my diagnosed leg length discrepancy, I found out 5 years later that I didn’t need it and my hips had shifted to accommodate said lift which exacerbated my problems. Needless to say I had a sacrificial burning of that lift and that osteopath who misdiagnosed the leg length discrepancy better hope I never meet him in a dark alley.
Here is just a sample of the myriad of issues that could cause low back pain….
Weak musculature, improper footwear, sitting down for too long, traumatic injury, tight glutes, tight hamstrings, tight piriformis, tight iliacus, tight psoas, weak multifudus, herniated discs, weak abdominals, active trigger points, chronic muscular dysfunction, tight quadratas lumborum (QL), leg length discrepancy, kyphosis, lordosis, scoliosis, improper muscular firing sequences, ischemia, strain, sprain, chronic muscle fatigue, chronic shortening of musculature, improper mechanics, muscle atrophy, improper gait, muscle contractile imbalance, scar tissue, over exertion……….. You see what I mean. I’m no expert but there are probably a 101 more reasons to add to this list. You now see how easy it is for experts to palm your issues off to any number of potential issues. It doesn’t mean they are wrong but it doesn’t necessarily mean they are right either!
I have since come to believe that my salvation and a life free of chronic back pain doesn’t lie in the hands of the experts, it categorically lies in my own hands. There is no one procedure, muscular stretch, massage or one needle that can solve the problem. All of those modalities can and should be used, but the reason that there is a physical therapy clinic on every corner is that we lack the motivation and discipline to do what needs to be done ourselves. 90% of all modalities prescribed and utilized by these clinics can just as easily be done at home.
My own self discipline and hence my own self-care recently has been abysmal. As a result, there has been a significant increase in my hip dysfunction and hence a marked increase in lower back pain. Currently I have to stretch for a minimum of 2 hours a day. (It’s not a case of choice. If I don’t do it, I will slowly be looking like I am trying to reverse Darwin’s theory of evolution and reverting back to walking like an ape). I focus on stretching every muscle related to the low back, but I pay special attention to my QL, psoas and iliacus which have been dubbed “the great pranksters” by many experts as the pain is often referred and difficult to pinpoint. If you have that deep dull ache in your low back (T-12 thru your sacrum) focusing on lengthening and strengthening your iliopsoas is key. Static stretching for chronic shortening and hence pain has showed to be less effective than active isolated stretching (AIS) which basically means you move the muscle into stretched position and hold for 2 seconds only then to return the muscle to its normal state of being and repeat for a set number of cycles. This technique does not activate the stretch reflex response in the muscle body and therefore allows for faster muscle accommodation and inevitable lengthening, which is our ultimate goal.
In conclusion, don’t merely ignore the issue you have in your lower back. Create a daily stretching regimen and do it every day of your life. This is the only way you will be pain free. If it comes to that time that you feel you have to see a doctor or a physical therapist, you have simply fallen off the wagon and need to get back on. They will temporarily fix you but it is building a habit around stretching to achieve spinal and hip mobility which in turn allows you to perform activities of daily living pain free and help you achieve that athletic edge that maybe has eluded you. Good luck.
If you are one of the few people that implement a process around your chronic lower back pain and found this article to be helpful then please comment on it and share it with others – thanks.