Low back pain: who hasn’t experienced it at one time or another. We’ve summarised the top 6 most current and effective ways to improve low back pain – with a bonus tip thrown in!
1. Exercise + education
Who would’ve thought right? Exercise plus education was found to be THE best intervention for reducing low back in a recent review of 21 studies from around the world published earlier this year (1). Exercise alone was found to be not as effective, highlighting the importance of seeing a qualified therapist who is able to teach you about what’s going on in your body and your condition well as give you specific exercises. The study also highlights that ongoing maintenance exercise is important for continued protection against future back pain (more than 1 year) and confirmed what every physio has told you in the past: back belts/braces are no good for preventing back pain.
2. Stop smoking
If there wasn’t already enough reason to put down the ciggies, smoking has been shown to be terrible for back pain as it restricts your blood vessels leading to reduced blood & nutrient supply and dehydration of your intervertebral discs, which are anyway already poorly vascularised (2). Smoking also appears to increase degeneration of these cushiony pads between your spinal segments (3). Also add to this that smoking makes your ligaments and connective tissue less elastic, reduces bone density and therefore puts you at higher risk of facet disease, osteoperosis and arthritis, and those cancer sticks become much less attractive (4).
3. Sit less
Sitting increases the pressure on your lumbar discs by 40% compared to normal standing. If you slouch or sit hunched over, this increases to 85% greater loading on spine (5). If you do this for the standard 8 hours a day at your desk, it’s no wonder that prolonged sitting can irritate and flare up low back pain. Regular movement and changing positions often (because even sitting with ‘perfect posture’ can cause pain if you do it for too long) are key to keeping low back pain under control. To help you change this habit, schedule a reminder that will nudge you to sit up, stretch back over your chair or get up and go for a walk to the kitchen; you can do this in Outlook, on your Google calendar or even anytime a regular work activity happens, like when you get a phone call or your boss tells you off.
4. Customise your core training
While their intentions are good, what most group core training classes lack (even some as specific as Pilates) is an individualised & specific assessment of a patient’s true core function; this means not only looking at if your transversus abdominus, pelvic floor and multifidus muscles are firing, but also their timing, endurance and ability to function together with your other more superficial muscles, and whether they do this during standing and movement. Note I said their function in STANDING and MOVEMENT: clinically, there are many high level athletes that, while great lying on their backs (!) doing leg lifts and table top toe taps, are completely unable to stabilise their backs and trunks when you get them standing up and doing an exercise. Which doesn’t say a lot of the functional benefits on a matwork Pilates class. Isolate, but then integrate and always progress to the clients’ sport/work needs. Because I ain’t ever seen a pro footballer who kicks goals from bed.
5. Mobility rules.
Aka get your stretch/roll/myofascial work on! Pain begets the need to self-preserve, and your body is wonderfully adaptive and incredibility self-protective. It will switch on other muscles so you can continue to walk and move in spite of your pain; unfortunately this is a little like getting your 6” 2, 95kg best mate to sub in for your 15 year old sister’s ballet solo: whilst they might give it their best shot, they’re really not built for this job, and will quickly get worn out and injured themselves. Common culprits are your hip flexors, quads, hamstrings and quadratus lumborum; extremely helpful fellows, but not built for the job. So get thee on that foam roll.
6. Get your ELDOA on
Just one minute a day to prevent pain, surgery and injections?
It has a funny name but the ELDOA method is a cutting edge, extremely effective long term solution to disc degeneration, facet joint pain, spondylostheses, pelvic pain and as a preventative measure against the unavoidable gravity-induced degeneration that occurs simply because we are upright mammals. ELDOA is a French acronym that translates to ‘Longitudinal Stretching with Osteo-Articular Decoaptation’.They were devised by world-renowned doctor/osteopath/physio/PT/chiropractor Guy Voyer DO after 30 + years of working with the French national ballet dancers & pro hockey players and finding that hands-on treatment (even with his amazing qualifications) only went so far; the ELDOA basically consist of postural exercises that target specific joints and work to decompress, relieve pain, and restore function and balance. I had the opportunity to train under Guy in Sydney earlier in the year and French accent aside, the man is brilliant, and these exercises actually do work, as the clients I’ve used them with since can confirm.
And your bonus tip to reduce low back pain:
7. Eliminating gluten
Naysayers of a gluten-free/minimising diet may find it interesting to know that gluten molecules closely resemble cells lining our joints, as well as cells in our brain and gut. Because gluten can cause an inflammatory response in most people (even if you don’t bloat or get sick after eating bread, this doesn’t mean that gluten is not doing you harm), your body attacks these molecules in defence. Here’s the kicker: your body will also attack the cells lining your joints and brain in the same way, because it recognises them as the being the same molecule. Result: increased inflammation and pain in the joints and a worsening of your symptoms. Try cutting out gluten-containing foods for two weeks and see how it affects your back pain; you may also find bloating and digestive issues disappear and you have clearer mental state and concentration.
- Steffens D, Maher CG, Pereira LM, et al. (2016). Prevention of Low Back Pain: A Systematic Review and Meta-analysis. JAMA Intern Med. 176(2):199-208.
- Elmasry, S., Asfour, S., de Rivero Vaccari, J.P. & Travascio, F. (2015). Effects of Tobacco Smoking on the Degeneration of the Intervertebral Disc: A Finite Element Study. PLoS ONE 10(8): e0136137. doi: 10.1371/journal.pone.0136137.
- Fogelholm, R.R. & Alho, A.V. (2001). Smoking and intervertebral disc degeneration. Med Hypotheses. 56(4):537-9.
- Nachemson, A.L. (1976). ‘The Lumbar Spine, an Orthopedic Challenge’, Spine. 1:59.