If you think you’ve got ‘the Lumbago’……think again!

by admin on January 27, 2011

We’ve come a long way from calling all low back pain ‘the lumbago’, and in this article I’ll explore some leading causes of, and remedies for low back pain that have soft tissue (muscle/tendon/ligament) as their source.

What’s happening to our low Backs? (Part 1)

Low back pain (LBP) is one of the most commonly experienced musculoskeletal conditions and registered massage therapists see patients suffering from it on a daily basis. Because the low back carries most of the body’s weight and the waist is a pivot point for turning, flexing and extending, the low back is particularly vulnerable to injury. Primary care physicians most often give patients a diagnosis of nonspecific mechanical LBP, because it is difficult to identify the exact structures that are giving rise to the local pain. This is where Registered Massage Therapists come in.

If you suffer from low back pain you are not alone. Nachemsons’ research report, which may be the most quoted paper in the field of low back pain, states that 80% of us will suffer back pain ‘to some extent,’ men as often as women, and ‘white collar as often as blue collar workers’. Also, according to Dagi and Beary, approximately 80% of all back cases can be attributed to non-specific soft tissue conditions (i.e., muscle and tendon strain, ligament sprain, postural abnormalities, poor muscle tone).

Other causes of back pain include inter-vertebral disc disease (10%), and a combination of osteo-arthritic degeneration, postural deformities, and numerous other diseases. However, musculoskeletal disorders are of primary importance in this discussion as they constitute the largest number of complaints seen by registered massage therapists, and other healthcare practitioners. (Hertling and Kessler)

Three leading soft tissue causes of low back pain are:

The great thing is that all three of these conditions can be treated with manual therapy and therapeutic exercise. In this installment we’ll discuss muscle strain and ligament sprain as a leading sources of low back pain.

Strains and sprains are common and the pain associated is the body’s way of getting you to stop what you’re doing. Usually when we think of sprains and strains we think of our ankles or our wrists, but we need to also think of these injuries in terms of our low backs.

  • Muscle strain can be mild (movement causes pain and stiffness for a few days), moderate (movement causes pain and stiffness for a few weeks) or severe (the muscle will not function at all)
  • Ligament sprains are mild if there is pain but no loss of movement, moderate if there is pain and difficulty moving with swelling and bruising, and severe if extremely painful and if movement is severely inhibited with swelling and bruising.

Your low back can be strained or sprained in a variety of ways, but 97 % of non-specific low back pain problems are triggered by mechanical factors such as awkward movements or being in a static stressful position for too long. Small repetitive micro-traumas related to your occupation (bending/lifting/sitting awkwardly) or your leisure pursuits (sports, gardening, home renovations) can be the cause. The body first responds to these small micro-traumas with postural compensations, and by ramping up the healing process to accommodate these small lesions. But like a piece of tired elastic, frayed and ragged muscle fibers have their breaking point, and if the rate of muscle tissue repair fails to keep pace with the rate of damage, the end result is obvious. The pain begins as a mild discomfort, graduates to moderate discomfort, and finally fails in its attempt to adapt and ends up in spasm. (Leon Chaitow 2006)

Most of the causes of low back pain involve poor use of the body, complicated by poor stability, tone, flexibility and balance. All of this adds up to poor function. So how do we improve the overall function of the body so that it can withstand these awkward uses to which we subject it? And how do we do this easily and efficiently, so that it doesn’t feel like we have a second job?

First of all, it’s important to rid yourself of the stress-provoking postures. A great website for information about ergonomics is http://ergo.human.cornell.edu/ with links that provide information on ergonomic assessment and adaptation to work environments to relieve postural stress and musculoskeletal disorders.

If your problems are sedentary in origin, whenever discomfort develops from maintaining a constant posture or sustained activities for a period of time, perform the following:

  • Stand with your feet shoulder width apart with the knees slightly bent. Place your hands on your waist with the fingers pointing backwards and……
  1. Extend your low back by leaning backwards
  2. Side-bend in each direction
  3. Rotate your trunk by turning in each direction while keeping the pelvis facing forward

And, stand up and walk around every 20 minutes when sitting for extended periods of time.

This may sound simplistic, but it has a large impact on reducing the trauma experienced by your low back on a daily basis!

These suggestions are great for everyday use at your workplace, but the following illustrations show quick and easy exercises that can be performed at home and go a long way in relieving your soft tissue-related low back problems, and preventing new ones.

Warning: If you experience any discomfort other than muscle soreness, slow down the pace or decrease the number of repetitions. Should pain persist, discontinue exercises and contact your physician immediately.

Stretching:


Strengthening:


(These stretching/strengthening exercises can be found in PDF format under EXERCISES tab at top of this page)

Good luck with the exercises this week. Next week, we’ll talk about how your posture is affecting your low back and easy ways to take the pressure off.

Of course exercise is 50% of the solution and a good massage is the other 50%. To get you started on your journey to a pain free low back book in for an appointment. See you soon….

My best,

Heather Scheibal, RMT

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