Low Back Pain: Questions and Answers (Part 2)
In Part 1 of this article, we discussed the fact that 95 percent of all low back pain (LBP) is non-specific. That means the cause is unknown, leaving back pain sufferers at the mercy of a huge industry of practitioners and drug manufacturers who frequently offer conflicting opinions and recommendations for treatment. If you are the patient, be sure to do your research.
Here are more frequent diagnoses, the relevant research, and the “takeaways” you need to know.
Diagnosis #3: lack of core stability (transverse abdominis weakness), or poor core strength.
Core stability – research shows poor core stability is a symptom of back pain, not a cause. Do work to strengthen your core, if you can do so without pain, but focus on entire muscle groups, not just the abdominals.
Takeaway – Even perfectly conditioned athletes suffer from low back pain, so be leery of a diagnosis that focuses on that as a cause.
Diagnosis #4: Tight hip flexors (psoas) and tight hamstrings pull on the spine.
Psoas – there is scant evidence that short psoas muscles are associated with back pain.
Hamstrings – A 2018 study found no evidence to recommend passive hamstring stretching for low back pain. Many studies have determined tight hamstrings are a symptom, but not a cause, of back pain.
Takeaway: Resist attempts to “release” or manually release the psoas. Instead, as recommended above, focus on strengthening your glutes and your lats.
Diagnosis #5: Excess weight and older age.
Overweight – although it seems logical that LBP and excess weight could be related, a study published in 2007 was unable to establish a link. In other words, there may be a connection, but it is unproven. In fact, a study in 2012 found men who were thirty pounds overweight did not harm their lumbar discs even when engaged in repetitive loading activities.
Old age – a 2009 population-based study of almost 35,000 Danish twins, aged twenty to seventy-one, found no significant age-related differences in incidence of low back pain. Heredity seems to be a greater determining factor.
Takeaway – Do not accept a doctor dismissing your back pain as related to your weight or age. Of course, if you are carrying too much weight, it’s always a good plan to release the extra pounds.
When back pain hits you, and for most of us it will, be aware that most acute LBP starts to improve after two to five days, and typically resolves entirely in less than a month with non-steroidal anti-inflammatories (NSAIDS) and light activity. Of course, that doesn’t mean you shouldn’t seek treatment, but take an extremely conservative approach.