Thirty-one million Americans experience low back pain at some point in their lives. Did you see that? Shall I repeat? THIRTY-ONE MILLION Americans experience low back pain at a cost of about fifty billion dollars per year.

Back pain is the single leading cause of disability worldwide and one of the most common reasons for people missing work. It is the second most common reason for visits to the doctor.

Most of those cases are not caused by disease or trauma but by things that are completely preventable and we will get into that later.

Low back or lumbar spine pain can be the result of many factors. A few mechanical or non-organic causes (meaning not from a disease process) are:

• Poor posture
• Bending improperly
• Chronic sitting (!!!!)
• Obesity
• Arthritis
• Stenosis
• Herniated discs
• Poor hydration
• Emotional stress

Back pain can also be the result disease of the internal organs:

• Kidney stones
• Kidney infections
• Blood clots
• Bone loss
• Cancer

The lumbar spine consists of five vertebra L1, L2, L3, L4, and L5; the sacrum and the coccyx or tailbone. In between each vertebra are intervertebral discs which function as shock absorbers dissipating forces throughout the entire spine instead of concentrating forces in one area. The discs also keep the vertebra from grinding against one other. The vertebra and discs are held together by groups of ligaments which connect bone to bone and tendons which connect muscles to the vertebra. The spine also has what are called facet joints that link the vertebrae together and allow the spine flexibility enabling you to bend forward, backward and sideways. There is a space between these joints where nerves exit your spinal cord.

So, aside from disease processes that cannot be helped (or can they? More on that in subsequent blogs.) How does poor posture and improper bending techniques cause back pain?

A spine that is in normal alignment maintains the integrity of the three primary curves. We know the lumbar spine wants a forward or anterior curve. Slouching while sitting or walking removes this curve and flattens the lumbar spine. This forces the front of the vertebra closer together and creates a gap towards the back of the vertebra which can cause the disc to protrude and/or impinge the nerves exiting the spine at that particular level. This causes pain at that level or pain that can radiate into the entire lower extremity in addition to numbness and tingling. Ignored, this can cause weakness of the limb that may never return.

Do genetics play a role in back pain? I’ve had patients over the years attribute many impairments to genetics. And there are studies to indicate that genetics may play a role. However, I passionately believe that the way we treat our bodies has a greater impact on how our bodies ultimately treat us. Besides, doesn’t, “My parents both had back pain so I suppose that’s just how it is” sound hopeless? I mean what’s the point of even getting treatment if that is how you feel? It’s more empowering to say, “I’m going to make changes in my lifestyle to better support my body.” That’s the path to true healing.

Another component to low back pain may be psychological. Research published in the journal Arthritis Care and Research analyzed data from 11 studies covering a total of 23,109 people and found people with symptoms of depression had a much higher risk of developing LBP in the future compared with those showing no depression.

Dr. John E. Sarno, a physician in the field of physical medicine and rehabilitation is a pioneer in establishing a mind/body connection to low back pain and has written four books on the subject.

When physical therapists treat, patients will oftentimes trust us with personal details of their lives. Sometimes they are caregivers to loved ones, sometimes they are at a crossroads and are confused about what to do. Sometimes they hate their jobs and don’t see a way out. This feeling of nowhere to turn can manifest as back pain. When I’ve treated a patient for at least four sessions without any change in symptoms, I will ask specifically what else is going on in their lives. Often there is something going on that they can’t change at the moment. I’ll discuss the possibility of their pain being caused by whatever stressor they are experiencing at that time. Sometimes even realizing that can empower the patient to make changes in their lives to eliminate the pain.

The spine is hugely complex and I am oversimplifying a lot. Ultimately back pain can be caused by a multitude of factors, many of which are posture related. So how do you minimize and prevent low back pain?

• In a healthy diet. Our bodies use the food that we ingest as fuel for its many functions. What do you think would happen if you put diesel in you Mercedes Benz? Get rid of bread, soy, wheat, corn and sugar. Load up of leafy green vegetables and fruits, grass-fed beef, free range chicken and wild caught seafood. Eat organic whenever possible.
• Maintain a healthy weight. If you are overweight, this places more pressure on your joints. We often just think about ankles and knees when it comes to this. However, your spine is comprised of multiple joints susceptible to the same stressors as ankles and knees.
• Remain active and avoid prolonged inactivity or bedrest. This just makes you weaker and more prone to pain.
• Quit smoking! Smoking impairs blood flow and deprives your spinal tissue of oxygen and nutrients.
• Get at least seven (7!) hours of sleep every night. Study after study show the importance of sleep and the negative effects of sleep deprivation on the body. Check it out here.
• Hydrate! Hydrate! Hydrate! The percentage of water in our bodies is between 50 and 75% depending on gender. Water is necessary for flushing toxins, to metabolize proteins and carbohydrates the body uses as food, for the lubrication of joints and so much more! Please check it out here.

Thanks for reading! In good health until the next time!